By Linda Shrieves
Orlando Sentinal, June 17, 2011, p. B &B8
About 200 advocates for the elderly and the poor jammed a public hearing in Orlando on Thursday to voice concerns about Florida’s proposed Medicaid overhaul –echoing the same reaction seen at public hearings throughout the state.
Although representatives from several HMOs offered examples of how they have coordinated care for patients and saved lives, most of the people at the hearing criticized the state’s plans to move most Medicaid recipients into managed-care plans.
“Managed care works if you’re well. It does not work if you have complex health problems,” said Amy O’Rourke of the Cameron Group, a professional geriatric-care management company based in Orlando. “I have 13,000 elders, and I have not seen one managed-care program work for elders with complex care.”
Thursday’s hearing was the 10th in a series of 11 public hearings organized by the Agency for Health Care Administration during the past week. The state agency is gathering comments from Medicaid consumers, families and others about the state’s Medicaid proposal before submitting the plan to the federal government.
The public comments are to be forwarded to the U.S. Department of Health and Human Services, where officials must approve Florida’s proposed changes because they require a waiver of federal Medicaid rules. State agency officials said they plan to turn in the waiver request Aug. 1
In Orlando, advocates for the poor also warned that the state has based its Medicaid makeover on a five-year pilot project that was riddled with problems.
The new Medicaid managed-care program “will be built on the incredibly shaky foundation of the reform pilot of the last five years,” said Greg Mellowe of Florida CHAIN, a statewide advocacy organization focused on health-care issues. “You can imagine the uproar that would occur of a pharmaceutical company began selling a new medication without bothering to finish the trials. That’s what is happening here.”
Throughout the state, the hearings have been magnets for critics of the new plan. In West Palm Beach, more than 200 people packed an auditorium, where elder-law attorneys warned that the new Medicaid program would reward managed-care companies for moving senior citizens out of nursing-home care
And at a public hearing in Fort Lauderdale, Broward County Medicaid patients begged state health officials Thursday not to expand the managed-care program they say failed miserably in their county and prevented them from getting medications and doctor appointments, The Associated Press reported.
Yet Robinson Johnson, a registered nurse and certified case manager for Wellcare, told the Orlando audience how she coordinated care for patients and sometimes persuaded managers to make exceptions to get her HMO patients specialized care. “I haven’t ever heard, ‘We can’t do that,’ ” she said. “There’s another face to managed care: It’s people like me who really, really care about the [patient].”
Linda Solash-Reed, an attorney affiliated with the Florida Academy of Elder Law Attorneys, criticized the new law because she said no data prove it would save money. Worse, she said, the state has no evidence that the new program would work for senior citizens because they were not included in the original pilot project.
“No data, wrong data and bad data spells disaster for Florida taxpayers,” Solash-Reed said.
If approved, the state’s Medicaid managed-care program would be phased in, but the first group to be moved into managed care would be seniors in long-term care. The long-term care program would be fully implemented by October 2013, while the managed care for other Medicaid beneficiaries is scheduled to be fully implemented by October 2014, according to the state agency.
Although Sen. Joe Negron, one of the architects of the state’s Medicaid makeover, on Wednesday urged tea-party members to show up and express their support for the plan, it did not appear tea-party proponents attended the Orlando hearing. Negron has defended the Medicaid plan, saying that charges of “grant dumping” are scare tactics.
The public can also submit written comments by email to firstname.lastname@example.org or FLMedicaidManagedCare@ahca.myflorida.com, or letters can be sent to Centers for Medicare and Medicaid Services, Center for Medicaid and State Operations, 7500 Security Blvd., Mail Stop S2-01-16, Baltimore, MD 21244-1850
Andrew Doughman contributed to this report.
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