Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date.
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Associated Press (12.08.05) - Friday, December 09, 2005
David Royse
More than half of Florida's 2 million Medicaid recipients are already in some type of managed care plan or health network, and their treatment is controlled by the state. Under the new program, the state will still mandate coverage for certain illnesses, but HMOs will determine the amount, duration and scope of treatment. To alleviate fears that the HMOs will be unwilling to enroll patients with costly illnesses like HIV/AIDS, the new program will set risk-adjusted premiums. HMOs that take such patients will be paid higher premiums. If the patient can be treated for less than the premium, the HMO keeps the difference.
Gov. Jeb Bush, who pushed for the plan, said the current system of the state reimbursing doctors and hospitals for treatment is resulting in ballooning costs and insufficient care. Backers of the bill say HMOs will be able to catch potentially expensive health problems early by emphasizing preventive care.
But Medicaid advocates are worried that the new plan will hurt the sickest and most vulnerable, who are also the costliest patients to treat.
The bill will go into effect next year in Duval County, which includes Jacksonville, and Broward County, which includes Fort Lauderdale. Taking the program statewide would require another vote by the Legislature.
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