News from Tallahassee for 8/23/14

Will medical-pot centers end up in low-income areas? posted on 8/22/14

by Aaron Deslatte | Orlando Sentinel

TALLAHASSEE – Here's one aspect of Florida's medical-marijuana debate getting little airplay: would the dispensaries be crowded into poor and minority neighborhoods?

If voters statewide pass Amendment 2 this fall, the dispensaries have to open somewhere. Critics of legalizing marijuana such as Attorney General Pam Bondi and others have warned it could lead to pill-mill like explosion of dispensaries "on every street corner." But there is some evidence that they may be concentrated in poorer, urban and disproportionately minority areas, not suburban strip malls.

A new study published this month in the Journal of the American Planning Association found evidence that the dispensaries are being concentrated in poorer, minority communities within states that have already legalized medical marijuana.

University of Colorado Denver urban planning researchers Jeremy Németh and Eric Ross find evidence that land-use regulations adopted in cities where medical marijuana is legal are more likely to steer dispensaries to lower-income, higher-minority areas.

They call it classic NIMBYism (Not In My Back Yard): Although 23 states have legalized medical marijuana and 73 percent of the population nationally favored doing so in a 2010 Pew poll, 44 percent said they would be "somewhat or very concerned" if a dispensary opened near their home.

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A Third With Medicaid Chose Own Plan posted on 8/22/14

by AP

Only about one-third of Florida’s Medicaid recipients transitioning into managed care statewide chose their own health insurance plans.

Enrollment for the general population started in May and ended in August. Consumers received a letter in the mail two months before enrollment and were given at least 30 days to choose an insurance plan. Those who did not choose a plan were automatically enrolled into a plan by state health officials.

State health officials said 34 percent of Medicaid recipients chose their plan while 66 percent were assigned one. But nearly half of the 66 percent who were automatically enrolled were assigned to a plan they had a prior relationship with.

Pediatricians in Florida could see relief from low Medicaid payments posted on 8/19/14

by Nick Madigan | Miami Herald

caduceusAfter years of hearings and delays, the possible resolution this fall of a class-action lawsuit against Florida health and child-welfare officials could mean that physicans will at last receive what they consider to be adequate compensation for treating children of the poor.

The lawsuit, filed in 2005 by pediatricians, dentists and nine children against the Agency for Health Care Administration, the Department of Children and Families and the Department of Health, claimed that Florida violated federal law by providing inadequate Medicaid services to children, and that their care had been hampered by low Medicaid payments to doctors. A federal judge is expected to rule on the case in October.

Medicaid payments to pediatricians — and to primary-care doctors in general — were bumped up for two years by the Affordable Care Act. But that will end Dec. 31, and the Florida Legislature’s passage of $3.4 million in increased Medicaid payments to pediatricians for the coming fiscal year doesn’t come close to achieving parity with federal Medicare levels for comparable services.

If the lawsuit goes the plaintiffs’ way, the state might have to come up with about $227 million a year, according to AHCA, to permanently increase payment rates to pediatricians and dentists — although an appeal would likely delay the change.

That leaves some physicians in Florida in a state of limbo, not knowing how much they will be paid or when.

“I can’t be playing games with the government,” said Bruce Eisenberg, a Miami Beach pediatrician who, like many doctors in Florida, reduced his Medicaid caseload over the years to less than 10 percent of his practice because of the traditionally low payments. He and other physicians say they usually operate at a loss when they treat patients under Medicaid.

“I sort of do it as a service to the community,” said Eisenberg, who has been a pediatrician for 25 years. Before the ACA hikes went into effect, he said, Medicaid rates paid to Florida doctors for most procedures were about half as much as those set by Medicare, the federal health insurance program for people aged 65 or older. Many physicians have elected to stay out of the system altogether, leaving low-income families with little option but to turn to emergency rooms or urgent-care clinics when they are ill.

If the payment rates are not permanently improved, “I definitely won’t be increasing my percentage of Medicaid patients,” Eisenberg said. “I could be seeing a lot of other patients who could be paying fairly for my time. My time is valuable.”

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200,000 Floridians Can Still Get Insured posted on 8/19/14

by AP

More than 200,000 Floridians may be eligible to sign up for health insurance under President Obama's Affordable Care Act soon even though enrollment doesn't officially start until November.

Consumers that get married, move, give birth or gain citizenship may qualify for a special enrollment period. They may also qualify if they became unemployed or got a divorce. Enroll America, an ACA advocacy group, released a report Tuesday showing 222,700 Floridians may be eligible to for special enrollment.

Enroll America used Census data to estimate the number of consumers who may qualify for special enrollment.

The national nonprofit estimates nearly 7 million Americans between the age of 18 and 64-years-old are likely to experience one of those significant life events. Nearly 3 million of them are currently uninsured. The group estimates the other 4 million have insurance but will lose coverage over the course of the year.

Jeb Bush’s opposition to medical marijuana draws rebuke from ACLU posted on 8/15/14

by john kennedy | Palm Beach Post

Former Florida Gov. Jeb Bush’s decision to come out against a November ballot proposal making medical marijuana an option for treating a wide range of illnesses drew a quick rebuke from the state’s American Civil Liberties Union.

Howard Simon, the ACLU’s executive director, drew a parallel between Bush’s opposition to medical marijuana and his 2005 intervention in the case of Terri Schiavo, the brain-damaged Florida woman found by a court to be in a persistent vegetative state.

“Once again, Jeb Bush is trying to impose his views on medical treatment on Florida patients,” said Simon, whose organization clashed with Bush in the Schiavo case.

Simon added, ““Opponents of the amendment seem to hope that the people of Florida will have forgotten Jeb’s history of using government to invade people’s medical choices, such as when he used his power as governor to push aside years of court decisions that determined that Terri Schiavo would not have wanted to be kept alive in a vegetative state.

“He then attempted to command the machinery of state government to force feed a person who was brain dead,” Simon said.

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