News from Tallahassee for 2/27/15

DOC chief will re-do lucrative private health contracts in wake of deaths posted on 2/13/15

by john kennedy | Palm Beach Post

Florida’s prisons chief said Wednesday that she plans to renegotiate or rebid lucrative private health care contracts in the wake of widespread reports of inmate deaths and poor treatment.

Department of Corrections Secretary Julie Jones told the House Judiciary Committee that “all options are on the table,” for reviewing contracts with private Corizon Prison Health Management and Wexford Health Sources, which signed five-year contracts in 2013.

Corizon’s contract is worth $1.2 billion and Wexford’s is $240 million.

“I don’t believe privatization was the wrong thing to do,” Jones told the committee. “I think we didn’t do it in the right way.”

Jones later said that DOC already has opened talks with Corizon and Wexford on reworking the long-term contracts.

She said a goal would be to get included better oversight of prescription drug delivery, mental health services, and an enhanced level of nursing within prisons, with more registered nurses available than less-skilled staffers.

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Last Weekend to Enroll on HealthCare.gov posted on 2/13/15

by Lottie watts & AP | Health News Florida

healthcare.gov logoAhead of the Sunday deadline to sign up for insurance on HealthCare.gov, the latest enrollment numbers show that close to 1.4 million people in Florida have signed up. That's more than any other state that uses the federal marketplace.

"Florida has been a very active state, South Florida particularly,” said Bill Corr, deputy secretary with the U.S. Department of Health and Human Services. “There are a lot of people that are uninsured, and we still have more to go."

As of Feb. 6, 1,393,068 people in Florida enrolled or re-enrolled in a plan. South Florida is leading in enrollment, with 661,917 people who have signed up so far. In the Tampa Bay area, about 187,000 have signed up, and in Central Florida, about 160,000 have enrolled.

According to federal data, 57 percent of consumers in Florida re-enrolled in plan, while 43 percent picked a plan for the first time.

About 93 percent of people who have signed up who are signing up are getting tax credits that bring the monthly premium down to less than $100.

“Our goal is to be sure that every Floridian has access to affordable, quality health insurance, and I think that's what happened,” Corr said.

Open enrollment ends Sunday, Feb. 15.

The number of people signing up jumped last week, the Health and Human Services Department reported. Nearly 276,000 signed up in the 37 states served by the federal insurance marketplace, compared with about 180,000 the previous week.

Although enrollment centers haven’t seen the same long lines as last year, volunteers from Austin, Texas, to Columbus, Ohio, report a surge this week, not yet captured in official numbers. And the revamped HealthCare.gov website so far has avoided last year’s technology meltdown.

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Lawmakers scramble to plug $1.3 billion deficit in health budget posted on 2/11/15

by Michael Van Sickler and Daniel Chang, Times/Herald Tallahassee Bureau

caduceusState lawmakers were scrambling to find $1.3 billion to plug a sudden budget deficit after a top Medicaid chief said Tuesday that Florida will lose federal money to help hospitals treat poor and uninsured patients.

Eliot Fishman, director of the Children and Adults Health Programs Group in the Center for Medicaid and CHIP Services at the Centers for Medicare & Medicaid Services, or CMS, told attendees at an Orlando health care conference that the federal government won't extend Florida's "Low Income Pool" program, or LIP, that reimburses hospitals that treat large numbers of poor and uninsured patients, according to news media reports.

The money was set to expire on June 30 with no agreement in place that it be renewed.

Fishman's announcement appears to overturn a main premise by Gov. Rick Scott that the fund would be available next year, thrusting his budget projections into disarray. A Scott spokeswoman, Jackie Schutz, characterized Fishman's statement as far from conclusive, pointing out that state officials were meeting with the CMS today to discuss the LIP extension.

But Democrats seized on Fishman's comments as proof that the refusal by Republicans to approve Medicaid expansion was to blame.

"Gov. Rick Scott and the Republican-led Legislature have understood for many years that federal law provided for Medicaid expansion in place of the 'Low Income Pool' monies for hospitals," U.S. Rep. Kathy Castor, D-Tampa, said in a statement. "Gov. Scott and the Florida Legislature should not block progress any longer and bring our tax dollars home to Florida."

Even if Florida legislators expanded Medicaid as envisioned under the Affordable Care Act, the state's safety-net hospitals would still need additional funds to cover the costs of treating the uninsured and Medicaid patients.

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CMS Official: No More LIP for Florida posted on 2/10/15

by Carol Gentry | Health News Florida

The nation’s Medicaid chief said this morning the federal funds Florida hospitals have depended on to pay for the uninsured will not be arriving any more.

There is “no way” that Florida’s “Low Income Pool” program will continue when it expires in June, said Eliot Fishman, director of the Medicaid division of the Centers for Medicare and Medicaid Services (CMS). “Not in its present form.”

Fishman’s message blows a hole in Gov. Rick Scott’s budget, which includes $2 billion in federal funds for the Low Income Pool, or “LIP.” Half of the LIP is federal matching funds.

The loss of this funding also puts pressure on the Legislature, which is to open its 2015 session in three weeks.

It was clear from Fishman’s formal presentation that CMS is impatient with what it sees as Florida’s stubbornness to incorporate funding from the Affordable Care Act that is designed to replace LIP and other older ways to cover indigent health care.

Fishman noted that a number of states are experimenting with new ways to use the Medicaid funds to pay for health care in ways that reward quality of care and cost-effectiveness.

But Florida’s hospitals are stuck with a huge unpaid bill because there are still millions of uninsured in the state. “You can’t even start these conversations unless people have coverage,” he said.

If the coverage problem weren’t holding things up, he said, “we are very prepared…to be flexible and work with you on the best way to do it. Whenever it happens, we’ll be there.”

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Senate Health Panel Tries Again on Telemedicine posted on 2/5/15

by BRANDON LARRABEE | News Service of Florida

Pointing to a need to increase access to health care in areas such as rural communities, a bipartisan group of House and Senate leaders Tuesday expressed confidence they will reach agreement this year on a plan to boost the use of telemedicine in Florida.

Sometimes called "telehealth," telemedicine involves using the Internet and other technology to provide care to patients remotely.

As a basic example, a physician could use a video link to consult with a patient who is at home.

While some providers such as hospitals have started moving forward with telemedicine, Senate Health Policy Chairman Aaron Bean said lawmakers need to put guidelines in state law.

For instance, Bean said such a law would allow Florida's Medicaid system to pay for care through telemedicine, something it cannot do now.

“In order for you to get paid to see a Medicaid patient, you have got to see them live, you’ve got to see them in person, you’ve got to document it," Bean said. "What we are going to do with our telemedicine bill will open that up, so if you see them virtually, through telemedicine, we’ll recognize that as a visit.”

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