News from Tallahassee for 1/26/15

Florida Health Insurance Costs Highest posted on 1/8/15

by Robin Williams Adams | Lakeland ledger

LAKELAND | If health insurance took a bigger chunk of your paycheck the past few years, you're far from alone.

In Florida in 2013, premium payments and deductibles ate up 12.4 percent of median household income for people 65 and younger — the highest impact nationwide.

The national impact was 9.6 percent.

Although annual increases in premium costs slowed somewhat nationwide from 2010 to 2013, employees are less likely than their employers to feel relief in their wallets.

That's what the Commonwealth Fund found in a report it released Wednesday on state trends in the cost of employer-provided health insurance coverage from 2003 to 2013.

"Premium costs have risen faster than incomes in every state," said Cathy Schoen, one of the report's authors and executive director of the Commonwealth Fund Council of Economic Advisors.

A Florida worker's annual payment for his or her share of the insurance premium went from $750 in 2003 to $1,073 in 2010 to $1,408 in 2013. This is on a single-person, private employer-sponsored plan's premium.

Put another way, employees went from paying an average 21 percent of the cost in 2003 to 26 percent in 2013.

They saw a 5.2 percent annual increase from 2003 to 2010 and a 9.5 percent increase from 2010 to 2013.

Overall premium costs in Florida, however, went down in 2010-13 by at least 3 percentage points, an indication of the report's contention that cost savings aren't reaching the employees.

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Where did PUP clients go? posted on 1/7/15

by Fred Hiers | Ocala Star Banner

The former owners of Physicians United Plan, a Medicare Advantage plan that had more than 6,200 members in Marion County before the state shut it down last year, have dropped the federal lawsuit they filed against their former accountants.

Drs. Sandeep and Rohini Bajaj of Orlando, along with their family partnership, who were PUP's majority shareholders, filed suit in October and alleged that the accountants hid PUP's financial troubles from state regulators.

The Bajajs, who founded the company in 2005, sought in excess of $500 million in damages from Illinois-based McGladrey LLP, the sole defendant.

An attorney who represents McGladrey declined to comment for this story. An attorney for the former PUP owners did not return telephone calls for this story.

Meanwhile, many of PUP's 38,000 displaced customers have signed onto Medicare Advantage plans offered by competitors. Many in Marion County went to well-known, established firms such as Freedom Health Inc., and many in South Florida went to to CarePlus Health Plans.

The state, citing PUP's financial troubles, shut down the plan in June. At that time, the Medicare Advantage plan had 38,000 enrollees statewide and was the biggest plan of its kind — with 6,200 enrollees — in Marion County.

Statewide, about 13,000 former PUP clients signed up with Freedom Health after PUP closed, according to Joe Vessio, Freedom's vice president for sales and marking.

Vessio said PUP clients were looking for plans that included their doctors but also provided stability, growth and reliability.

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Annual Look-Ahead: What to Expect in 2015 posted on 1/5/15

by BRANDON LARRABEE | News Service of Florida

With Gov. Rick Scott set to be sworn in for his second term and legislative committee meetings beginning next week, the topics that will dominate discussion in the Capitol in the coming year are already starting to shape up. Here are 10 stories that could generate major headlines -- or at least dominate the Tallahassee chatter -- in 2015.

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Judge: FL Medicaid for Kids Violates Law posted on 1/2/15

by AP

A federal judge has ruled that Florida’s health care system for impoverished and disabled children violates several U.S. laws.

In a ruling Wednesday, U.S. Circuit Judge Adalberto Jordan of Miami said lawmakers had for years set the state’s Medicaid budget at an artificially low level, causing pediatricians and other specialists for children to opt out of the insurance program for the needy.

Jordan said that amounted to rationing of care and exacerbated a shortage of pediatricians, particularly in rural areas.

“This is a great day for the children in this state,” said Dr. Louis B. St. Petery, a Tallahassee pediatrician who is executive vice president of the Florida Pediatric Society and helped spearhead a 2005 lawsuit against Florida’s Department of Health, Department of Children and Families and the Agency for Health Care Administration.

“This action was taken because we found that children weren’t being treated properly if they were on Medicaid. Our position as pediatricians is that children do not choose their parents. They don’t have a choice to be born into a rich family or a poor family,” St. Petery told the Miami Herald.

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Troubled Plans Top Health News in 2014 posted on 12/22/14

by mary shedden | health news florida

Take a look at the top health care stories in Florida in 2014, and it’s clear that the business of Medicare and Medicaid continued to dominate the news.

Good news -- and plenty of bad, too -- topped the most read stories on Health News Florida in the past year. And yes, the glitches and changes tied to new Affordable Care Act rules created plenty of buzz as well.

The competition over coveted Medicaid managed care contracts was a reader favorite early in the year. Meanwhile, Medicare Advantage plans at the top of their game – and those mired in controversy and financial calamities – were attention getters throughout the year.

Some of these important health stories kept going, long after the first headline caught your attention. And we’ll continue to do our best to keep your updated in 2015. But now, here’s a look back at the top 10 stories of the past year:

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