News from Tallahassee for 5/22/15

State Rebuffed In Children's Medicaid Fight posted on 5/5/15


A federal judge last week rejected the state's latest attempt to end a decade-long lawsuit that contends Florida has not properly provided care to children in the Medicaid program.

Attorneys for the state pointed to a recent U.S. Supreme Court decision in an Idaho case to argue that Judge Adalberto Jordan should dismiss claims that Florida has failed to adequately provide care such as check-ups and screenings to low-income children.

But Jordan, in a brief order issued Thursday, dismissed only one of three counts in the case, which has been spearheaded by the Florida Chapter of the American Academy of Pediatrics. The dismissed count dealt with arguments that Florida has not paid adequate reimbursement rates to doctors and dentists and, as a result, has limited the amount of care available in the Medicaid program.

In a court document filed last month, plaintiffs in the case acknowledged that the Supreme Court ruling in the Idaho case required that the reimbursement-related count be dismissed. But Jordan agreed with the plaintiffs that two other counts --- which include allegations such as care not being available with "reasonable promptness" and outreach to Medicaid-eligible children being inadequate --- should continue forward.

Jordan, who began hearing the case as a U.S. district judge but is now an appeals-court judge, held a trial in the case in 2012 and issued a 153-page decision in December that found widespread problems in the way the Medicaid program has provided care to children. The ruling included findings about the effects of low reimbursement rates but also dealt with other issues.

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Gov. Rick Scott officially convenes commission on hospital spending posted on 5/5/15


As promised, Gov. Rick Scott is convening a commission to look at taxpayer-supported hospitals.

Scott first pitched the idea in April, amid a still-unresolved clash between the House and Senate over healthcare funding. He officially created the new Commission on Healthcare and Hospital Funding in an executive order Tuesday.

The group has been tasked with investigating "the role of taxpayer funding for hospitals, insurers and healthcare providers, and the affordability, access and quality of healthcare services they provide to Florida families as a return on taxpayer investment."

The governor also wants the commission to investigate "the extent to which taxpayer-funded hospitals pay for lobbyists, campaign contributions and advertising."

Democrats were quick to bring up the fact that Scott resigned as CEO of a for-profit hospital chain after federal agents went public with an investigation into the company in 1997. The company, Columbia/HCA, would later plead guilty and paid a record $1.7 billion in government penalties and fines.

"Now, Rick Scott — who resigned from the health care company he founded amid federal fraud investigations — has decided his time would be well spent auditing the books of Florida hospitals," Florida Democratic Party Chair Allison Tant said in a statement. "How does that help resolve the gridlock in the legislature? The only hospital management advice Rick Scott knows how to offer is training executives how to fleece the federal government for billions."

Scott's three-page executive order notes that Florida’s Medicaid program costs $23.6 billion — nearly one-third of the state budget.

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Collapse continues: Senate says House’s early exit unconstitutional posted on 4/30/15

by John Kennedy and John Pacenti | Palm Beach Post

FL Senate President Andy GardinerTALLAHASSEE — With the Florida Legislature already in a ditch, the Senate heightened tension Wednesday by accusing the House of violating the state Constitution by adjourning and ending its work three days early.

Senate President Andy Gardiner said in a letter to House Speaker Steve Crisafulli that unless both chambers agree to quit, the Florida Constitution bars one chamber from adjourning for more than 72 consecutive hours during a session.

The House stunned the Senate by leaving Tuesday afternoon, effectively killing a host of high-priority bills and underscoring the crumbling relationship between Florida’s Republican leaders.

Gardiner, R-Orlando, said the Senate plans to technically stay in session until Friday’s scheduled close and called for House members to join the Senate by returning to work at the Capitol.

Crisafulli, though, wasted little time responding – shrugging off the Senate’s demand.

“I understand that you are angry that the House concluded our business,” Crisafulli, R-Merritt Island, told Gardiner in his own written response.

But the speaker added that as long as the Senate continued to push legislation aimed at creating a privatized form of Medicaid expansion allowed under the Affordable Care Act, there would be no agreement between the Republican-led sides.

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House Packet on Medicaid Called Misleading posted on 4/30/15

by Carol Gentry | Health News Florida

Florida House leaders, who for three years have rejected federal funds to expand health coverage to the poor, brought the legislative session to an early halt Tuesday because of their rock-solid belief that “Medicaid is broken.”

This strongly held position is not new. It developed in the past when doctors shunned Medicaid because of low pay rates. Even as Medicaid has been transformed and turned over to the private sector, the attitude has persisted and intensified among groups opposed to the Affordable Care Act and all its parts, including Medicaid expansion.

Last week, the position appeared in materials distributed at a Florida House Republican caucus held behind closed doors. They contain data that appear to provide a scientific case against Medicaid expansion and the Florida Senate proposal to accept $2.8 billion in federal funds to cover 800,000 low-income uninsured next year.

Health News Florida received a copy from the House Majority Leader’s office, asked for feedback on it from two well-known Medicaid researchers from the Georgetown University Health Policy Institute and the Henry J. Kaiser Family Foundation.

Both organizations are non-partisan and neutral on health policy matters. Joan Alker, director of the Georgetown Institute’s Center on Children and Families, has written that she hopes that Florida will cover the uninsured, but has taken no position on specific legislation.

Both Alker and Rachel Garfield, associate director of the Kaiser Commission on Medicaid and the Uninsured, said the GOP packets contained cherry-picked studies that, put together, appear to cast doubt on Medicaid’s effectiveness. The studies were not flawed, they said, but there was a heavy spin on the conclusions.

Alker said there were “so many inaccuracies and misperceptions” within the House arguments that “really it would take too long to address them all.” She and Garfield provided widely accepted studies to explain their point.

Here are some discoveries.

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Scott Files Lawsuit Over Medicaid Expansion posted on 4/29/15

by AP

Florida Gov. Rick Scott sued the Obama administration Tuesday, charging that federal officials are coercing the state to expand Medicaid in order to get $1 billion in federal hospital funds.

The Republican governor points to a 2012 U.S. Supreme Court decision saying the federal government can't coerce states to expand Medicaid, which is exactly what he says the Obama administration is doing by withholding hospital funds.

"President Obama's sudden end to the Low Income Pool (LIP) health care program to leverage us for Obamacare is illegal and a blatant overreach of executive power," Scott said in a statement.

But legal experts say that Supreme Court case doesn't necessarily apply. That's because the hospital funds Scott wants are part of an optional program, and the federal government has broad discretion over it.

The lawsuit was filed in a Pensacola federal court - the same place where Florida previously challenged the health care law. The Sunshine State filed the first lawsuit against the Affordable Care Act and was eventually joined by about two dozen other states.

Attorney General Pam Bondi's office hired outside attorney Paul Clement, who successfully argued that the Obama administration could not coerce states into Medicaid expansion. Clement was solicitor general under former President George W. Bush.

Republican Texas Gov. Greg Abbott has said Texas will support Florida in its litigation.

Only eight other states get the LIP hospital funding. Florida's is the first to expire on June 30th but other states are watching closely as the federal government has said the guidelines it uses to decide in the Florida case will be used in other states.

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