News By Industry
News from Tallahassee for 7/23/14
Enroll America making health insurance pitches wherever uninsured are posted on 7/14/14
by Lawrence Mower | Palm Beach Post
RIVIERA BEACH — Roughly 30 million Americans still don’t have health insurance.
That means Florence French has her work cut out for her.
French is an organizer with Enroll America, a nonprofit devoted to finding people eligible for for insurance through the Affordable Care Act and showing them where and how to enroll.
That means a lot of one-on-one pitches, wherever there are people: the Department of Motor Vehicles, homes, Home Depot parking lots.
On Sunday, French was at the Valley of Life Ministries, a small Haitian church in a strip center on Broadway near Blue Heron Boulevard. The church’s president, Marie Antoinette Jean Pierre, takes care of and feeds people who walk through the church’s door. Many are homeless.
French’s job lately has been to find people who qualify for a special enrollment period.
The first enrollment period for the Affordable Care Act, also known as Obamacare, ended in March. The next enrollment period is in November, but will carry a $95 fine for adults who missed the first enrollment. The penalty escalates to $300 and $700 in subsequent years.
But if someone has a qualifying life event recently — including a marriage or divorce, a move or a new job, a 26th birthday or a new child — they can use the federal exchange right now to buy health insurance without a penalty. They have 60 days from the date of the event to enroll.
State Blasts Insurers for Hiding Rates posted on 7/11/14
by Carol Gentry | Health News Florida
Florida health plans were wrong to use a state "trade secrets" law to hide their rate proposals from the public, the Office of Insurance Regulation says in letters to 15 insurers.
In what became a nationwide embarrassment for Florida, insurers falsely placed a "zero" on the public rate-filing form for 2015 in the run-up to the June 27 reporting deadline. OIR officials say their intention was apparently to hide their actual rate proposals from one another, but it backfired when Health News Florida reported on the unusual phenomenon.
The trade-secrets law was never intended for that purpose, and its use is blocking the state's goal of making rate proposals "transparent," OIR Assistant General Counsel Virginia Christy wrote in a July 3 letter to plans participating in the 2015 federal Health Insurance Marketplace.
Because of the way the trade-secrets law is written, OIR says, it cannot just release the information to the public. It must wait for someone to request the document and then give the companies 30 days' notice that it intends to release it, so that they can try to block it through court action. The July 3 letters provided that official notice.
The first public records request was filed June 30 by Bryan Trochessett of Chandeleur Investment Consulting, LLC, according to Christy's letter. Later, other requests were filed by reporters and the consumer group Florida CHAIN.
CHAIN's Policy Director Greg Mellowe said in a July 8 letter to OIR that the agency should release the rate proposals right away because the trade-secrets claim is phony.
Mellowe wrote that the insurers and HMOs "are intentionally misleading the public" and added a zinger for state officials "For its part, if OIR has knowingly allowed such false information to be reported and then defended such reporting, it may have facilitated insurance fraud."
Lawyers, Patients Fight Cost of Records posted on 7/10/14
by Carol Gentry | Health News Florida
Doctors used to give patients a copy of their medical records for free. But that service is waning, as today's large group practices shed the hassle and risk by outsourcing the record-handling.
For-profit companies in the new "release of information" or "disclosure-management" industry include HealthPort Technologies LLC in suburban Atlanta and Bactes Imaging Solutions LLC in San Diego.
They say it is costly to process record requests in compliance with patient privacy laws. In Florida, they get $1-a-page for hospital records, whether the copies are on paper or digital.
For doctors' records, the price is likewise $1 a page in most cases. The only price breaks are for patients, who pay a quarter a page after 25 pages, and government agencies.
The Florida Board of Medicine has been debating whether to do away with the exceptions and have a $1-a-page maximum charge for everyone. A hearing is now scheduled for October in South Florida.
HealthPort Technologies' General Counsel Jan McDavid says most people don't understand why the industry wants the charge to be the same for copies in electronic and paper format; they think a download should be less expensive. But what's costly isn't the paper, she said, it's the personnel.
"There are about 32 steps involved" in processing a document-copy request," she said. "It takes a lot of training; it's a very highly regulated environment."
State Looks to Managed Care as Answer in Legal Battle posted on 7/8/14
by JIM SAUNDERS | NEWS SERVICE OF FLORIDA
Pointing to a new managed-care system, the state is seeking to scuttle a long-running lawsuit that challenges the adequacy of care provided to children in Florida's Medicaid program.
A federal judge will hold a hearing Tuesday in Miami, with attorneys for the state Agency for Health Care Administration expected to argue that the lawsuit, spearheaded by the Florida Pediatric Society, is moot.
In documents filed during the past week, the agency contended that a new statewide Medicaid managed-care system will ensure adequate networks of doctors for children and that the system includes safeguards for quality of care. The managed-care system, approved by lawmakers in 2011, is expected to fully take effect Aug. 1.
"In light of all of the many changes to the Florida Medicaid program's service delivery system, the statutory changes which evidence significant changes in policy, and the (federal Centers for Medicare & Medicaid Services) approvals and oversight …this case is moot, and should be dismissed,'' a filing last week said.
White House to Rick Scott: Medicaid expansion would create 63k jobs posted on 7/2/14
by Alex Leary | Tampa Bay Times
The White House has a Medicaid expansion argument for Gov. Rick Scott and Florida Republicans: It creates jobs.
A state-by-state report to be released Wednesday (an advance copy was provided to the Tampa Bay Times) estimates that Florida would generate 63,800 jobs, mainly in health care, from 2014-2017. That’s the three years that the federal government would have paid the entire cost of providing health care to 848,000 people.
The study by the Council of Economic Advisers -- titled "Missed Opportunities" -- is part of an ongoing push by the Obama administration on a central part of the Affordable Care Act. " It makes a number of other claims evaluating states that have expanded and Florida and 23 others that have not.
It claims, for instance, that the number of Floridians experiencing depression would drop by 68,000. Or that 38,00 fewer people would see “catastrophic out-of-pocket costs in a typical year." The report relies on the Urban Institute among other sources.
“Today’s report is yet another reminder that access to affordable health care makes a real difference to families, hospitals and state economies across the country," President Obama
said in a statement. "I applaud the governors and state legislatures of both parties who have done the right thing and expanded Medicaid in their states, and I urge the governors and state legislatures who have not yet expanded Medicaid to put their constituents’ health over partisan politics and give millions more Americans the access to affordable health care they deserve.”
Scott, who emerged from obscurity in opposition to Obama’s health care law, initially rejected the expansion then, in February 2013, reversed himself. “While the federal government is committed to pay 100 percent of the cost, I cannot, in good conscience, deny Floridians the needed access to health care," Scott said, talking about helping the "poorest and weakest" Floridians.
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