Congresswoman Corrine Brown has called on the federal Centers for Medicare and Medicaid Services (CMS) to impose additional terms and conditions on the State of Florida's managed care pilot program for Medicaid. CMS and state officials are currently in negotiations over the state's request to continue the program. "This experiment has not worked for many of my constituents and we need stronger protections going forward," Brown said.
The pilot project places Medicaid beneficiaries in managed care plans that offer customized benefit packages, including some services not available in traditional Medicaid. The pilot currently operates in Duval, Broward, Nassau, Baker, and Clay counties, but will expire on June 30 if CMS does not grant an extension. The State applied for a three year extension and recently requested a temporary 30-day extension under the current terms and conditions. CMS has issued new special terms and conditions with which the state must comply in order to continue the program. They remain in draft form and have not been made public. "I am pleased that CMS proposed new conditions, which I can only assume are stronger than those imposed by the Bush administration in 2006," Brown observed.
Based on input from various health care providers in Jacksonville, Congresswoman Brown sent a letter to CMS outlining several concerns and recommendations for improving the program for patients and providers. "My top priority is that CMS have personnel stationed in Florida, she said." We are the fourth largest state and the nearest CMS office is in Atlanta. That's too far to develop relationships and insights and see what's really going on." Other recommendations include an integrated, local transportation system to get patients to doctors, culturally sensitive program requirements so the provider community reflects the community it serves, more robust mental health programs, and a minimum medical-loss ratio to ensure that more taxpayer dollars are spent on care -- not overhead. CMS has requested a formal response from the state.
Florida passed legislation that would expand the managed care program for Medicare statewide. "I am skeptical of statewide expansion," cautioned Brown. "But if we can get the pilot program right, perhaps it can be a model for the rest of the state and the country."