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HMO wars: the Revenge of Humana

Back in 2003, a last-minute complicated provision got added to a conforming bill (ahh! the sunshiney ole’ days) that ultimately ensured that an HMO like Miami-Dade’s Preferred Medical Plan would automatically get 15,000 Medicaid recipients. Guaranteed.

Big HMOs like Humana didn’t like it, but they couldn’t get lawmakers or the courts to reverse the provision.

Until now. At the last minute yesterday evening in the Senate Health Regulation Committee, Melbourne Sen. Thad Altman presented a simple amendment striking the language – “Subsection (13) of section 409.9122, Florida 6 Statutes, is repealed.”

The amendment was pushed by Humana lobbyist Pete Buigas, who’s also representing Simply Healthcare Plans, a new HMO that, he says, has a harder time starting up because there’s not enough competition in Miami-Dade as a result of the provision.

Expect some behind-the-scene tussling to ensue. It looks like the HMOs don’t just want to gobble up fee-for-service in Medicaid. They want to gobble each other up as well.