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Negron outlines plans for Medicaid reform

Sen. Joe Negron today outlined for fellow senators his plan to reform the state's Medicaid program. The state will need a waiver to accomplish many of its goals, including moving Medicaid patients into HMOs. And Negron said if Florida doesn't get the waiver, the state may have to handle Medicaid on its own, without federal financial help.

"If the federal government elects not to allow us to manage the program in a way we believe is in Florida's best interset, then we'll operate our Medicaid program with our resources," Negron said, noting that he doubted it would come to that.  "We're going to give the federal government 100 good reasons to give us this waiver."

Medicaid costs Florida about $22 billion a year, with a little more than half of that provided by the federal government.

Lawmakers have long been seeking ways to cut Medicaid costs. Highlights of Negron's proposal include moving most Medicaid patients into HMOs, nearly doubling payments to Medicaid providers, requiring that 90 percent of Medicaid money go to health care, giving Medicaid providers more protection from lawsuits, and cutting services so Medicaid plans will be more in line with what's available in the private sector.

"Medicaid is a very generous program, especially on paper. What it purports to provide to you is much greater than anything provided in the private sector," Negron said.

Negron also said his bill will not include putting persons with disabilities into Medicaid HMOs, a measure that has concerned advocates for the disabled.

Negron predicted his plan will save Florida more than $1 billion in the first year, and more than $4 billion over three years.

After the presentation, Karen Woodall who lobbies on behalf of Medicaid patients, said she liked some of the ideas Negron highlighted, such as increasing Medicaid provider payments, and the requirement that payments go almost exclusively to patient care. She also appauded Negron for pulling people with disabilities out of the HMO concept. 

But she questioned why it would be necessary to give Medicaid doctors increased protection against lawsuits, saying it's low reimbursement rates that keep doctors from participating in the program, not concern about lawsuits.

She also expressed concern about rolling back benefits. Some benefits provided by Medicaid -- such as eyeglasses, dentures and hearing aids -- are necessary because Medicaid patients are so poor that they don't have extra money to pay for those items. Negron won't release details until later this week, but Woodall wondered how far the service cuts would go to meet the stated goal of coming in line with private plans.

"They're not going to be able to have savings unless they're whacking the heck out of benefits," Woodall said. As to the comparison to private plans, Woodall said this: "The reality is a lot of private health care is inadaequate. That's the reason we have the (federal) Affordable Care Act, which this state is suing to not participate in."