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Major companies pulling out of Medicaid Reform
By Carol Gentry and Christine Jordan Sexton
8/27/2008 © Florida Health News
Three companies that together cover 60 percent of the Medicaid patients enrolled in a pilot project called "Medicaid Reform" have notified the state that they are pulling out on Dec. 1 and have asked to be assigned no more members. The actions follow the state's decision to reduce payments by 5 percent on Sept. 1.
By Christine Jordan Sexton
8/27/2008 © Florida Health News
So often, when there’s good news about health costs or coverage, Florida misses out. It happened again Tuesday with the release of survey data by the U.S. Census Bureau. Nationally, the percentage and number of people without health insurance dropped last year, but the trend skipped over this state.
By Carol Gentry
8/22/2008 © Florida Health News
A report that Medicare equipment fraud is running billions of dollars a year, far more than federal health officials have claimed, drew a regretful I-told-you-so Friday from Republican Sen. Mel Martinez, who has been speaking out on this issue for months. Democrat Bill Nelson expressed outrage at the news that administration officials deliberately looked the other way and misled Congress.
By Carol Gentry
8/22/2008 © Florida Health News
Some of the heaviest hitters in Washington are scheduled to convene in Orlando in mid-September to engage in "high-level dialogue" with private-sector powerbrokers on the crisis in health-care access, cost and quality. "It will not only make news -- it will make a difference," organizers say. Maybe. For sure, it will make for good politics. Both Presidential campaigns are sending representatives, and there may even be an appearance by the candidates themselves.
Healthy Kids cuts 22,000 from WellCare, stiffens penalties
By Carol Gentry
8/21/2008 © Florida Health News
Florida's Healthy Kids Corp. is cutting back its business with WellCare Health Plans Inc., offering WellCare's subsidiary HMOs as an option in 11 fewer counties in the year that begins Oct. 1, according to a contract filed with the Securities and Exchange Commission late Wednesday afternoon. The contract says Healthy Kids enrollment in WellCare plans will drop by 22,000 children and that the company will face stiffer penalties if it under-spends on patient care.
By Carol Gentry
8/21/2008 © Florida Health News
August in Florida: hot, muggy, one storm after another. But there’s one thing to recommend August; it’s the only month that self-employed Floridians can buy “group” health coverage. It’s the only time of the year that sole practitioners and independent contractors can’t be turned away because they’re too old or too risky.
By Carol Gentry
8/19/2008 © Florida Health News
Wall Street analysts predicted the share price of WellCare Health Plans Inc. would move up Tuesday in the wake of its announcement Monday night that it will turn over $35.2 million immediately to the U.S. Attorney's Office. As Oppenheimer's Carl McDonald put it, it's "only" $35 million. But the Tampa company, which has been under a Medicaid fraud investigation for nine months, could face additional fees and penalties.
Keen's last report: HMOs had docs that Medicaid dumped
By Christine Jordan Sexton
8/15/2008 © Florida Health News
TALLAHASSEE -- About 60 doctors who were kicked out of Florida’s Medicaid program were able to return to the public payroll indirectly by going to work for Medicaid HMOs and managed-care networks, according to a draft report at the Agency for Health Care Administration. Also: Taxpayers paid $52 million for newborns who should have been covered by HMOs. These findings were in a report that Inspector General Linda Keen was working on when she was ushered out the door last month.
By Carol Gentry
8/13/2008 © Florida Health News
States are required to notify the federal government when they bar health-care providers from their Medicaid program for fraud, negligence, or some other serious offense. But a two-year study found that didn't happen most of the time -- especially in Florida. The Agency for Health Care Administration says the report is just flat wrong.
State bans bias in small-group market; insurers fight back
By Carol Gentry
8/13/2008 © Florida Health News
Florida's Office of Insurance Regulation has proposed a rule aimed at ending discrimination in the small-group market against companies that have fewer than 10 workers. Any hassles required of a mom-and-pop shop would apply equally to larger, more profitable customers, the rule says. But two United Health subsidiaries have filed a challenge to the rule, throwing the market into chaos.
By Christine Jordan Sexton
8/12/2008 © Florida Health News
TALLAHASSEE – It took Linda Keen only six months to go from an “indispensable part” of the leadership team at the Agency for Health Care Administration to being out of work. The only thing that changed was the arrival of AHCA Secretary Holly Benson, a believer in Medicaid Reform -- the project that Keen criticized last year. Keen's admirers predict her ouster will have a chilling effect on other inspectors general.
By Tim Collie
8/8/2008 © Florida Health News
Because of Florida’s peculiar geography, with its state Capitol located hundreds of miles from its major metro areas, a relative handful of reporters have to cover an enormous bureaucracy and a multibillion-dollar budget. it’s about to get a whole lot harder, as bodies and experience disappear from newspapers' capital bureaus. Coverage of state health issues and agencies, never abundant, is likely to shrink along with the size of the press corps.
Suit accuses Benson of intervening for friends, donors
By Gary Fineout
8/7/2008 © Florida Health News
A whistleblower suit filed Wednesday against the state accuses Holly Benson, secretary of the Agency for Health Care Administration, of improperly intervening in cases involving her friends and political allies at her last post. The accusations cover some of the same ground that the Ethics Commission looked at earlier and found insufficient evidence to bring charges. The suit comes just a few weeks after Benson forced out AHCA's inspector general.
UCF team reports success with bubonic plague vaccine
By Harry Wessel
8/5/2008 © Florida Health News
ORLANDO -- The research team that developed a successful vaccine for the top-ranked bioterrorism threat, anthrax, now appears to be on the verge of knocking off the number-two threat, as well -- bubonic plague. Professor Henry Daniell and his research team at University of Central Florida report that their oral vaccine for plague proved effective in animal studies and is ready for human trials.
By Tim Collie
8/5/2008 © Florida Health News
Deep staffing cuts at newspapers across Florida this summer are taking a toll on coverage of health issues at the very time it may be needed most: during an election year and a severe economic downturn. Left uncovered, veteran reporters say, will be concerns about access to care and how to finance it – issues that affect millions of Floridians. "Our watchdog role is diminished," said Terence Shepherd, a Miami Herald editor.
By Carol Gentry
8/1/2008 © Florida Health News
Florida’s two largest Medicaid HMOs kept 50 percent of the state money they received last year for mental health care, even though they were supposed to spend at least 80 percent on patients, new state records show. Both are subsidiaries of WellCare Health Plans Inc., which has been under investigation for suspected Medicaid fraud since October.
By Carol Gentry
7/31/2008 © Florida Health News
Medical Savings Insurance Co., which has been battling the hospital industry, state regulators and its own customers for years, is bowing out of Florida. Hospital officials are celebrating the departure of the company created by the controversial J. Patrick Rooney. But some customers have been left in the lurch, unable to find affordable replacement coverage. The company offered no explanation, but clues lie in court records and a report at the Office of Insurance Regulation.
By Carol Gentry
7/30/2008 Florida Health News
BONITA SPRINGS – Florida, like the rest of the nation, needs to shift some spending from acute-care settings to primary and preventive care, two legislators who sit on the Florida House Healthcare Council say. “Why are costs continuing to escalate? Because money’s not going into primary care,” said Rep. Alan Hays, R-Umatilla. He and Rep. Kelly Skidmore, D-Boca Raton, addressed a combined conference of the Florida Association of Community Health Centers and Area Health Education Centers on Tuesday.
By Carol Gentry
7/29/2008 Florida Health News
A week ago, WellCare Health Plans Inc. released documents admitting that it failed to repay $46.5 million to two states, Florida and Illinois. On Monday, a spokeswoman for Illinois' Medicaid program said that state expects to get very little of the money. If the Illinois audit is correct, two Florida programs that help uninsured children and people with mental illness stand to receive a total of $45.6 million.
By Christine Jordan Sexton
7/25/2008 © Florida Health News
TALLAHASSEE -- The state Agency for Health Care Administration has inflated the savings from Medicaid's pilot project in order to get a groundswell of support to expand it statewide, according to a report released Friday by an advocacy group. Florida CHAIN claims the money saved in the five-county pilot is about 4 percent per person, not the 20 percent that AHCA claimed in its most recent quarterly report.
Report: Only 10% of Medicaid credits were used
By Christine Jordan Sexton
7/24/2008 © Florida Health News
TALLAHASSEE - A key component of Florida’s Medicaid pilot project -- awarding points toward free products to patients who display healthy behaviors -- has not been used by most of the people it was intended to help, an analysis released Thursday says. Only 10 percent of credits earned in the first 18 months were used, according to the report, and administrative costs were $1.1 million.
By Bill Hirschman
7/23/2008 © Florida Health News
Florida hospitals and doctors overbilled taxpayers by more than a third of a billion dollars over three years, according to findings from contractors who checked claims for the Medicare program. Health-care providers derided the auditors as "bounty hunters," but Medicare officials say they've fixed the bugs and are taking the program nationwide.
By Carol Gentry
7/22/2008 (c) Florida Health News
Hundreds of thousands of Florida residents who have health problems are shut out of the private insurance market. But the state isn't helping them. That's why Florida won't share in $49 million in grants that the federal government announced on Monday.
By Christine Jordan Sexton
7/22/2008 © Florida Health News
TALLAHASSEE -- Three years after a series of hurricanes slammed into Florida, hospitals across the state are finally getting promised financial help for damages and increased expenses they incurred in the wake of the killer storms. By the end of September, the state will send out more than $13.2 million. But remarkably, the state's hospitals are turning down half the money available.
By Christine Jordan Sexton
7/18/2008 © Florida Health News
TALLAHASSEE -- A new report from a free-market think tank argues that Florida’s Medicaid pilot program has “numerous accomplishments” and should be expanded statewide. It contends that previous studies critical of the program -- including one by AHCA Inspector General Linda Keen – were flawed. The report is being published just as news emerges that Keen has resigned under pressure.
Correction: Weldon, Mica voted against doctor-pay fix
Rep. Ander Crenshaw voted to override the President's veto of the Medicare bill. The original version of a July 17 Florida Health News story misstated his vote. We apologize for the error.
7/17/2008 © Florida Health News
A majority of Florida's 27-member Congressional delegation are Republicans who tend to side with President Bush on most things. But when it came down to the wire on the Medicare bill to fix a steep cut in pay to doctors, almost all of them skedaddled. Only two stuck with Bush on the veto override: Republican Reps. Dave Weldon and John Mica.
By Christine Jordan Sexton
7/16/2008 © Florida Health News
TALLAHASSEE -- In a move to get more of their unpaid bills covered by Medicaid, dozens of Florida hospitals have agreed to subsidize the salaries of temporary state workers who have authority to determine patients’ eligibility. The Legislative Budget Commission approved the unusual program because of the growing backlog of applications for assistance.
7/15/2008 © Florida Health News
Today, President Bush will veto the Medicare reform act that the Senate passed last week, a deputy health secretary reportedly said Monday during a conference call with lobbyists. The veto could trigger an immediate 10.6 percent pay cut for doctors who treat Medicare patients, which would stand until both branches of Congress can hold a vote to override the veto. "I'm appalled at President Bush, that he could carry out something like this," said Deborah H. Tracy, president-elect of the Hernando County Medical Society.
By Susan Jaffe
7/11/2008 © Florida Health News
WASHINGTON, D. C. – The Medicare reform bill that would reverse doctors’ pay cut would also crack down on a type of health plan that has drawn numerous complaints. The private fee-for-service plan, the highest-paid and fastest-growing product in the Medicare Advantage program, would have to sign up doctors and hospitals for their members to use. Under current law, there is no requirement -- something Paul and Fran Kujda of Orlando learned the hard way.
By Susan Jaffe
7/10/2008 © Florida Health News
WASHINGTON, D. C. – Florida Sen. Mel Martinez was among nine Republicans who dropped their earlier opposition to sweeping Medicare reform legislation Wednesday, leading the Senate to adopt it by unanimous consent. The bill reverses a steep pay cut to doctors who treat Medicare patients, taking some money from private health plans. The turning point came when Sen. Edward Kennedy made a surprise return to the Capitol.
By Carol Gentry
7/7/2008 © Florida Health News
As Congress reconvenes today after a week off, Florida Sen. Mel Martinez is under heavy pressure from Florida AARP and the state medical association to drop his opposition to a bill that would shield doctors from a steep Medicare pay cut. As the New York Times reports today, Republicans nationwide are feeling the heat. The Florida alliance of AARP and FMA is a case of strange bedfellows, since they're often on opposite sides of political issues.
By Susan Jaffe
7/2/2008 © Florida Health News
WASHINGTON, D. C. — Doctors who treat Medicare patients were scheduled for a 10.6 percent cut in their fees beginning Tuesday, but now their bills won’t be processed at all – until at least July 15. The U. S. Centers for Medicare and Medicaid Services is putting a temporary freeze on processing claims to avoid having to cut payments. Florida doctors warned members of Congress last spring that they could be forced to turn away Medicare patients if their payments are cut when the cost of maintaining a practice is rising.
By Carol Gentry
6/26/2008 © Florida Health News
What public-health group could possibly object to a bill called the Family Smoking Prevention and Tobacco Control Act? Here's who could object: The American Association of Public Health Physicians. Kevin Sherin, director of the Orange County Health Department, is the new president of the group -- one that doesn't mind being edgy.
By Chris Gerbasi
6/25/2008 © Florida Health News
MIAMI -- Jodricka and Tony Vassell, who have eight young children and only a modest income, have had to become experts in navigating the health-care system. When FIU's first class of medical students arrives in 2009, families like the Vassells will welcome them into their homes to teach them about the real world.
By Susan Jaffe
6/19/2008 © Florida Health News
WASHINGTON, D. C. – Frail, elderly people entering a nursing home shouldn’t be forced or tricked into signing away their legal right to sue if they are later mistreated, Sen. Mel Martinez said Wednesday at a hearing on his patients’ rights bill. When his father entered a nursing home, Martinez said, “I remember signing a lot of stuff...did I sign an arbitration agreement? I don’t know.”
By Carol Gentry
6/17/2008 © Florida Health News
In a federal crackdown Tuesday on what it called “online cancer fraud,” the Food and Drug Administration released the names of suspected violators who have received warning letters, including two in Florida: Karyl Sellinger of Herb Time in St. Augustine and Mark Rosenberg of the Institute for Healthy Aging in Delray Beach.
6/13/2008 (c) Florida Health News
Reports of drug-related deaths jumped 11 percent in Florida last year, according to a newly issued report from the state's medical examiners. Drugs were present in 8,620 bodies that went to a medical examiner's office in 2007, up from 7,741 cases in 2006, the report says. Both illegal and prescription drugs were implicated.
By Carol Gentry
6/12/2008 © Florida Health News
It still isn’t clear who’s behind the “People for Choice Health Care Coalition,” an anonymous group sending out scary cards to fight reform of the Medicare payment system for medical equipment. But one mystery surrounding the group's mail-out to elderly voters around West Palm Beach has been solved: The poster child for the campaign -- a white-haired man in a wheelchair -- is Richard Harley, 85, a retired real estate broker in Bartow. He said he has never heard of the People for Choice Health Care Coalition.
By Susan Jaffe
6/10/2008 © Florida Health News
WASHINGTON, D. C. – Ruth Kleiner of Delray Beach, who has emphysema, got a letter the other day from the company that delivers her portable oxygen tanks. She read it three times, but still wasn’t sure what to make of it. She couldn't get through to Medicare, perhaps because 4 million other Medicare beneficiaries are also trying to figure out the payment system for medical equipment that will take effect in 10 metro areas -- including South Florida and metro Orlando -- July 1. Medicare officials say the point is simple: Stop over-paying. Save money.
By Susan Jaffe
6/9/2008 © Florida Health News
WASHINGTON, D.C. – Someone who's upset about Medicare pay cuts to medical equipment suppliers is sending out anonymous scare cards to seniors using the photograph of a Florida man who died nine months ago. The cards arrived the last week of May at the massive Century Village complex in Deerfield Beach. Adele Becker, who lives there, was astonished to see that the card prominently featured a photo of her late husband Morris, who died in a Boca Raton nursing home last August.
By Alan Snel
6/6/2008 (c) Florida Health News
TAMPA -- Jessica Reynolds, community outreach manager for Healthy Start Coalition of Hillsborough County, has $12,000 a year to sell the message: Don’t drink or smoke if you’re pregnant. She's found an unconventional yet effective way to reach women of child-bearing age in bars, restaurants and workout centers in a spot where they have little else to look at besides the wall in front of them.
By Kara Carnley
6/5/2008 (c) Florida Health News
GAINESVILLE – Dosing middle-aged mice with a key ingredient found in red wine seems to slow the aging of the heart significantly, according to a study published Wednesday by scientists from several research centers. One of the dozen listed authors was Christiaan Leeuwenburgh, Ph.D., chief of the Division of Biology of Aging at UF’s Institute on Aging. The Institute plans to start human trials this summer.
By Susan Jaffe
6/2/2008 © Florida Health News
WASHINGTON, D. C. - Medicare would no longer pay private health plans thousands of dollars more every year to cover Miami-Dade members than those in neighboring Broward and Palm Beach counties under legislation Rep. Robert Wexler will introduce this week. The extra cash enables companies to offer benefits to Miami-Dade members that their friends just across the county line can only dream about, such as free transportation to doctor's appointments.
By Christine Jordan Sexton
5/23/2008 © Florida Health News
TALLAHASSEE -- Florida’s health care agency quietly told HMOs last year that they could spend less money on health care services for the mentally ill than Florida law requires in counties that are part of the state’s Medicaid reform pilot project. AHCA took that action even though five months earlier, Gov. Charlie Crist vetoed a bill that would have lifted the requirement for all HMOs across the state – a bill the industry had lobbied hard for.
By Bill Hirschman and Carol Gentry
5/22/2008 © Florida Health News
It has been 3 ½ years since Floridians overwhelmingly passed Amendment 7, the “Patients’ Right to Know” about mistakes that occur in hospitals and disciplinary actions against doctors. Court appeals have delayed implementation of the amendment all this time, but that shouldn’t last much longer. Hospital attorneys say their clients need to get ready for a whole new way of doing business.
By Whitney Sessa
5/14/2008 © Florida Health News
First it was children’s jewelry, then pet toys. Now lead from China has been found in a patient’s dental work in Ohio. To make such an event less likely here, the Legislature on its final day in session May 2 made Florida the first state to require dental laboratories to tell their dentists and their patients where a product originated and the materials it contains.
By Christine Jordan Sexton
5/13/2008 © Florida Health News
TALLAHASSEE -- Some health care providers and advocates are mobilizing to warn mentally and physically disabled Medicaid clients about a new state requirement that could force them into HMOs. Those who work with severely disabled patients say a sudden shift of caregivers or drugs could be harmful. “It’s just not the way to treat these folks,” said Bob Sharpe, president and CEO of the Florida Council for Community Mental Health.
By Whitney Sessa
5/8/2008 © Florida Health News
GAINESVILLE -- When Erica Lipner-Bernstein paid $500 for her Gardasil vaccine, she couldn’t help but think of its “one less” commercials, which urge women to take the shots so they’ll be “one less” possible victim of cervical cancer. She also couldn’t help but wish it were “one less” bill she had to pay. Her family’s health insurer would cover treatment if she caught the cancer-causing human papillomavirus, but it doesn't pay to prevent transmission. Thousands of other Florida college students are in the same boat, and school health centers are beginning to act.
By Brittany Rajchel
Florida Health News
GAINESVILLE -- The University of Florida will cut its health sciences programs more than $14 million by eliminating some faculty and staff positions, clinical programs and research funding, according to the budget released Monday. In accordance with the new state budget, which eliminates $50 million in UF’s state funding, University President Bernie Machen ordered all colleges to cut spending by 6 percent. That includes the Office of Health Affairs and the colleges of Medicine, Nursing, Pharmacy, Public Health and Health Professions, Veterinary Medicine and Dentistry.
By Carol Gentry
5/6/2008 © Florida Health News
In the belief that one person can make a difference, Clearwater pharmacist Larry Golbom paid his own way to appear before an FDA advisory panel in Maryland on Monday to warn against approval of a new form of OxyContin. By the time he got home late Monday night, he had reason to hope he’d had an impact.
By Carol Gentry
5/5/2008 © Florida Health News
A white-coat crusader from Clearwater, pharmacist Larry Golbom, is scheduled to appear before an FDA advisory committee today in Gaithersburg, Md., to warn against allowing sale of a new form of the prescription painkiller OxyContin. Purdue Pharma says its new pills are safer than the old ones, but Golbom predicts, “Somebody will figure out a way to inhale this product or extract the active ingredient.”
By Christine Jordan Sexton
5/1/2008 © Florida Health News
TALLAHASSEE—Florida lawmakers are using the budget to quietly move thousands of additional Medicaid patients into HMOs, marking the second straight year in which the Legislature has used the end-of-session budget frenzy to make changes that could benefit WellCare Health Plans and other corporate HMOs. Tucked deep inside the 2008 budget is a requirement to shift patients out of MediPass, which pays a primary care doctor to act as the patient’s case manager, into a health plan if they live in one of 25 counties, including Miami-Dade and Hillsborough. They may remain in MediPass only if they request it.
By Christine Jordan Sexton
4/30/2008 © Florida Health News
TALLAHASSEE -- Florida lawmakers in recent years have touted HMOs as a way to hold down costs in the state’s Medicaid program. But few choose HMOs for their own coverage. Only 15 percent of legislators, who receive free health insurance for themselves and their families, have enrolled in HMOs, according to the Office of Legislative Services. Instead, the vast majority are enrolled in the state’s self-insured plan, a looser type of managed care that lets members go outside the network if they’re willing to make a larger co-payment. “My colleagues clearly are not treating everyday Floridians as well as they treat themselves,’’ said House Democratic Leader Dan Gelber.
By Carol Gentry
4/30/2008 © Florida Health News
It’s been observed that only the health care industry expects customers to make major purchases without first knowing the price, or even getting a ballpark estimate. Now a bill on its way to Gov. Charlie Crist would do something about that -- the Health Care Consumers Right to Information Act.
By Carol Gentry
4/30/2008 © Florida Health News
TAMPA – Sen. John McCain praised Florida Gov. Charlie Crist’s “Cover Florida” plan on Tuesday and said that as President he would encourage development of similar cost-cutting maneuvers. The Crist plan, now in negotiations between House leaders and the governor’s staff, would let Floridians buy scaled-down health policies for as little as $150 a month. In a 27-minute speech to an invited audience at H. Lee Moffitt Cancer Center, McCain debuted the major themes of a health-insurance program that could hardly be more different from those of either Democratic opponent. It would not attempt to cover the 47 million uninsured through any government program, but would try to enable more people to buy policies by making coverage less expensive.
By Christine Jordan Sexton
4/29/2008 © Florida Health News
TALLAHASSEE -- Florida's experiment with Medicaid managed care won't be expanded into Miami-Dade, Hillsborough or seven other counties anytime soon.
Rep. Aaron Bean, chair of the House Healthcare Council, told Florida Health News on Monday that during budget negotiations the Senate refused to accept the House's proposal to expand reform into nine additional counties by 2010.
By Carol Gentry
4/25/2008 © Florida Health News
Florida’s lawmakers shouldn’t accept free health insurance for themselves and their families while facing decisions on cutting coverage for others, some health policy analysts and consumer advocates say. “It doesn't look right," says Bill Newton of Florida Consumer Action Network. It looks "sneaky," says Michael Cannon of the Cato Institute, a conservative think tank in Washington, D.C., and may make them too willing to require added coverage on insurance plans, since it doesn't cost them anything.
By Christine Jordan Sexton
4/24/2008 © Florida Health News
TALLAHASSEE---While Florida lawmakers debate how to make health insurance more affordable for Floridians, it's not something they have to worry about for themselves or their own families.
Nearly all of the state’s 160 lawmakers have helped themselves to a perk of the job: Free health insurance, including dental. All but six have signed up for it, according to the Office of Legislative Services, which oversees spending. Nearly 80 percent also enrolled their spouses and children at no charge, records show.
4/23/2008 © Florida Health News
Most Florida Medicaid patients who will be affected by proposed cuts in their health coverage are either too young, too old, too sick or too poor to make a personal appeal to lawmakers in Tallahassee. So others are speaking out on their behalf.
One is Tampa speech therapist Enid Gildar, who worries that many of the children she treats will lose their Medicaid coverage. Others are executives from hospitals that treat the lion’s share of Medicaid patients.
On a trip to Tallahassee April 1, Gildar said, she urged lawmakers to take money from sports stadiums and road-building, to raise cigarette taxes – not make deep, painful cuts in programs for children and the disabled. Her arguments didn’t get much traction, she said.
By Christine Jordan Sexton
4/21/2008 © Florida Health News
TALLAHASSEE—Gov. Charlie Crist questions the Legislature’s move to cut $1 billion from the health care programs that serve the poor, elderly and disabled, urging lawmakers to borrow money from the state’s landmark settlement against big tobacco. In a tight year that has brought a $5 billion reduction in revenue, top Republican legislators agreed to spend $7.12 billion in general revenue on health and human services. Sen. Durell Peaden, R-Crestview, and Rep. Aaron Bean, R-Fernandina Beach, will lead the conferees.
By Susan Jaffe
4/18/2008 © Florida Health News
Last fall, Bob Schulbaum saw newspaper ads from private Medicare health plans offering great deals: $3,000 worth of over-the-counter drugs, and payment of more than $1,000 in Medicare Part B premiums*. But reading the fine print, Schulbaum discovered he was out of luck because he lives in Delray Beach; the benefits were not available in Palm Beach County. Health insurers have explained that because the government pays health plans thousands of dollars more to take care of a Medicare patient in Miami-Dade County than in its neighboring counties, the plans can afford to give extra benefits in Miami but not in Delray Beach.
And next year the disparity in payments is growing even larger. Plans in every other Florida county are getting a 3 or 4 percent raise, but they’ll get a bonanza in Miami-Dade.
By Christine Jordan Sexton
4/17/2008 © Florida Health News
TALLAHASSEE—House Health chief Aaron Bean said he will make changes to his insurance proposal after listening to concerns from Gov. Charlie Crist, state regulators and even members of his own party. One change: employers would no longer be able to require that workers buy health insurance as a condition of employment. Bean’s bill, CS/HB 7081, will be debated by the House today. Meanwhile, Crist continues a full-court press for his own plan, Cover Florida.
Bean, R-Fernandina Beach, wants to create a voluntary, virtual marketplace where employers who join could give their workers access to stripped-down health plans from insurance companies, HMOs or even providers such as dentists.
4/17/2008 © Florida Health News
Tampa-based WellCare Health Plans added Medicare members to its health plans at a 34-percent growth rate during the 2008 enrollment season, confounding Wall Street analysts who had thought it would shrink.
As of March 12, the end date for the report released this week by the Centers for Medicare and Medicaid Services, WellCare had added more than 54,000 Medicare members for 2008. That should add revenues of about $115 million, said Carl McDonald, managed-care analyst for Oppenheimer & Co.
By Christine Jordan Sexton
4/16/2008 © Florida Health News
Gov. Charlie Crist is expected to win approval for his Cover Florida plan from the Florida Senate today, a sign that the governor's continued push for his top legislative priority is working so far. Also on the agenda: certificate of need, mental-health parity and extension of Health Flex.
By Christine Jordan Sexton
4/9/2008 © Florida Health News
TALLAHASSEE – A Marianna couple, Stephanie Wise Adams and Jeff Adams, say they tried over and over to buy health insurance, but were turned away because of health risks. When Jeff Adams started feeling bad last year, he ignored his symptoms until he had to be rushed to the emergency room at Jackson Hospital in Marianna, they said. His gall bladder was so badly infected he had to have surgery and five days in the hospital. Now the couple, who are real estate agents, are paying off a bill negotiated down to $30,000.
4/8/2008 © Florida Health News
Personal information on thousands of Georgia Medicaid patients was accessible on the Internet for at least a week in late March because of a goof by a Web site developer, Tampa-based WellCare Health Plans acknowledged Monday.
By Susan Jaffe
4/7/2008 © Florida Health News
More definitely isn’t better when it comes to medical treatment, according to a groundbreaking study of Medicare patients released this morning. The Dartmouth Atlas of Health Care 2008 says too much treatment not only wastes money, but can lead to worse results. In some parts of Florida, it says, there appears to be substantial overtreatment caused by excessive numbers of doctors and hospital beds. The Fort Lauderdale and Sarasota areas were listed as highest in the nation for spending on outpatient care.
By Christine Jordan Sexton
4/4/2008 © Florida Health News
TALLAHASSEE - Florida lawmakers have scuttled an effort to expand the state’s controversial Medicaid reform pilot program for now. The program is already running in Broward and in Northeast Florida and House Republicans wanted to expand it into Monroe and Miami-Dade counties. But the House Policy and Budget Council on Thursday voted to delay the expansion into South Florida, as well as Pasco, Pinellas, Hardee, Hillsborough and Manatee and Polk counties, until 2010.&The Senate has not supported the expansion.
By Susan Jaffe
4/4/2008 © Florida Health News
WASHINGTON – Among a group of Winter Park internists who fill in for each other on weekends, three have left traditional medical practice in the past four months. One went to the VA, one to a hospital and the other stopped accepting insurance. But of those remaining, Dr. Cecil Wilson won’t quit without a fight. So Wilson came to Washington this week to persuade Congress not to cut payments to doctors under Medicare, which covers 75 percent of his patients.
Christine Jordan Sexton
4/3/2008 © Florida Health News
TALLAHASSEE – The legislative session opened last month with Gov. Charlie Crist’s ambitious agenda to expand access to affordable health care and deregulate the hospital system. But ever since, most of the attention has been on the pain of finding $3 billion in cuts to balance the budget. With half the session gone, little is clear except that nothing is safe from the budget ax – not even false teeth.
By Christine Jordan Sexton
4/2/2008 © Florida Health News
TALLAHASSEE -- While lawmakers are targeting dozens of health care programs for deep cuts or elimination, one controversial program begun by former Gov. Jeb Bush may be spared. Despite the Department of Health putting it on the chopping block, House Republicans have so far refused to cut any of the $2 million the state now provides for “crisis pregnancy” centers and a statewide hotline that pregnant women can call for advice. The program was begun at the urging of Gov. Jeb Bush, who is staunchly opposed to abortion.
By Carol Gentry, editor
3/31/2008 ©Florida Health News
Floridians give their hospitals scores that are 5 to 8 percentage points lower than the national average in all 10 categories on a patient-satisfaction survey now available at a federal Web site. The key question -- Would you recommend the hospital to friends and family? – drew affirmative answers from 61 percent of Floridians compared with 67 percent nationwide. A similar gap pops up in questions on cleanliness, noise, pain control and how well nurses and doctors communicate with patients.
By Carol Gentry
2/6/2008 © Florida Health News
WellCare Health Plans has added a new state Medicaid program to its client list by becoming one of two companies that will share in a $1.24 billion contract with Hawaii, according to a Web site operated by that state. UnitedHealth Group subsidiary EverCare, which specializes in managing health of the elderly and disabled, was the other winner. The contract, awarded through competitive bidding, runs through June 2011.
By Christine Jordan Sexton and Carol Gentry
2/4/2008 © Florida Health News
Florida Medicaid reform was ushered in with the promise that it would improve access to care for the poor, elderly and disabled. If they were enrolled in managed-care networks, the thinking went, they would have no trouble finding good doctors. That’s not how it worked out for David Reid, a 61-year-old Broward resident who was one of the first enrolled in the pilot program two years ago. He cannot see the doctors who were listed in the HMO’s directory, he said, and can’t get coverage for the prescriptions that work best for him.
By Christine Jordan Sexton
2/1/2008 © Florida Health News
TALLAHASSEE -- Tucked inside the $70-billion budget that Gov. Charlie Crist unveiled on Thursday is a controversial plan to eliminate the certificate-of-need process for the construction of new hospitals.
By Carol Gentry
1/30/2008 © Florida Health News
ST. PETERSBURG – Some doctors treat physical ailments. Others specialize in mental health. But patients don’t cooperate by splitting themselves into separate spheres. That’s why Health Integrated has struck it rich by taking on the most expensive patients that health plans enroll: Those who have a mix of chronic illnesses, such as low-back-pain or diabetes, and mental or behavioral health issues, such as drug abuse or depression.
By Carol Gentry and Christine Jordan
1/25/2008 © Florida Health News
TALLAHASSEE -- The administration of Gov. Charlie Crist says safeguards in its new prescription drug-card program should prevent diversion of the controlled drug Soma -- the No. 1 seller in the state-sponsored discount program -- to the black market. Spokesman Thomas Philpot said before any prescription is filled, it must be written by a doctor and verified by a pharmacist “It’s a commonly prescribed drug,” Philpot said. However, the drug is not one of the top 10 in sales of prescription drugs nationally, according to IMS Health, which compiles data on the pharmaceutical industry.
By Carol Gentry and Christine Jordan Sexton
1/24/2008 © Florida Health News
TALLAHASSEE – More than 20,000 uninsured and elderly Floridians have signed up for prescription-drug discount cards since the state-sponsored program began a month ago, Gov. Charlie Crist proudly told reporters Wednesday. The cards have saved users nearly $58,000 so far, a result he called “impressive.
03/28/08 © Florida Health News
TALLAHASSEE – The Florida Department of Health (DOH) has joined federal officials in investigating an outbreak of suspected selenium poisoning associated with use of a nutritional supplement sold as Total Body Formula. To date, 27 cases have been identified in Calhoun, Gulf, Lake and Washington counties, according to a department advisory issued Friday. The DOH advisory said the products may cause severe adverse reactions, including nausea, vomiting and diarrhea, joint pain and fatigue.
By Christine Jordan Sexton
03/28/08 © Florida Health News
TALLAHASSEE—-Ten additional counties—including heavily populated Miami-Dade-- would be included in Florida’s Medicaid reform initiative under a proposal released by House leaders on Thursday. The expansion is included in the $1 billion-plus cuts in health care spending proposed by House Healthcare Council Chairman Rep. Aaron Bean, R-Fernandina Beach.
By Susan Jaffe
3/21/2008 © Florida Health News
WASHINGTON – If some Floridians really want a better Medicare health plan, they might have to pack up and move to Miami – and soon. They have only until March 31 to switch before they’re locked into their coverage for 2008. Because of the way private Medicare health plans are designed and funded, the same insurance company can lure customers with appealing benefits and extra perks— worth hundreds of dollars—in Miami-Dade County, while charging more, or even dropping benefits entirely, from the same plan in neighboring Broward.
By Carol Gentry, editor
3/21/2008 © Florida Health News
A nurse anesthetist recently arrested in Miami was able to continue moving from one job to another for two years after the U.S. Army revoked his practice privileges in 2006 in connection with the infection of 15 patients with Hepatitis C, according to official records released Thursday by the state of Texas. Jon Dale Jones, 45, was able to get a Florida nursing license last August despite having his practice privileges revoked in March 2006 action by the Army and despite being found to be addicted to drugs in November 2006 while working at Georgetown University Hospital in Virginia, the records show.
By Christine Jordan Sexton
3/20/2008 © Florida Health News
TALLAHASSEE---The GOP-controlled Legislature continues to be divided over the future of Florida’s Medicaid program, setting the stage for a confrontation over the next few weeks. While the House of Representatives aims to expand Florida’s experiment with Medicaid managed care, a state Senate panel on Wednesday approved a bill that would exempt from the reform experiment for at least one year developmentally disabled people as well as children with persistent mental illness.
By Christine Jordan Sexton
3/19/2008 © Florida Health News
TALLAHASSEE -- A state Senate panel on Tuesday gave the first go-ahead to Gov. Charlie Crist’s ambitious proposal to lower the number of uninsured residents by making pared-back health coverage available to all who want it for $150 a month or less.
By Carol Gentry
3/14/2008 © Florida Health News
A nurse accused of infecting 15 patients with Hepatitis C at an army hospital in Texas in 2004 was able to keep working and move on to other states – including Florida -- because the Texas agency that licenses nurses in that state did not file charges against him, according to state health officials there. Records at the Texas Board of Nursing show that no disciplinary action was ever taken against the nurse anesthetist, Jon Dale Jones, who was found by a team of state and federal epidemiologists to be the source of infection. Bruce Holter, spokesman for the nursing board, said Friday afternoon that he will try to find out what happened, but rejected the suggestion that the board dropped the ball. "I can promise you that is not the case," he said.
By Nancy McVicar
3/13/2008 © Florida Health News
WEST PALM BEACH -- Visit the Taj Mahal and then get a hip replacement. Fly over a volcano, then undergo heart bypass surgery. Have that nip/tuck you’ve been wanting, then recuperate at a beach resort. n an era when 47 million Americans – 3.6 million in Florida – have no health insurance, the chance to save thousands on both necessary and elective surgeries is luring patients to exotic locales.
By Christine Jordan Sexton3/12/2008 © Florida Health News
TALLAHASSEE – Even though the Legislature has to trim $2.5 billion to balance the state budget, a House leader says he needs up to $8 million for a new program: a software system that lets Floridians shop for health insurance.
Rep. Aaron Bean, who chairs the House committee in charge of health and human services spending, said the system is one of the keys to the health care reform plan he will pursue this session. But he knows this plan is a hard sell.
By Christine Jordan Sexton
3/11/2008 © Florida Health News
TALLAHASSEE – What if the state created a Web site where consumers could shop for no-frills health insurance? The House Health Care Council, chaired by Rep. Aaron Bean, meets today to begin drafting such an electronic health insurance market.
By Christine Jordan Sexton and Carol Gentry
3/6/2008 © Florida Health News
TALLAHASSEE -- Overturning decades of secrecy over "peer review" records, the state Supreme Court on Thursday fully upheld a constitutional amendment that gives Floridians the right to know about doctors' and hospitals' mistakes. Amendment 7, which was passed by more than 81 percent of voters in 2004, gives patients a right to see "any records made or received in the course of business by a health care facility or provider relating to any adverse medical incident." The identities of patients are to be kept confidential. The 4-3 opinion stings the Florida Legislature by tossing out a bill it passed to limit the effects of Amendment 7.
By Christine Jordan Sexton
3/7/2008 © Florida Health News
TALLAHASSEE -- The chair and vice chair of the House Healthcare Council are split on whether Florida's Medicaid Reform pilot project, now being tested in five counties, should be expanded into Miami-Dade County over the objections of numerous skeptics. Committee Chair Aaron Bean, R-Fernandina Beach, has said he will be lead sponsor for the legislation, which is being pushed by Speaker Marco Rubio, R-Miami. But his vice chair, Juan Zapata, isn't on board.
By Carol Gentry, editor
3/6/2008 © Florida Health News
GAINESVILLE – A University of Florida professor hired to evaluate Florida’s Medicaid Reform project says there isn’t enough information yet to justify expanding it, which the House Speaker wants to do.
By Susan Jaffe
3/5/2008 © Florida Health News
WASHINGTON –AARP wants Congress to trim overly generous federal payments to private Medicare health plans, even if it means the seniors’ advocacy group might feel the pinch too. The group – 39 million members strong, including almost 3 million in Florida -- is in its third year of a partnership with UnitedHealthcare, which operates two Medicare Advantage health plans, SecureHorizons and Evercare. In return for endorsing the plans, AARP receives a commission each time a Medicare beneficiary enrolls.
By Carol Gentry and Christine Jordan Sexton
2/29/2008 © Florida Health News
MIAMI -- House Speaker Marco Rubio’s announcement this week that he wants to expand Medicaid Reform to Miami-Dade cast a pall over more than 100 doctors and patient advocates who met Thursday to call for changes in the project. Among the speakers at the seminar, “Exploring Alternatives to Medicaid Reform,” were a former Florida Medicaid director, Bob Sharpe, and Doug Cook, former chief of the Agency for Health Care Administration.
By Christine Jordan Sexton
2/28/2008 © Florida Health News
TALLAHASSEE – Legislators, who passed a law last year intended to make it easier to get flu shots, are steamed at the Florida Department of Health because it didn't get the law implemented in time for the current flu season. The law, which was opposed by the state's doctors, allows pharmacists to administer the shots within certain safeguards. But the state medical boards, which were supposed to collaborate on the educational requirements, dragged their feet, according to the state pharmacy association.
By Susan Jaffe
2/27/2008 © Florida Health News
 WASHINGTON -- Simple reminders aren’t enough to persuade some people to take care of themselves. So Humana Inc., Florida’s most popular Medicare health plan, is trying something different – a reward for being good. How about a gift card for Macy’s, CVS, Lowe’s or Borders?
By Carol Gentry, Editor
2/26/2008 © Florida Health News
Both of Florida’s top-selling commercial health insurers say they like Gov. Charlie Crist’s proposal for covering more of Florida’s uninsured citizens. UnitedHealthcare intends to bid for the business if Crist’s plan for low-cost, stripped-down coverage still looks good after it goes through the legislative process, said John Matthews, Southeastern director of public policy and public affairs. Blue Cross and Blue Shield of Florida is also bullish on the “Cover Florida Plan,” said Randy Kammer, vice president of regulatory affairs and public policy.
By Christine Jordan Sexton
2/20/2008 © Florida Health News
TALLAHASSEE -- Saying he has a “sympathetic heart,” Gov. Charlie Crist unveiled a health care agenda Tuesday that aims to find all of Florida’s uninsured residents and offer them the opportunity to buy a health insurance policy for $150 or less a month.Crist’s plan would allow insurance companies to sell policies with pared-back benefits but require them to sell to all comers – including those who are at higher risk for illness.
By Christine Jordan Sexton
2/18/2008 © Florida Health News
TALLAHASSEE -- Gov. Charlie Crist plans to offer a health proposal Tuesday that would lift some regulations on health insurance – abolish some so-called “mandates” – so that carriers would have an incentive to cover more of the uninsured.
Crist also wants to expand access to dentists for the poor and uninsured by boosting pay in health department dental clinics and loosening licensure restrictions for retired dentists, according to staff at the governor’s office and in industry groups involved in negotiations.
By Susan Jaffe
2/15/2008 © Florida Health News
WASHINGTON – Medicare officials have ordered Health Net, Inc., one of the largest publicly traded health insurers in the nation, to stop marketing its “Health Net Orange” prescription drug plans. According to an obscure notice on a government Web site, enrollment is frozen because of problems with processing applications and misinformation in letters to members about 2008 coverage. The plans have 379,000 members, including 41,000 in Florida.
By Carol Gentr
2/14/2008 © Florida Health News;
Even though it’s burdened by an ongoing fraud investigation, WellCare Health Plans Inc. of Tampa has shown “extraordinary” growth in its nationwide Medicare health plan enrollment this selling season, according to Oppenheimer & Co. Humana, too, is growing.
By Christine Jordan Sexton and Carol Gentry
2/13/2008&© Florida Health News
TALLAHASSEE -- Holly Benson, in line to become Florida’s top health regulator, says she’s excited about helping Gov. Charlie Crist find ways to expand coverage to millions of uninsured Floridians. As Secretary of the Agency for Health Care Administration, Benson will be chief cheerleader for the governor’s upcoming proposal to the Legislature on how to trim the ranks of the uninsured.
By Carol Gentry
2/7/2008 ©Florida Health News
ST. PETERSBURG – The Medicare Advantage insurance plan with the funny name – Any, Any, Any – stampeding back onto the playing field after a year of suspension by state and federal regulators.
By Susan Jaffe
7/10/2008 © Florida Health News WASHINGTON, D. C. – Florida Sen. Mel Martinez was among nine Republicans who dropped their earlier opposition to sweeping Medicare reform legislation Wednesday, leading the Senate to adopt it by unanimous consent. The bill reverses a steep pay cut to doctors who treat Medicare patients, taking some money from private health plans. AARP and physician groups lobbied Martinez heavily, but the decisive moment in breaking the Republican filibuster was the unexpected return of Sen. Edward Kennedy.
By Alan Snel
7/9/2008 © Florida Health News
TAMPA -- When orthopedic surgeon Bob Nucci bought controlling interest in the Tampa Bay Storm last year, he acquired an unusual vehicle to market his practice. He’s spent $250,000 on billboards around Tampa Bay that simultaneously promote both the Arena Football League team and the Nucci Spine Institute.
By Susan Jaffe
7/11/2008 © Florida Health News
WASHINGTON, D. C. – The Medicare reform bill that would reverse doctors’ pay cut would also crack down on a type of health plan that has drawn numerous complaints. The private fee-for-service plan, the highest-paid and fastest-growing product in the Medicare Advantage program, would have to sign up doctors and hospitals for their members to use. Under current law, there is no such requirement -- as Paul and Fran Kujda of Orlando learned the hard way.
By Susan Jaffe
7/10/2008 © Florida Health News
WASHINGTON, D. C. – Florida Sen. Mel Martinez was among nine Republicans who dropped their earlier opposition to sweeping Medicare reform legislation Wednesday, leading the Senate to adopt it by unanimous consent. The bill reverses a steep pay cut to doctors who treat Medicare patients, taking some money from private health plans. AARP and physician groups lobbied Martinez heavily, but the decisive moment in breaking the Republican filibuster was the unexpected return of Sen. Edward Kennedy.
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