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Feds Reject Florida Medicaid Copay Plan
February 12, 2012
Taking aim at a controversial piece of Florida’s Medicaid overhaul, federal health officials this week rejected hitting beneficiaries with $10 monthly premiums and charges for some emergency-room visits.
The federal Medicaid agency, in a letter dated Thursday, notified the state that the proposals violated federal requirements that are designed, at least in part, to shield poor people from additional costs.
Democratic lawmakers and advocates for Medicaid beneficiaries, such as the group Florida CHAIN, blasted the proposals last year when the Republican-controlled Legislature included them in a massive plan to revamp Medicaid.
Florida CHAIN released a statement Saturday describing the proposals as “too extreme and too dangerous to be given serious consideration.”
“Congress already allows states to require Medicaid recipients to contribute to their care, but there are limits on what states can charge the poorest because they can afford so little,” the advocacy group said. “Legislative leaders knew that but were unconcerned, repeatedly insisting that they had provided ‘a hundred different reasons’ for the federal government to approve their request.”
While controversial, the proposed charges were a relatively small part of Florida’s move to overhaul Medicaid. The key part of the overhaul would eventually shift almost all beneficiaries into managed-care plans — an idea that remains under federal review.
Republican leaders argue the overhaul is needed to control costs and to improve fragmented care in the Medicaid system. Critics, however, have long contended that the changes could hurt beneficiaries.
One of the proposals rejected this week by the federal Centers for Medicare & Medicaid Services would have required most beneficiaries enrolled in managed-care plans to pay $10 monthly premiums.
In the submitting the proposal to federal officials in August, the state Agency for Health Care Administration said it was part of a legislative effort to ensure that beneficiaries are “active participants in the program.”
“The Florida Legislature intended that eligibility for Medicaid include certain personal responsibilities on the part of recipients,” AHCA said in the proposal. “The new law includes provisions on participation in activities to promote healthy behaviors and modest financial participation in the program.”
The other rejected proposal would have imposed $100 co-payments on beneficiaries if they go to emergency rooms for non-emergency care. Lawmakers hoped the change would reduce costly emergency-room visits for care that could be provided in places such as doctors’ office or clinics.
In Thursday’s letter, the federal Medicaid agency said the proposed $100 charges were higher than allowed in federal law. But it also indicated concerns about Medicaid beneficiaries unnecessarily using emergency rooms.
“CMS shares the state’s goal of promoting cost-effective use of hospital emergency department services, and we will be happy to work with you to consider alternative approaches to meeting this goal,” the letter said.
By The News Service of Florida
Comments
10 Responses to “Feds Reject Florida Medicaid Copay Plan”
“Progressive”, in my years I have come to associate this term with people who believe the world owes them an existance. They tend to shun hard work to live at others’ expense. They demand their “rights’ to everything except responsibility for their actions. They always blame someone other than themselves when things go wrong. They believe only they are smart enough to
control the government and everyone that disagrees with them are stupid and are not “enlightened”.
Huh…your comment is totally false.
Look at those countries with universal healthcare…their health care stinks.
If you think their healthcare plan is so great…maybe you should move there and see if you enjoy the lowclass health care that you will receive.
The pay is so low in this area for many people that even if you work you can’t afford health insurance.
Some people are so ignorant. Not everyone on Medicaid is a deadbeat and jobless. I, for example have a job and pay for my health insurance. My ex husband lost his job, therefore, not being able to provide health insurance for our children . Now before you bible belts hash at me for being divorced, I’d be in the same situation if we were still married.
I was going to add my children to the insurance at my job, but the bi weekly premium was going to be $700. The average person can’t afford that. I applied for Medicaid for only my children but was denied and given a share of cost. Each child’s medical expenses would have to be $1900 a month before Medicaid would kick in so basically my children still have no health care coverage. Every day I pray they don’t get sick. Thankfully, my ex has another job and their insurance will start in April.
With that being said, don’t assume for one second that every individual is a dead beat or doesn’t want to provide for themselves or their kids.
I’m all for copayments and monthly premium if they are affordable and/or based on income. Too many people, whether self pay, on Medicaid, or insurance take advantage of the ER. If I got to ER on my BCBS and it’s not a true emergency then I get no discount and have to pay for it all out of pocket. You better believe I will be seeing my primary care vs. the ER when the time comes.
Have some compassion. I know it doesn’t grow on trees, but it’s real easy to acquire.
Universal health care is definitely NOT the answer!!!!!!!!!!!!!
Better put a little more research into that idea.
Know many on medicaid that say they would not sit in doctors office
when they can get care faster at ER. They ALWAYS go to the ER
first for every ailment.
Universal healthcare is the answer , its too bad we can’t elect someone progressive enough to get it done like other first world countries. No reason we should constantly fall behind
If the girls would STOP spitting our kid after kid and get an education and find work things would be a lot better. That’s the problem with government assistance you can have as many kids as you want and your benefits go up each time. While the state takes their sweet sweet time finding the father’s or mother’s.
wonder: one way to solve the problem. vote republican
The states needs to make all these young 20 and 30 year old people get out and get a job. People that work all their life get layed off have to show proof they are looking for a job to draw money they have paid in. Why are these people that do not work get free health care when I have to work to pay for mine. They should be made to show proof they are out LOOKING FOR A JOB. I hope this passes maybe it will help lower the er copay on everyone that has to work for insurance. It will also keep down things like going to er for cold etc. for free.