Months after the state of Florida submitted its plans to privatize most of its Medicaid program, the federal government is still asking the state to explain the feasibility of those plans.
The News Service of Florida is reporting that the federal government sent a list of questions to the state regarding its plans to move most of its Medicaid recipients to privately-managed care plans. The state must garner approval from a federal agency before moving forward with its plans.
According to the News Service:
The federal Centers for Medicare & Medicaid Services sent a list of questions in January, more than five months after Florida submitted proposals to shift hundreds of thousands of beneficiaries into HMOs and other managed-care plans.
Questions touched on a wide range of issues, including safeguards that the state will put in place as it contracts with HMOs.
Already, the federal government has shot down the state’s plans to charge all Medicaid beneficiaries $10 a month for the program, as well as a request to charge a $100 copayment for receiving non-emergency medical care in a hospital. Feds told state officials that they could not impose premiums on families whose income is “at or below 150 percent” of the federal poverty level.
The federal health agency also denied Florida’s request to phase in a medical loss ratio (MLR) requirement for health insurance companies. MLRs are used to set a standard for the amount of money collected through premiums that health insurance companies must spend on actual services, as opposed to administration. In this case, insurance companies in Florida will be required by federal law to spend 80 percent of the money they collect on health services and a maximum of 20 percent on administration.
The lack of approval from the federal government has been a source of frustration for members of the GOP-led Florida Legislature. Gov. Rick Scott and Republican lawmakers in the state have argued that Florida’s Medicaid spending is the source of the state’s budgetary problems.
State Sen. Joe Negron, R-Palm City, even introduced a memorial (which failed to go up for a final vote on the Senate floor) urging the federal government to approve the state’s Medicaid overhaul plans.
The feds currently do not have a set date for when they will approve or strike down the state’s plans. However, the News Service reports that the state health agency negotiating with the feds “expects to release what is known as an ‘invitation to negotiate’ for the long-term care portion by July 1.”