Extension for Medicaid privatization scheme in Florida under CMS review

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The Centers for Medicare & Medicaid Services recently agreed to review a research and demonstration waiver for a controversial Medicaid privatization scheme in five Florida counties, but it has not granted the state authority to expand the program statewide.

The Florida program was designed to reduce Medicaid costs by setting up private managed care schemes in five counties—Baker, Broward, Clay, Duval and Nassau—but the program has been somewhat controversial. In its letter to the state's Agency for Health Care Administration, CMS said it would review the state's request to extend the program by three years.

CMS, however, acknowledged that it had some “concerns” over the program, and opted to review the request under section 1115a of the Social Security Act, which allows the federal agency to request changes to the waiver. It also allows the agency an open-ended timeline with which to review the waiver. The state had requested a review under section 1115e of the Act, which applies to statewide demonstration programs.

Opponents of the program see this as a minor victory, noting that CMS has acknowledged concerns with the program and refused to allow it to spread beyond the five counties. Many Floridians participating in the trial reported being unable to visit a doctor, let alone receive adequate treatments, and as many as 25% of participating physicians were forced to drop out due to the bureaucracy of the private companies running the program. Additionally, some companies involved in the program had admitted to stealing millions of dollars from the state. (McKnight's, 6/4/10)