Florida passes Medicaid HMO plan with special nursing home provisions

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The Florida Legislature has approved a bill to move three million Medicaid enrollees into a managed care program, making it one of the biggest states to do so.

The bill, a compromise between Florida's House and Senate, now awaits approval by the federal government. If approved, the program change would go into effect in July 2012, The New York Times reports. Under the bill, Florida would determine how much to spend on Medicaid each year and share profits with the managed care companies if they exceed 5%, the newspaper reported. The state and the managed care company would work together to determine which services are covered, putting an end to the fee-for-service system.

The bill has a special provision for nursing home patients, who also will be transferred into managed care. Payments would go straight to nursing homes while bypassing the managed care companies. Money would not be deducted for administrative fees. Instead, savings would be achieved by shifting patients to home- and community-based programs. The managed care program would exempt disabled individuals.