Democratic U.S. Sen. Bill Nelson Tuesday called on federal health officials “to exercise oversight and enforcement authority to protect more than 13,000 Florida children with special needs,” who he says were wrongly taken out of the state’s specialized care program.
The Department of Health, however, has refuted a CNN report that spurred Nelson’s concern, saying it “demonstrates a misunderstanding of Florida’s Medicaid system, the health insurance industry and the ethical standards of the State of Florida.”
In a letter to U.S. Health and Human Services Secretary Tom Price, which was co-signed by Democratic Congresswoman Kathy Castor of Tampa, Nelson said “the state has still not notified all of the families whose children were improperly removed from the program,” known as Children’s Medical Services.
That’s “despite a Florida judge’s ruling two years ago that required the state to stop using a new screening tool that declared thousands of kids ineligible,” he said.
CNN reported this month that “in the spring and summer of 2015, the state switched more than 13,000 children out of Children’s Medical Services, a part of Florida Medicaid. Children on this plan have serious health problems including birth defects, heart disease, diabetes and blindness.
“The state moved the children to other Medicaid insurance plans that don’t specialize in caring for very sick children,” CNN’s report added.
The Health Department issued its own takedown of that story, saying in part that a “new screening process for CMS eligibility has been in place since January 2016, which was developed by working collaboratively with the CMS medical providers to make sure all children who require the specialized care provided by CMS are eligible for the plan.”
The department added: “It is completely inaccurate for CNN to assert that Florida health officials made decisions based on politics. This claim is 100 percent false. The department remains committed and focused on providing high quality healthcare to Florida’s medically complex children.”
The Nelson/Castor letter says “we have seen over the years that the State of Florida has evaded its legal responsibilities in many instances to ensure access to care for the children of Florida,” adding that “we urge HHS to exercise its oversight and enforcement authority to ensure that children in Florida are appropriately enrolled in the plan that best fits their needs.
“At a minimum, every family affected should be notified immediately and given an opportunity to have their child reevaluated for FLCMS coverage. Furthermore, we urge you to contact the Florida Department of Health and ensure that the 13,074 children who lost access to FLCMS receive the care they deserve.”
The full letter is below.