Breaking: Medicaid details emerge

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Florida senators are ready to take up a long-awaited Medicaid overhaul that would start enrolling beneficiaries in managed-care plans in 2013 and provide legal protections for doctors who treat Medicaid patients, reports Jim Saunders of the News Service of Florida.

House and Senate negotiators hammered out the agreement in private, and it is expected to be presented to the full Senate Thursday afternoon. A copy of the bill was not publicly available, but it was outlined in a document presented earlier Thursday to Senate Democrats.

As has been discussed for months, almost all Medicaid beneficiaries will be required to enroll in HMOs or provider-service networks — another type of managed care — in the coming years.

The state would be carved into 11 regions in which managed-care plans would compete for contracts, according to the document. That is more than the eight regions that the House wanted, but less than the 19 that senators proposed.

Enrollment for seniors who need long-term care would start in October 2013, and enrollment for the broader Medicaid population — such as women and children — would start a year later, according to the document.

It was not immediately clear from the document whether people with developmental disabilities would eventually be required to enroll in managed-care plans, or whether a system known as the iBudget would be used.

The bill will not include a ?edical-loss ratio,?which would set a minimum percentage of money that managed-care plans would have to spend on providing care to beneficiaries. Instead it would require HMOs to share with the state Medicaid profits of more than 5 percent.

That decision comes despite a letter from the federal government last week that indicated Washington will require a medical-loss ratio. Federal officials will have to sign off on the Medicaid overhaul.

The bill also will try to make Medicaid more appealing to doctors, in part, by placing limits on malpractice lawsuits involving Medicaid beneficiaries. Non-economic damages in such cases would be capped at $300,000, with any individual doctor? liability limited to $200,000.

Peter Schorsch is the President of Extensive Enterprises and is the publisher of some of Florida’s most influential new media websites, including SaintPetersBlog.com, FloridaPolitics.com, ContextFlorida.com, and Sunburn, the morning read of what’s hot in Florida politics. SaintPetersBlog has for three years running been ranked by the Washington Post as the best state-based blog in Florida. In addition to his publishing efforts, Peter is a political consultant to several of the state’s largest governmental affairs and public relations firms. Peter lives in St. Petersburg with his wife, Michelle, and their daughter, Ella.