Clock ticking on Medicaid overhaul sell to Feds

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Needing federal approval to overhaul the Medicaid program, Florida health officials have less than three months to develop a detailed plan to sell to the Obama administration.

The state Agency for Health Care Administration faces an Aug. 1 deadline for submitting proposals to the federal government to try to transform Medicaid into a managed-care system.

Also, before the proposal is submitted, AHCA will have to hold public meetings in 11 regions of the state and allow additional time for public comments to be submitted.

?bviously, we know we have a tight time frame,? AHCA Secretary Elizabeth Dudek said Monday after a meeting of the state? Medicaid and Public Assistance Fraud Strike Force.

State Chief Financial Officer Jeff Atwater, the chairman of the strike force, asked during the meeting about the complexity of seeking federal approval, typically known as getting a federal ?aiver.? But he said lawmakers needed to move quickly, as they try to revamp a $20 billion Medicaid program that many criticize for spiraling costs.

? think it is aggressive,? said Atwater, a former Senate president. ?ut I don? think our legislators had a choice.?

The Republican-dominated Legislature approved a two-bill Medicaid overhaul on the May 6 final day of the legislative session. Gov. Rick Scott is expected to sign the bills, though he has not formally received them yet.

Under the legislation, AHCA in July 2012 would start moving forward with a mandatory managed-care program for seniors who need long-term care — and finish by October 2013. It would start carrying out mandatory managed care for a broader Medicaid population in January 2013 and finish by October 2014.

With some recently passed bills slated to take effect as soon as July 1, AHCA is not alone in facing tight deadlines. For example, Department of Children and Families Secretary David Wilkins said Monday a bill requiring drug testing for welfare recipients will take effect July 1.

?e?e got a large team trying to put that together right now,? Wilkins said.

But the wildcard in the Medicaid issue is when — and whether — the federal government will allow Florida to carry out the overhaul. Opponents argue that parts of the plan will get vetoed by the federal government, such as requirements that beneficiaries pay $10 a month in premiums and $100 co-payments if they seek non-emergency care in hospital emergency rooms.

Florida CHAIN, a group that advocates for Medicaid beneficiaries, said in an analysis on its website that such provisions ?onflict with basic federal laws.?

The bills provide the broad outline of how lawmakers want to revamp Medicaid. But it is up to AHCA to develop waiver proposals that include myriad details to be reviewed by the federal Centers for Medicare and Medicaid Services.

Florida already has federal waivers that address different parts of the Medicaid program. Roberta Bradford, AHCA? deputy secretary for Medicaid, told the strike force Monday that agency officials are evaluating possible options for seeking approval of the overhaul.

The state last year requested federal approval to continue a pilot managed-care program in five counties. But with the pilot scheduled to expire June 30, federal officials still have not signed off on continuing that waiver.

Peter Schorsch is the President of Extensive Enterprises and is the publisher of some of Florida’s most influential new media websites, including,,, 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.