Herald-Tribune

By: Editorial Staff

Florida state is spending $19.8 million to pay over the costs of attorneys involved in both of the sides of the lawsuit against the state for its improper Medicaid program for children. This is so because the state – for ten years – did not assess the issues that were brought up regarding this in the federal court.

The survey done by the Georgetown University’s Center for Children and Families provided data regarding the low reimbursement rates and the issues that have come up with the managed-care companies in referring to doctors and getting the necessary equipment to deliver proper care to children.

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Furthermore, a recent survey of pediatricians suggests that the managed care programs administering Medicaid coverage for kids are falling short in other areas. (Those plans assumed coverage for most Florida children in the program beginning in the fall of 2014.) The survey, conducted by the Georgetown University Health Policy Institute’s Center for Children and Families, pointed to consensus concerns.

Since the 131 providers who participated in the survey represented only a 6 percent response rate, the Georgetown analysts said the findings could not be “generalized.” Nevertheless, low reimbursement rates were cited as barriers to access, and two-thirds of the respondents reported an increase in patients who had been reassigned to a new managed-care plan or doctor without their knowledge; that practice is unacceptable. Local physicians who treat Medicaid patients say they encounter difficulties with the managed-care companies in making referrals to specialists or even obtaining basic medical equipment for kids.

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