Bush signs Medicaid revision

Associated Press
Published June 4, 2005

JACKSONVILLE - Trueman Hill says before he went on Medicaid four years ago he was barely able to make it to the end of his driveway before becoming winded.

The 59-year-old farmer was overweight and had a heart condition, high blood pressure and diabetes that was endangering his legs.

But Medicaid hooked him up with nurse Marie Howard, who helps him monitor his condition and medications and guided him in losing 60 of his 310 pounds. His diabetes and blood pressure are under control and his mobility and stamina improved.

Gov. Jeb Bush cited Hill as an example of how tailoring a plan to fit a patient's needs can lead to success. Bush signed a bill Friday that is designed to make the Medicaid program for the state's poor and elderly more like private managed care.

"Medicaid is a vital safety net for Florida's most vulnerable, and it's time we transformed the program to reflect the needs of patients, rather than the dictates of government," Bush said, noting the state has 2.2-million low-income, elderly and disabled residents on Medicaid.

The new law allows the state to move forward in designing a test project that would first be tried in two counties, Duval and Broward.

The measure would shift the way Medicaid patients get care, from a system where they go to a doctor or hospital that gets reimbursed to one where a managed care network, such as a health maintenance organization, takes charge. The government would pay the HMO or some other provider network to manage a patient's care, and the network would largely decide how to do it.

The state must first get approval from the federal government, and when officials have a final proposal to submit to Washington, they will need additional approval from the Legislature. The federal government pays about half the cost of Medicaid.

Alan Levine, secretary of the Agency for Health Care Administration, said he hopes to have a detailed plan of the changes by this fall.