Medicaid pilot projects get bad internal review
Associated PressPeople are having trouble getting care under the plan proposed by Jeb Bush, a report says.
Published October 18, 2007
TALLAHASSEE - Florida's move to shift Medicaid patients into managed care plans has made it hard for some patients to get access to care, and a planned expansion of the reform should be delayed until the problems are fixed, a review by the state Medicaid agency has found.
The review of the change in Medicaid procedures, released Tuesday by the Agency for Health Care Administration's inspector general, is the first evaluation of how smoothly - or not - the shift is going in Florida.
And it's significant because the finding of problems with how patients get care under the Medicaid system comes from within the agency, which has been a vocal booster of the plan since it was proposed by then-Gov. Jeb Bush.
The shift of Medicaid patients into private managed care plans is being tested in pilot projects in the Jacksonville and Fort Lauderdale areas.
But inspector general Linda Keen said some Medicaid recipients in the trial runs have had trouble choosing their health plan or their doctor.
The report also said it can't be determined yet if the program is improving those people's care, as was promised, or is saving money, also a goal of the proposal.
Expansion of the program to statewide implementation shouldn't proceed until improvements are made and those questions are answered, the report said.
Agency for Health Care Administration Secretary Andrew Agwunobi, who ordered the investigation into the reform plan's progress and who was appointed by Bush's successor, Gov. Charlie Crist, didn't comment directly on whether the agency would push forward with the plan, but praised the review.
"I believe that it represents the type of independent and objective analysis I was seeking," Agwunobi said in a statement. "Our duty as an agency is to now monitor the progress of the project, take into account input from all sources, and provide that same strong leadership in advising Gov. Crist and the Legislature on future decisions regarding reform."
Advocates for patients have generally praised the report, saying it confirmed what they warned before the experiment began a year ago - that some people would have trouble getting needed care paid for under the new plan.
The report said many of the plans it checked made it nearly impossible, or at least difficult, to find out which drugs were covered under the plan, and doctors lists were wrought with errors making it hard for patients to determine whether the particular plan would be right for them.
The inspector general also faulted the program for not having a system for people to complain about problems.