Gov. Rick Scott said Tuesday he has little interest in a fellow Republican’s plan that guts the state’s Department of Health, while also closing Lantana’s A.G. Holley Hospital.

Even before he was sworn-in, Scott’s transition advisers gave him a blistering review of the DOH, dismissing it as a wasteful bureaucratic agency ripe for change. Legislation by Rep. Matt Hudson, R-Naples, would decentralize most of the department’s services, and give county commissions authority to run county health departments.

So far, though, the proposal looks like a no-sale with Scott.

“I’m trying to figure out what it does,” Scott said.  “Does it improve quality? Does it reduce costs? Does it improve service? If if it doesn’t do something that makes the lives of Florida’s citizens better, why would we think about doing that?

“I haven’t seen anything — the way it’s been explained to me — in the bill that does any of those things,” Scott concluded.

Several public health advocates blasted Hudson’s proposal Monday when it cleared a House subcommittee.

The measure would largely get the state out of the business of running county health departments, turning them over to county commissions to operate. State and federal dollars would be steered in block grants to county governments, based on population, which would gain more control over how the dollars are spent.

About 12,000 state Health Department jobs would be slashed, although supporters of the move said many would convert to county positions. A.G. Holley’s closure, seen as another cost-saving move, would shutter Florida’s last remaining tuberculosis hospital, most likely by January.

The House’s push to meet Gov. Rick Scott’s demand for $1 billion more in school spending came into sharper focus Tuesday, as a budget panel unveiled about $300 million in health and humans services cuts aimed at freeing-up dollars for classrooms.

Emergency room visits would be limited to a dozen per-year for adults in the state’s Medicaid program, while chiropractic and podiatry services for some 34,000 mostly low-income and elderly Floridians would be eliminated under the House’s approach, which cleared the Health Care budget subcommittee on a 10-4 vote, with Democrats opposed.

Chairman Matt Hudson, R-Naples, said House Speaker Dean Cannon, R-Winter Park, had hinted that cuts in many programs would be needed to meet a goal of pumping more money into public schools this election year — blunting a $1.3 billion cut schools weathered last year.

“He certainly is going to make sure we spend money on people over things,” Hudson said. “And students are certainly a priority for the speaker.

“ I would anticipate that when the other budgets roll out, you’ll see they’re a collective package in that we will be very aggressive in making sure that not only are we meeting the health care needs, but we are meeting the education needs.”

Democrats, however, urged that Republican leaders find more deft ways to make budget reductions. Eliminating some routine health coverage completely for some of the frailest Floridians can result in the state absorbing costs elsewhere.

Several college students who said they received $1,200-a-month from the state as part of the Department of Children & Families’ ‘road-to-independence’ program for youngsters who have been in foster care, argued against another House plan to cut the program’s maximum eligibility age to 21 — down from the current age 23.

The change would save about $10 million, but eliminate 657 people from the program.

Those who testified Tuesday before the committee recalled childhoods spent cycling through foster homes and schools before setting themselves on a path to college and a professional future only with the help of mentoring and the program’s cash.

“It’d be absolutely devastating to end these services at age 21, just when people are getting their feet under them,” said Andrea Cowart, 22, of Dunedin, who attends St. Petersburg College.

Cowart said she was in foster care for almost seven years and attended 10 to 15 schools. She had dropped out of high school her freshman year and had a child at age 17. Motherhood, she said, changed her course — but only with the financial help from the state program.

“It made what was impossible, possible to me,” she said.

Florida Insurance Commissioner Kevin McCarty’s approval Monday of a sharp increase in worker’s compensation insurance rates paid by businesses is rekindling a fight between potent power bases of the ruling Florida Republican Party.

McCarty’s 8.9 percent rate hike drew scorn immediately from the business lobby, Associated Industries of Florida, which blamed higher health care costs on doctors pocketing extra money from repackaging prescription drugs they give worker’s comp patients.

“Almost one third of this rate increase is due to the ever-expanding practice of physicians dispensing repackaged drugs at prices exponentially higher than the statute allows pharmacies to charge for the same drugs,” said Jose Gonzalez, an AIF vice-president.

 ”Associated Industries of Florida will diligently seek the Legislature’s intervention to close this loophole during the 2012 session and allow Florida employers to use those millions of dollars to create new jobs rather than line the pockets of those who unfairly manipulate the system for their own gain,” Gonzalez said.

Over the past two years, Florida business groups have been scuffling with the Florida Medical Association, Florida Orthopedic Society and the American Federation of State, County & Municipal Employees (AFSCME), a Democratic power base, over the prescription repackaging issue.

Last year, lawmakers approved a measure backed by then-Chief Financial Officer Alex Sink that would have imposed new restrictions on doctors’ repackaging, lowering costs to the state and private companies. Sink, who lost to Republican Rick Scott in last fall’s governor’s race, was among those saying the change would have saved private companies $34 million in worker’s comp costs.

But then-Gov. Charlie Crist vetoed the measure.

Among those supporting Crist’s veto in June 2010 was Automated Healthcare Solutions, a Miramar company headed by a pair of doctors, Paul Zimmerman and Gerald Glass, who later that summer gave more than $1 million to political spending committees headed by the Legislature’s then-incoming leaders, Senate President Mike Haridopolos and House Speaker Dean Cannon.

The company provides software that helps doctors dispense and manage patient prescriptions, a profitable sidelight for many doctors. Because the legislation vetoed by Crist would have imposed new restrictions on doctors’ repackaging,  it also threatened Automated Healthcare’s services.

Zimmerman, the company’s CEO, says in a statement on the company’s website that its services are designed to “enhance revenue production by allowing physicians to retain profits.”

Haridopolos and Cannon last year used the money funneled from the doctors primarily to help then-Attorney General Bill McCollum in his losing Republican primary fight with Scott.

But with McCollum out of the picture, the doctors quickly pivoted following the campaign – pouring $735,000 into the Florida Republican Party and another $145,000 to Scott’s spending committee – in an attempt to make nice with the new GOP nominee, who is now a resident of the Governor’s Mansion.

And the doctors are still giving. While the business groups looking to cut worker’s comp costs aren’t shy about giving to the ruling state GOP, Automated Healthcare Solutions also has donated $203,500 to the party so far this year, records show, as it becomes more apparent another effort to rein-in repackaging is coming. 

 

Without waiting for President Obama’s administration to appeal lower court rulings, Florida Attorney General Pam Bondi and 25 other states are asking the U.S. Supreme Court to decide whether the federal health care law is unconstitutional.

Florida led the challenge against the Obama administration, arguing that its requirement that most Americans purchase health insurance – also known as the “individual mandate” – is unconstitutional.

Last month, the 11th Circuit Court of Appeals in Atlanta ruled that the individual mandate is unconstitutional but upheld the remainder of the sweeping health care law, including a dramatic expansion of Medicaid.

But even Obama’s attorneys believe that much of the law relies on the requirement that individuals purchase health insurance.

Although several other cases are working their way through the courts, attorneys on both sides believe that a U.S. Supreme Court decision in Florida’s multi-state case will ultimately decide the matter.

Bondi’s lawyers argued that the Patient Protection and Affordable Care Act forces individuals to engage in commerce and is an imposition on states because of increased Medicaid costs which they cannot avoid.

“Both features of the Act raise constitutional issues that go to the heart of our system of limited government and the Constitution‘s division of authority between the federal government and the States. Of the various challenges working their way through the federal courts, only this case allows the Court to address both of these fundamental questions,” lawyers representing Bondi and the National Federal of Independent Businesses, wrote in the appeal filed today.

Bondi is holding a noon press conference on the filing today in the Capitol.

A federal appeals court tossed two Virginia lawsuits Thursday challenging the constitutionality of the federal health care law’s insurance requirement, also known as the individual mandate.

The U.S. Fourth Circuit Court of Appeals dismissed both lawsuits, ruling that neither the state’s attorney general Ken Cuccinelli or Liberty University had standing to challenge the law. The three-judge panel’s decision overturned a lower-court ruling invalidating the insurance requirement.

Thursday’s ruling now leaves an even score on other appellate rulings on the health care law. First, a three-judge panel in Cincinnati ruled in favor of the law. A more recent decision last month from an Atlanta three-judge panel ruling in a multi-state lawsuit headed by Florida that the individual mandate portion of the law was unconstitutional but left the remainder of the law intact.

And it heightens the importance of the Florida lawsuit, which observers say will ultimately be decided by the U.S. Supreme Court.

Gov. Rick Scott, who made his fortune in the health care industry, launched his foray into politics more than two years ago with an effort to keep the proposed health care reforms from going into law. Scott is an outspoken critic of the law and once said fighting against it was one of the reasons he ran for governor.

Yesterday, lawmakers approved a request from Scott’s administration for a $3.4 billion grant drawn from the federal Affordable Care Act. The Legislative Budget Commission signed off on taking the cash to provide home visitation services to at-risk families.

Gov. Rick Scott provided a glimpse Tuesday at his second-year agenda as Florida’s chief executive, promising to continue pushing toward job-creation by cutting regulations and declaring war on the state’s 1,500 special districts.

Expanded oil-drilling in the Everglades, which Republican presidential candidate Michele Bachmann pointed to as a possibility during a recent visit to the state, looks like a longshot to Scott.

But he didn’t rule it out.

“I think we have to be very cautious with any oil-drilling, whether it’s in the Everglades or whether it’s near our beaches,” Scott told the Economic Club of Florida, meeting in Tallahassee.

Drilling has gone on in a remote stretch of Collier County since the 1940s. But currently only a relatively modest 2,800 barrels of oil are pulled daily from the site, according to Collier Resources, the company which does the drilling.

Scott, though, seems more focused on lifting state regulations — and reining in the tax-and-spending authority of Florida’s wide-ranging special districts. Palm Beach County, alone, has more than 9o such authorities, covering water management, health care, fire districts and more.

Scott told Tuesday’s gathering that these districts control $15 billion in taxes.

“That’s a lot of money,” Scott said. “And there’s not a single voter who gets to vote on what these tax rolls should be.”

Scott took aim at the state’s five water management districts earlier this year. The Legislature’s approval of $700 million in property-tax cuts — the biggest share imposed on the South Florida Water Management District — is expected to be cemented Wednesday when the Legislative Budget Commission signs off on new budgets for water managers. 

In the 2012 legislative session, which begins in January, Scott also plans to push for cutting 1,100 state rules and regulations he said are unnecessary, duplicate federal standards, or stand in the way of sparking the economy.

“We’ve got to do anything we can to make sure we keep this from being an expensive place to live,” Scott said. “If we do that, there will be plenty of jobs.”

Once they were colleagues, he as owner and she as CEO of Solantic Walk-In Urgent Care, the multi-million-dollar clinic chain.

On Tuesday, Rick Scott and Karen Bowling, were brought together again, this time as a pair of public officials as the state’s Republican governor named his former top administrator to the board of trustees at Florida State College in Jacksonville.

Bowling was CEO at Solantic for the duration of Scott’s ownership of the company, which he had tranferred to his wife, Ann, shortly before taking office in January. Scott sold the company earlier this summer for an undisclosed amount — but purported to be around $50 million — to its minority shareholder, private equity firm Welsh, Carson, Anderson & Stowe of New York.

Scott had poured about $28 million of his own money into Solantic’s early founding. He and Bowling grew the firm to 32 clinics statewide, including two in Palm Beach County.

But Scott’s ownership also drew heat when his health care policies intersected with Solantic’s business model. He pushed — but later hit pause — on a plan to require drug-testing for state employees, while also signing into law a Medicaid overhaul that would put almost 3 million low-income, elderly and disabled Floridians into managed care.

Florida drew a rare rebuke Monday from the federal Chemical Safety Board, for failing to enact workplace protections for state and municipal employees, following the deaths in 2006 of two plant workers at a Daytona Beach wastewater plant.

In a letter to Gov. Rick Scott, CSB Chairman Rafael Moure-Eraso said that legislation providing workplace protections failed to pass in 2009 and 2010. Last spring, no legislation was even introduced.

In issuing its first ever “unacceptable response,” to a state and its Legislature, the non-partisan safety panel again called for lawmakers to approve standards similar to those in place for private employees under the federal Occupational Safety and Health Administration.

“The board maintains that implementation of these recommenations is necessary to secure the health and safety of Florida’s public employees. We therefore strongly encourage you and your colleagues in the state Legislature to reconsider the CSB’s recommendations,” Moure-Eraso wrote Scott.

Doug Martin, lobbyist for the American Federation of State, County and Municipal Employees (AFSCME), said the slap by the federal agency was deserved. The Florida League of Cities has fought state recommendations developed by a task force comprised of leaders from the public and private sector.

The issue was shelved this year, though, as lawmakers steered clear of enacting  measures the League of Cities has insisted would prove too costly for cities, Martin said. Experts said the two workers killed in the Daytona Beach explosion, and a third badly burned, may have been spared if they had been better trained in safety procedures.

“Florida is a national embarrassment,” Martin said.

UPDATE: Gov. Rick Scott signed the bill (HB 155) into law today.

Three groups of physicians are threatening to sue the state if Gov. Rick Scott signs into law a bill barring doctors from asking patients if they own a gun.

Lawyers representing members of the Florida chapters of the American Academy of Pediatrics, American Academy of Family Physicians and the American College of Physicians asked Scott to veto the measure (HB 155) because they say it restricts their First Amendment rights to freedom of speech.

“Healthcare professionals throughout the state of Florida routinely speak with patients about effective methods to minimize a variety of risks to their health and safety,” attorneys Bruce Manheim Jr. and Douglas Hallward-Driemeier of the Washington-based law firm Ropes & Gray wrote to Scott last week. Scott has until June 9 to act on the law.

Doctors advise patients about safety issues associated with swimming pools, dangerous chemicals, bike helmets and car seats, they wrote, and “provide anticipatory guidance regarding the significant health risks posed by firearms in the household.”

The bill would prohibit those talks and impose severe sanctions including fines and permanent revocation of licenses.

“In sum, if CS/CS/HB 155 becomes law, it will deprive healthcare professionals throughout the state of Florida of their rights under the First Amendment to freedom of speech. In violation of the U.S. Constitution, the law would also deprive patients of potentially life-saving information regarding safety measures they can take to protect their children, families and others from injury or death resulting from unsafe storage or handling of firearms,” the lawyers wrote. “For these reasons, we intend to file a lawsuit against you and other state officials in the event this legislation becomes law.”

The NRA sent out an action alert last week asking members to pressure Scott to sign the measure.

“Doctors need to treat illness, not guns. Pediatricians and other physicians, in growing numbers, are prying into our personal lives, invading our privacy and straying from issues relating to disease and medicine by questioning children or their parents about gun ownership,” the NRA’s Florida lobbyist Marion Hammer, a former NRA president, urged in an e-mail on May 26.

A few details are dribbling out Thursday afternoon on a rewrite of Florida’s Medicaid law — affecting 2.9 million low-income, elderly and disabled Floridians, but crafted as one of the Capitol’s best-kept secrets.

The Senate is expected to debate the legislation soon, with many seeing the proposed compromise for the first time on the eve of the scheduled end of the legislative session. But — no surprise at the Capitol — health care lobbyists are among those given a heads-up on what’s about to be sprung.

Lawmakers, basically,  have cobbled together portions of dueling House and Senate plans approved earlier this session that steer most of Florida’s Medicaid patients into managed care in a bid to shrink the program’s $22 billion price-tag, which currently commands about one-third of the state’s $69.7 billion budget.

Among the areas of compromise:

Regions: Senate had wanted 19; House, 8. The House-Senate package settles on 11 regions that track the Agency for Health Care Administration’s  service areas. HMOs, patient service networks (PSNs) and other managed care providers would compete in each;

Developmentally disabled Floridians: Will continue to draw services paid through the Agency for Persons with Disabilities new I-Budget system, effectively keeping these patients out of managed care for now. The Senate had advocated for this stance;

Medically Needy: Costly prescription drug and hospitalization services for these more than 40,000 critically ill and transplant patients would be maintained in the state’s budget. But these patients would have to enroll in managed care plans to obtain treatment;

Doctor payments: Increased doctor payments are “expected” from the managed care companies who gain control over Medicaid dollars. But the proposal stops short of the guaranteed payment boosts earlier pushed by the Senate.

As budget talks on health and human services appropriations stalled, the Senate is moving forward with its Medicaid overhaul. Senate GOP leaders have not scheduled the immigration bill for Saturday, although only two hours of notice are required to add it to the agenda.

The Senate will take up its proposal (SB 1972) on Saturday along with dozens of local bills and Senate confirmations of Gov. Rick Scott’s appointees. But no word yet on whether the chamber will address immigration reform, still in flux as Senate Budget Chief J.D. Alexander, now shepherding the bill (SB 2040), weighs his options.

The House and Senate are both looking to put most of the state’s 2.9 million Medicaid patients into HMO-style plans. But differences abound between the two approaches. The Senate would divide the state into 19 regions, based on state court circuits; the House proposes eight.

The chambers are far apart on immigration reform as well. The House’s Arizona-style plan is on hold as the Senate considers a more moderate approach.
(more…)

With NRA lobbyist Marion Hammer sitting in the front row of the public gallery, the Florida Senate easily approved three bills loosening gun laws, including a measure banning doctors from asking their patients about gun ownership.

Two other measures are now headed to Gov. Rick Scott, an NRA member and gun owner who has said he would sign them into law.

The “open carry” bill (HB 45), watered down yesterday, would protect concealed weapons permit owners from being prosecuted if their guns are accidentally exposed. Proponents of the measure say that current law could subject the inadvertent display of weapons to being charged with a felony.

The third (HB 155) would punish local officials with a fine for passing gun laws stricter than the state’s, already prohibited under state law.

Law enforcement officials opposed the open carry bill, saying it would make their jobs more dangerous.

And barring health care providers from asking safety questions about the presence of weapons in the household could endanger the lives of children and have a chilling effect on the doctor-patient relationship, pediatricians have argued.

Firearm injury is the leading cause of death for children and teens, said Senate Democratic Leader Nan Rich of Weston.

“Adolescents know about firearms. Children know about firearms and they know where they are. This Republican Party is a party of less government and this is the party that brings us more government intrusion that encroaches into the privacy of a doctor’s office and the doctor-patient relationship,” she said.

But Sen. Alan Hays, a retired dentist, said “it’s none of my business what kind of weapons if any” patients have in their homes.

“If it’s medically necessary you may inquire but otherwise stay out of the private business of your patient,” said Hays, R-Umatilla. The bill passed by a 27-10 vote.

House budget negotiators pushed back against the Senate Wednesday afternoon over health and human services spending — opposing pouring any money into programs that look designed to support the federal health care overhaul.

House lead negotiator Matt Hudson, R-Naples, rejected a series of Senate proposals, including one that would have increased Medicaid reimbursement rates for doctors.

The $338.3 million item was floated earlier Wednesday by Senate Health and Human Services budget chief Joe Negron, R-Stuart, along with another $37.1 million offer to boost payments to dentists treating Medicaid patients.

Hudson said the House won’t accept anything that could be seen as preparing the state for implementing the federal health care rewrite approved by Congress and pushed by the Obama administration.

Talks will continue between the two sides later tonight.

But the House also shrugged at the Senate’s earlier pitch to revive about one-quarter of state spending for the Medically Needy and Medicaid Aged and Disabled programs — which provides costly prescription coverage to 90,000 Floridians, many in critical health.

The House is insisting these big-ticket programs draw full funding in the final state budget.

Hudson said he welcomed the Senate’s move away from its earlier plan to strip state dollars from the programs.

“But it certainly needs to be a bigger step, in my mind,” Hudson said.

In its offer, though, the House finds money for spending on these programs by reducing state payments to hospitals and nursing homes that care for Medicaid patients. The Senate sought to shield nursing homes from the rate cuts — but the House is proposing 8.5 percent reductions in state support.

Meanwhile, community care providers in the deficit-plagued Agency for Persons with Disabilities would face 4.5 percent rate cuts, in the proposal from Hudson.

Negron and Hudson also tentatively agreed to work on setting stricter guidelines for spending by the agency, which Gov. Rick Scott sought to discipline earlier this spring with 15 percent rate hikes aimed at easing a $170 million deficit that had grown over several years.

Negron said lawmakers wanted to preserve services for the Floridians with Down Syndrome, autistic, spinal bifida and other disabilities served by APD. But he cautioned, “Even if you are doing the Lord’s work, you can’t bounce checks.”

House and Senate budget negotiators took early steps Wednesday toward resolving at least $3.3 billion in differences, with Senate Health and Human Services chief Joe Negron offering to boost spending for critically ill, aged and disabled Floridians, and eliminate a planned 5 percent cut to nursing homes.

“Everything in this offer reflects a priority,” said the Stuart Republican.

The Senate inched upward, offering to spend $38 million, including $13 million in state taxpayer money backed by federal dollars, on prescription drug coverage for some of the 46,000 adults in the Medically Needy program.

The Senate had earlier erased the program’s drug coverage, while maintaining physician services. But drug coverage is a vital and costly service for the transplant patients, critically ill Floridians and other hard-to-insure enrolled in the program.

 The offer, which is being reviewed by House negotiators, would bring back about one-quarter of the Medically Needy program.

Similarly, Negron said the Senate also was willing to spend $45 million on the Medicaid Aged and Disabled program (Meds A/D) which the chamber earlier proposed shutting down in April. The cut would have shut off prescription drug coverage for more than 42,000 low-income elderly and disabled Floridians.

 The Senate offer would cover less than one-quarter of those now served.

Rep. Matt Hudson, R-Naples, the House lead budget negotiator, is running the Senate proposal up the political flagpole in that chamber — and is expected to report back at midday.

Negron said that under budget allocations decided by House Speaker Dean Cannon and Senate President Mike Haridopolos, the Senate can spend about $300 million more than it had earlier. The House must come down $100 million from its budget for health and human services.

With the extra cash, Negron also said the Senate was eliminating a 5 percent cut planned for nursing home payments, although hospitals and HMOs still face deeper reductions. Medicaid payments to doctors and dentists also would be increased under the Senate offer.

Budget talks between the House and Senate had been stalled for more than a week. But now they’re going to move swiftly.

Racing toward a scheduled May 6 adjournment, Cannon and Haridopolos have said any differences unsettled by Friday will be turned over to the budget conference chairmen to decide.

 Issues bigger than these leaders will go to Cannon and Haridopolos a day later for final deal-cutting.

The House gave preliminary approval Wednesday to legislation aimed at closing “pill mills” that dispense painkillers and other prescription medications to drug dealers and addicts.

The measure (CS/HB 7095) advances the state’s plan to establish a prescription drug database, which earlier had been opposed both by Republican Gov. Rick Scott and House Speaker Dean Cannon, R-Winter Park, who have since reversed field and support the plan.

Scott even testified before a congressional committee last week touting Florida’s steps toward cracking down on pill mills, including those he initially condemned.

The legislation, poised for a final House vote Thursday, would include strict new regulations for doctors, pain-management clinics and prescription drug distributors, while also imposing new limits on pharmacies.

 The Senate’s version of the legislation (CS/SB 818) is still awaiting a full vote by the chamber.

The database push has been opposed by the Florida Medical Association and requires nearly all health care professionals, including doctors, to register with the state before prescribing controlled substances.

It also requires they use tamper-proof prescription pads, and forces health care providers to keep a log of all pain medications prescribed and give the log to law enforcement officials if requested.

The Senate health and human services budget committee Wednesday approved a massive rewrite of Florida’s Medicaid program, aimed at steering 2.9 million low-income Floridians into health coverage provided by managed care companies.

But the legislation (CS/SB 1972)  is now missing one of its more controversial provisions: liability limits for foster care providers. The sponsor of the Medicaid bill, Sen. Joe Negron, R-Stuart, quietly stripped the legal caps — leaving the fate of the move to separate legislation still advancing in the House and Senate.

Trial lawyers and children’s advocates have been fighting the lawsuit limits, especially in the wake of the death of 10-year-old Nubia Barahona and near death of her twin brother, Victor, allegedly at the hands of their foster parents who are now facing murder charges. 

The Senate Medicaid bill would’ve capped financial awards for pain and suffering damages involving agencies providing foster care services at between $200,000 and $1 million, and limited economic damages at $2 million under the provision. 

The state’s Department of Children & Families acknowledges the Barahona case stemmed from systemic failures within the agency and a private organization, Our Kids of Miami-Dade/Monroe Inc., which handled their adoption and could be shielded from more costly liability under the legislation.

Although no longer included in the Medicaid measure, similar legal shield legislation continues to advance, supported by agencies which say rising insurance costs are threatening their ability to continue operating.

Negron earlier defended the proposed limits saying, “There’s a delicate balance between the rights of individuals to seek redress for their injuries, while at the same time making sure that there are insurance policies for them to make claims against.”

Almost 90,000 poor, elderly or severely ill Floridians would lose government-paid prescription drug benefits beginning next year under legislation approved Friday by the Senate Budget Committee.

The move came a day after the same panel approved a red-ink plagued, $69.8 billion budget that included $450 million in cuts stemming from erasing the services.

But it also clouds the future treatment for some of the state’s most vulnerable patients, said Democratic Leader Nan Rich of Weston.

She said it’s time lawmakers look at tax or fee hikes to ease the deep cuts ruling Republicans are using to close an almost $3.8 billion budget gap.

“I know we need to cut,” Rich acknowledged. “But we’ve been cutting for three years now. We need to look at other options.”

The legislation (CS/SB 7174) affects more than 46,000 adults in the Medically Needy program, who would be limited to receiving state-paid physician coverage, losing drug coverage. State and federal financing of costly medication therapy, though, helps sustain many of these transplant patients and catastrophically ill Floridians.

The Senate also would end the state’s Medicaid Aged and Disabled Program (Meds A/D) in April, eliminating prescriptions for more than 42,000 low-income elderly and disabled Floridians.

Health and Human Services Chairman Joe Negron, R-Stuart, said he hoped to reinstate the programs during budget negotiations with the House, which has avoided the proposed cuts.

 But he said the stark decision also makes a case for the Legislature’s proposed Medicaid overhaul, which would steer 2.9 million low-income, elderly and disabled people into managed care programs to save money.

“You can’t do everything,” Negron said of the budget cuts coursing through health and social service programs. (more…)

A Medicaid rewrite that would steer 2.9 million low-income sick and elderly Floridians into managed care programs across 19 still-to-be-established regions cleared its first hurdle Wednesday in the state Senate.

The Health Regulation Committee approved the measure 11-0, despite concerns from some lawmakers that the legislation threatens many low-budget, community care providers who currently serve thousands of elderly Floridians in their homes.

Critics said they fear these providers could be hard-pressed to win contracts and play a role in a new system dominated by large HMOs and hospital-driven Provider Service Networks (PSNs).

But Senate sponsor Joe Negron, R-Stuart, said that competition was key to assuring that Medicaid patients received better and more efficient care.

Negron said lawmakers are looking to cut $1 billion from Medicaid’s current $22 billion budget, which now represents almost one-third of the state’s recession-wracked state spending plan.

“I want this bill to be bold and transformative, rather than just sniveling around the edges,” Negron said. (more…)

Gov. Rick Scott, who made his controversial millions of dollars in the private health care industry, Wednesday created a commission to examine government-run hospitals in Florida.

The executive order Scott signed creates the Commission on Review of Taxpayer Funded Hospital Districts.

 Before his swearing-in as governor, Scott’s health care transition team issued a report which included a stinging assessment of publicy funded districts, complaining that the hospitals they support largely muscle-out private facilities and may no longer be needed in Florida.

Palm Beach County’s health care district, created 20 years ago, was generally backed by Scott’s advisers at the time. The district’s taxpayer dollars are deployed countywide, not concentrated in one hospital.

“I am confident this new Commission will protect Florida taxpayers,” Scott said.  “At the same time, the commission’s guidance will help provide Floridians a high-quality health care system.”

Scott helped build Columbia/HCA, one of the nations’ biggest health care companies, until his ouster by its board. Three years after his departure, the company paid $1.7 billion to settle federal accusations of Medicare fraud.

 In announcing the commission’s formation, Scott said its goals will include reviewing how doctors are paid at the public hospitals, whether they serve as broad a population as they should, and whether taxpayers are getting their money’s worth.  The 10-member commission has until next January to complete its findings.

 There are more than 60 hospital or health care districts in Florida.

A stark state spending plan, flush with red ink, began taking shape Monday in the state Senate, with school dollars sliced 6.5 percent and a health care proposal on track to save $1 billion in Medicaid spending, much of it from program cuts.

Health and Human Services budget chairman Joe Negron, R-Stuart, praised the Senate’s $28 billion for maintaining spending on some key program, including funding for homeless, AIDS drug assistance, and the state’s KidCare and Healthy Start insurance programs.

But he acknowledged the Senate — like the House — is ready to recast Medicaid, putting almost 3 million Floridians into managed care programs to trim costs, while also cutting services.

“We’ve heard that the current system is irretrievably broken, so we’re starting a new system,” Negron said. 

A Medicaid pilot program operating in five counties since 2006, including Broward, has been derided as a failure by many critics. But Negron said the new program will look nothing like the pilot program and will not drive frustrated patients to use hospital emergency rooms — one of the costliest venues for care.

But the Senate is banking heavily on its high-wire reform effort. In the budget unveiled Monday, hospitals would lose 10 percent of state funding for treating both in- and outpatient Medicaid recipients — cutting $450 million from the budget. 

 The Medically Needy program, an optional program long paid by the state and federal governments, would be sharply scaled back to save $230 million under the Senate budget — eliminating financial help given transplant patients and other hard-to-insure Floridians.

School funding, meanwhile, would drop 6.5 percent under the Senate plan. In the good-cop, bad-cop approach of budgeters, that’s still the mildest slice: The House has recommended a 7.7 percent per-pupil reduction, while Gov. Rick Scott called for a 10 percent drop.