Gov. Rick Scott hailed the Obama administration’s approval Thursday of a two-year extension of the Medicaid managed-care effort underway in Broward and four other Florida counties since 2006.

The federal Centers for Medicare and Medicaid Services approved the state’s bid to continue the pilot project, which supporters and some analysts have credited with saving money and improving patient health care. But the HMO-styled coverage has been criticized by many treated within the program, who complain about being forced to change doctors, travel far distances to see specialty physicians or change prescription coverage.

Along with Broward, such coverage is in place in Baker, Clay, Nassau and Duval counties.

Scott and the state’s Agency for Health Care Administration see Thursday’s approval as setting the stage for a future federal OK on the statewide managed care plan approved last spring by the Republican-led Legislature.

That plan, which has already drawn tough questioning from CMS reviewers, would shift virtually all of Florida’s 2.9 million Medicaid recipients into managed care, beginning in 2013.

“I want to publicly thank the staff at the Agency for Health Care Administration for all their hard work and perseverance in negotiating the extension of our Medicaid pilot program,” Scott said.

“ Today’s approval of the program’s extension through June of 2014 illustrates the federal government’s recognition of the great successes we’ve experienced. We’ve seen higher quality in administration of care, produced cost savings and consumers in the pilot have found improved access for Medicaid recipients,” he concluded.

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.

A Republican hoping to unseat U.S. Rep. Debbie Wasserman Schultz literally set his sights on the Broward County Democrat at a shooting range, according to press reports.

Robert Lowry was one of the Southeast Broward Republican Club who went on a shooting spree at a gun range and fired assault rifles at targets including a man in a headdress holding a rocket-propelled grenade launcher.

Lowry’s target was a silhouette of a human figure with the initials “DWS” next to the head.

The target practice drew criticism from state Sen. Ted Deutch, a Boca Raton Democrat, who issued a statement condemning the event.

“In a nation that has a tragic history of violence against our leaders it is unconscionable that Congresswoman Debbie Wasserman Shultz’s opponent would fire an assault rifle at a silhouette bearing her name,” Deutch said.

“Congresswoman Wasserman Schultz is a dedicated public servant who has earned the respect of her constituents. She deserves far more than a halfhearted apology. The Republican Party of Florida should condemn this candidate in the strongest terms. Unfortunately, this is just the latest example of outrageous vitriol in our political discourse and it needs to stop,” he concluded.