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State Delays Medicaid Reform

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By CATHERINE DOLINSKI, The Tampa Tribune

Published: December 7, 2007

TALLAHASSEE - Like it or hate it, Medicaid reform probably isn't in Tampa's near future.

The Agency for Health Care Administration announced Thursday that although it has fully implemented the state's Medicaid reform pilot project, the agency will not recommend during the spring legislative session that lawmakers expand the program statewide.

The program, which transfers the care of state Medicaid beneficiaries to HMOs and other managed-care organizations, was a privatization initiative of former Gov. Jeb Bush and was intended to improve health care services while containing runaway Medicaid costs. Lawmakers approved the pilot in 2005 for five counties - Broward, Duval, Baker, Clay and Nassau - and retain final say over expanding it statewide.

"The pilot program has now been fully implemented in the five counties originally authorized by the Legislature," Andrew Agwunobi, secretary of AHCA, said in a statement. "We will continue to monitor the progress of the pilot and communicate with stakeholders in the program to gather the information necessary to make sound recommendations to Governor Crist and the Legislature."

Asked the reason for AHCA's reticence to move forward, spokesman Doc Kokol said the agency feels that issues raised this fall by AHCA's inspector general about the program need addressing. At the same time, Kokol said, AHCA awaits the results of an ongoing University of Florida study of the pilot.

"We're just not prepared at this point to make any recommendations," Kokol said.

Medicaid reform remains controversial among Florida's health care advocates, many of whom were ready to campaign this spring against it.

In September, AHCA Inspector General Linda Keen warned in a 74-page report that inadequate staffing and rushed implementation had compromised the program's success. Keen could not conclude whether the program actually meets either of its goals to contain costs or improve care.

Her report followed a more critical study by Georgetown University researchers who voiced similar concerns and noted that some doctors can't afford to provide care to Medicaid under the reform plan.

Social services advocate Karen Woodall was among those who lobbied against many of the Medicaid changes.

"I think it's a very responsible move on the part of the agency," Woodall said of AHCA's announcement. "The whole point of doing pilot projects was to see if the concept worked in reality. And there's been a number of problems."

The Associated Press contributed to this report. Reporter Catherine Dolinski can be reached at (850) 222-8382 or cdolinski@ tampatrib.com.

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