AHCA Responds to "False Medicaid Reform" Article

Dear Fellow Medicaid Reform Advocates,

I present the following letter to you in an effort to gauge consensus opinion about the present status of Medicaid Reform in the State of Florida. Your comments are highly valuable to me and will prove most helpful in determining the best course for future Medicaid Reform implementation. With the possibility of state-wide expansion of the reform movement, well over 2 million Patients will be directly impacted by Medicaid Reform treatment options and protocols. Of additional noteworthiness, Patient Family Members, Providers, and Health Care systems will also be affected by the course of Medicaid Reform in Florida. Collectively, we must remain focused on elevating the baseline Health Care status of all Floridians in a fiscally sound manner.

On behalf of Florida’s most vulnerable Patients, it is imperative that AHCA provides informed, caring, and compassionate leadership throughout the entire duration of Florida's Medicaid Reform effort.


Sincerely,

Dr. Marion D. Thorpe, Jr.
doc@marionthorpe.com

Letters: Medicaid reform having positive effects for patients

Palm Beach Post Editorial

Monday, December 11, 2006

In response to the editorial "False Medicaid reform" (Dec. 4): Denial is the last thing that the Florida Agency for Health Care Administration has shown toward the state's Medicaid program. In fact, under the leadership of Gov. Bush and the Florida Legislature, the agency publicly has showcased and thoroughly examined the shortcomings of the Medicaid program during the past two years, resulting in unprecedented reform of Florida's Medicaid program and philosophy.

Medicaid reimbursement rates are lower than competing rates, which makes finding physicians, especially specialists, difficult for Medicaid beneficiaries. The hard work of AHCA's local Medicaid office personnel to find care for those who come to them in need has helped many, but their abilities are limited.

Further, recipients should not have to call every doctor in an area hoping to find one to help and should have access to a wide network of doctors who are able and willing to provide them with high-quality care. In traditional Medicaid, the state has had no single entity to hold accountable for refusing care to beneficiaries.

We do now. Under Florida Medicaid reform, health plans are required by law to have an adequate network of primary- care physicians, specialists, dentists and all other health- care providers necessary to serve the needs of their enrolled population. Health plans now are responsible for helping individuals find and make an appointment with a physician. Reform plans are being extraordinarily proactive to identify access problems and resolve them, even outside their networks.

Real patient choice is also key to Florida Medicaid reform. Beneficiaries now can choose a health plan tailored to their unique health-care needs, and they are making those choices. Although The Palm Beach Post asserts that "choice" limits health benefits, traditional Medicaid services continue to be provided under reform. In addition, reform offers new services never provided by Medicaid before - at no cost to the state.

The truth is, Medicaid reform already has given more than 100,000 people in Broward and Duval counties the opportunity to take charge of their health care. Now, they have a real chance to receive the quality and timely medical care they deserve.

CHRISTA CALAMAS,

secretary

Florida Agency for Health Care Administration

Tallahassee