MM Curator summary
[ MM Curator Summary]: A state legislator wants to pre-empt the MCO protest machine.
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.
Sen. Jason Brodeur filed SB 1950, a 36-page proposal to reduce Florida’s number of Medicaid managed care regions — from 11 to eight — and require managed care plans to contract with two of the state’s cancer hospitals.
Filed Monday, the bill, in an attempt to blunt potential legal challenges to the nine-figure Medicaid procurement, contains language that would preclude any managed care plan from providing care to any of its enrollees until all administrative challenges to the procurement are settled.
Brodeur’s proposal would reconfigure the current 11 Medicaid-managed care regions.
The bill consolidates Medicaid Regions 1 and 2 into a Medicaid Region A. Medicaid Regions 3 and 4 will roll into the new Medicaid Region B. And Medicaid Regions 5 and 6 are rolled together into Region C. The rest of the Medicaid regions remain the same, with letters replacing numbers.
Florida requires most Medicaid beneficiaries to enroll in a managed care plan to receive services from the cradle to the grave. Only Medicaid-managed care organizations that win competitively bid Medicaid contracts in a region can provide the care. The current Medicaid managed care contracts expire on Dec. 31, 2023. The agency is gearing up to begin the new procurement process and work on the new Medicaid managed care contracts to replace the current agreements.
The bill comes weeks after Agency for Health Care Administration Secretary Simone Marstiller signaled the agency would push for some legislative changes to the program.
Marstiller asked lawmakers in the fall to include an additional $2 million in her agency’s fiscal year 2022-2023 budget to hire outside counsel.
Marstiller said she wanted funding available to the agency “at the ready” to ensure her team can employ the best outside legal help available.
The Senate bill does not propose any changes to the Medicaid dental program, although Medicaid Director Tom Wallace hinted the agency might want to pursue changes.
The bill also requires Medicaid-managed care plans to contract with Sylvester Comprehensive Cancer Center and Moffitt Cancer Center.
The Brodeur bill eliminates the state’s requirement to allow the public to have feedback before submitting Medicaid amendments to the federal government for review. AHCA told Florida Politics Tuesday the public comment requirement being eliminated from the bill was specific to creating the Medicaid managed care program. Federal law still requires a public comment period.
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