Florida Medicaid

TALLAHASSEE | MEDICAID PROVIDERS

Lawsuit-immunity plan for Medicaid providers costly, report says

A state report says the idea of making doctors who treat Medicaid patients immune to lawsuits would cost the state millions.

BY MARY ELLEN KLAS

HERALD/TIMES TALLAHASSEE BUREAU

TALLAHASSEE — As governor-elect Rick Scott and the Florida Legislature consider giving doctors immunity against lawsuits in return for treating Medicaid patients, a new report warns that such an arrangement could cost taxpayers at least $69 million a year.

State Chief Financial Officer Alex Sink, who lost to Scott in November, commissioned the actuarial report last month after lawmakers indicated they are considering extending the state cap on legal liability, known as sovereign immunity, to Medicaid providers.

The report concludes that if legislators give state immunity to doctors and hospitals, “the state basically takes the place of a doctor who commits a negligent act.” When a patient sues, taxpayers would pick up the tab of any medical malpractice claim up to $300,000. The cost of defending and investigating an estimated 551 claims a year would cost Florida $69 million a year, the report claims.

Florida legislators passed a resolution in November indicating that, during the 2011 regular session, they will enact reforms that “establish a more fair and predictable civil justice system and reduce the disincentive for serving Medicaid participants.” Translation: offer doctors immunity against lawsuits in return for accepting lower payments for treating Florida’s growing Medicaid population.

Sink’s report may be a parting shot at the Republican-controlled Legislature as she prepares to leave office on Jan. 4. But it is likely to be only the first of the salvos fired in the emerging battle over Medicaid reform during the upcoming legislative session. Sink’s campaign was heavily backed by state trial lawyers, while Scott won the support of the liability-averse Florida Chamber of Commerce and the Florida Medical Association.

Sink questions the assumption that doctors will be more willing to accept patients if they are shielded from malpractice claims. “No research has been done that supports that rationale,” the report states, and notes that Florida would be the first state in the country to offer that protection.

But Alan Levine, who headed Scott’s transition team overseeing Medicaid policy, is urging Scott to shield doctors from liability by capping the damages against them, not by giving them sovereign immunity that would cost tax dollars.

“She’s got the right answer, but she’s asking the wrong question,” Levine said of Sink’s report.

The report also raises questions about a policy of having a “two-tiered justice system for medical malpractice claims” by capping recovery for Medicaid patients but not for others.

“I agree that our state Medicaid program needs to be reformed,” Sink wrote in a letter to House Speaker Dean Cannon and Senate President Mike Haridopolos accompanying the report. “However, I do not believe that extending sovereign immunity will convince many doctors to increase the number of Medicaid patients they treat, yet the change could be costly for Floridians.”

Mary Ellen Klas can be reached at meklas@ MiamiHerald.com.

Read more: http://www.miamiherald.com/2010/12/22/1984444/lawsuit-immunity-plan-for-medicaid.html#ixzz1cqOTecLl

Florida Health Care Policy

Scott’s team urges him to consolidate health agencies into mega department

Gov. Rick Scott should reverse the work of Gov. Lawton Chiles 20 years ago, when he pushed for the separation of the state’s social service agencies, and get back to a large Department of Health and Human Services, Scott’s health care advisory team told him in a 68-page report on Monday.

The goal of the mega-agency would be to better coordinate overlapping functions now handled by the current Departments of Health, Elder Affairs, the Agency for Persons with Disabilities, and the Agency for Health Care Administration as the state attempts to reform the delivery of Medicaid services.

One proposal, submitted Monday Scott’s health care advisory team headed by Alan Levine, calls for sweeping changes in how the state delivers Medicaid and urges a continuation of many of the programs advanced by Levine when he was advising former Gov. Jeb Bush.

Levine, who is the former head of the North Broward Hospital District and formerly served as Health and Hospitals secretary under Louisiana Gov. Bobby Jindal, urged Scott to hire a “quarterback” in his office who could coordinate health policy and management and “be capable of working closely with the legislature.”

Levine predicted that consolidating so many agencies would take “at least a year to plan and implement” but was needed to improve policy coordination.

Among the recommendations:

• Merge the Agency for Persons with Disabilities with the Office of Elder Affairs and have it be a division within a larger health and human services agency
• Keep child welfare programs separate from  a larger health department.
• Continue to fight for repeal of the federal health care reform act because it is “very costly for Florida at the very time we cannot even afford to operate the Medicaid program in its current form.”
• Expand Medicaid reform from the pilot projects in Miami-Dade and Broward counties statewide.
• Adopt Medicaid reform that includes an “organized, coordinated network” of care for the elderly that uses the private sector to give people “services they need” and not necessarily “services they want.” The state would be responsible for providing “proper oversight to ensure needed services are not systemically denied.”