The Florida Agency for Health Care Administration last week sent a proposal to Gov. Charlie Crist (R) recommending that a Medicaid managed care pilot project be expanded to 20 additional counties, Florida Health News reports. The pilot, which currently operates in five counties under a federal Medicaid waiver, requires that beneficiaries sign up for managed care plans, usually HMOs, that offer additional benefits but also can place limits on them. The request includes an increase in Medicaid payments for specialists, which is intended to increase access for beneficiaries.

However, the proposal was made at the same time the agency plans to comply with Crist's request that state agencies reduce staff by as much as 10% in the event that the current economic downturn forces further spending cuts. Greg Mellowe, newsletter editor for the consumer group CHAIN, in an e-mail said that "it's almost surreal," adding, "It reveals the extent to which AHCA continues to be in denial about the problems dogging the Reform Pilot." According to Mellowe, "The Agency is essentially telling the governor that expansion is simply an automatic next step and that they're ready to proceed."

A report released last week by Georgetown University Health Policy Institute researchers stated that too little information is available to know whether the pilot saves any money for taxpayers or improves patient care. The report noted that doctors in the two largest counties where the program is operating have "complain[ed] about paperwork hassles" and that some patients have trouble getting access to specialized care, Florida Health News reports. The researchers also found that beneficiaries have expressed confusion about how the program works. According to the report, the project "appears to be moving in the wrong direction" (Gentry, Florida Health News, 10/20).

The report is available online (.pdf).