Medicaid overhaul 'message' coming

By Jim Saunders
11/4/2010 © Health News Florida

House and Senate leaders today said they will use a special legislative session this month to try to override Gov. Charlie Crist's veto of money for Shands teaching hospital and to "send a message" about overhauling Medicaid.

Incoming Senate President Mike Haridopolos and incoming House Speaker Dean Cannon outlined a series of issues they hope to address during a brief session Nov. 16 when lawmakers return to Tallahassee for an otherwise ceremonial meeting.

Overriding the veto of $9.7 million for Shands has long been discussed. But Haridopolos and Cannon also said they want to pass a resolution that would express their intent to revamp Medicaid and seek more leeway from the federal government about how the program is run.

"There's no more important program for all of us than Medicaid,'' Haridopolos said.

Cannon and Haridopolos said lawmakers will not try to override Crist vetoes of highly controversial bills, such as a measure that would have required women to have ultrasounds before they can receive abortions.

The Medicaid resolution would not make changes in the $20-billion program, leaving such decisions to the 2011 regular session. But Cannon said he thinks the Republican-dominated Legislature should "lay down a set of principles'' for how it wants to change the program.

Though details were not immediately available, that could involve moving to a statewide system of requiring beneficiaries to enroll in managed care --- an issue the House proposed during this spring's session.

Haridopolos also said the resolution would express to the federal government that the state wants more "flexibility" with Medicaid. The Senate proposed a far-reaching idea this spring that would have involved giving beneficiaries vouchers to buy private insurance. That idea was met with skepticism that the federal government would approve it.

One other idea that Haridopolos and Cannon said could be part of the resolution is expressing support for limiting lawsuits against doctors who serve Medicaid beneficiaries.

The new legislative leaders outlined several issues they likely will take up during the special session. Most appeared to be non-controversial.

Republican and Democratic lawmakers were caught off guard in May when Crist vetoed the Shands money and have long discussed a possible override.

"I remember when it happened --- it didn't seem to make much sense,'' Cannon said.

Hospitals have been lobbying for an override, at least in part, because the veto means the loss of about $13.4 million in federal matching funds that would be spread to teaching hospitals throughout the state.

Shands in Gainesville would get hit hardest, losing about $13.3 million in state and federal funds, according to the Safety Net Hospital Alliance of Florida. Other hospitals that would lose shares of the federal matching money would be Jackson Memorial Hospital in Miami-Dade County; Tampa General Hospital; Shands Jacksonville; Orlando Regional Medical Center; and Mount Sinai Medical Center in Miami-Dade.

Crist's staff has said the veto stemmed from Shands being treated differently in the budget process than other hospitals. But critics have charged that Crist vetoed the money because of political differences with outgoing House Speaker Larry Cretul, an Ocala Republican whose district includes Shands.

--Capital Bureau Chief Jim Saunders can be reached at 850-228-0963 or by e-mail at jim.saunders@healthnewsflorida.org.