ACTION NEEDED!!! Medicaid Reform Bills

[Guest guest]

HMO's

Approved by House and Senate to take over the HCBS Medicaid Waiver and your

health care in Florida:

 

Folks,

I felt the need to

inform you of one particularly serious and very detrimental change just

approved by the House and Senate and which will substantially and negatively

affect the supports and services your disabled loved one will receive.

What this is about, in

brief, is the state's negotiations with a small number of large HMO's that

would have the state divided up amongst them into 6 zones. The lobbyist for

one of these HMO companies wrote both the House and Senate Bills and both

chambers just passed these bills, forwarding them to the reconciliation

committees which which reconcile the minor differences and send them to

Governor Crist for signing.

What

this means for the way in which your disabled loved one's services will be

rendered:

The Waiver will become

an HMO in all aspects. You would have no choices to speak of under this

system. The appeal process for an HMO is much like the appeal process for any

for-profit insurance company. It is very difficult to get an individual on

the phone and to take an interest in your situation and issues. These HMO

companies would take over your independent case management (me), and all of

the remainder of your service providers and supports. Some of them would

likely have to contract with or hire existing providers at a reduced rate.

The Bills state that the HMO's would be required to contract with existing

group home providers in order to avoid a loss of placement but their internal

systems (ways of doing business) will have to change dramatically and all

other aspects will change for all other service types.

The HMO would be paid

up front by the state for all of the services you currently receive for a

period of five (5) years and their incentive would most certainly be to save

money--to NOT spend on you. Make no mistake about this one if it comes to

pass: When a company is paid in advance for doing work and it gets to keep

whatever is NOT spent, the incentive is to make you the recipient do with

less as they get to pocket the left overs. Employees of HMO's are evaluated

and rewarded for the money they save the HMO--not the money they spend on a

disabled person.

As the Florida House

and Senate have abandoned all reason in this matter (both having passed the

Bill) the only final option left is to hope that Governor Crist can be

persuaded to Veto the bill as he did with the recent Education Reform bill

(relating to teacher merit based pay). I do not know what the odds are but

attached is a sample letter and the following is the Governor's email address

and mailing address:

Email:

Charlie.Crist@...

Regular

Mail:

Office of Governor

Charlie Crist

State of Florida

The Capitol

400

S. Monroe St.

Tallahassee,

FL 32399-0001

 

 

-- AutismOnTheGo.com

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HMO Oppose Apr2010.doc