• E-mail
• Print
• Comment
• Font Size
• Digg
• del.icio.us
• Discuss article

Battle Lines Drawn Over Medicaid Spending Malpractice

Posted on: Monday, 28 February 2005, 15:00 CST

Feb. 28--With its usual full plate of issues, Florida's healthcare industry will be battling over Medicaid spending, doctors' malpractice issues, who should be able to prescribe drugs, the nursing shortage, and many other matters.

Everyone is carefully watching the governor's proposals to modify Medicaid. The industry acknowledges that something must be done to control costs in the $14 billion program, but no one wants to see its part cut.

One huge fear is that the program will ultimately be capped -- meaning qualified persons won't be allowed into Medicaid. That means those disenfranchised poor will not get primary care and could end up uninsured in emergency rooms. "We don't want to be the ones picking up their tab," says Rich Rasmussen of the Florida Hospital Association.

The Florida Medical Association "has mixed feelings" about Medicaid reform, says lobbyist Francesca Plendl. The governor would put more dollars into primary care, which would be advantageous to doctors. "But are we concerned about how much would be kept for administrative costs" by the private insurers that would manage Medicaid, Plendl says.

More primary care could mean "less money for hospitals when people are really sick," says Linda Quick of the South Florida Hospital and Healthcare Association.

Other healthcare battlefronts:

-- "Three Strikes" -- The FMA wants to minimize the damage done by the "three-strikes" amendment passed last November that triggers license revocations after doctors get three malpractice judgments against them.

Plendl, the FMA's lobbyist, predicts that doctors will be be forced to settle cases now so that they don't get a judgment against them, and if they have one or two judgments, they may flee the state to avoid a third.

"A lot of housekeeping needs to be done to clarify the amendment," says Plendl. The FMA wants clarifications that the amendment is not retroactive and that a Board of Medicine and a trial judgment on the same matter don't count as two strikes.

-- The Medically Needy -- The governor proposes a $400 million cut in hospital benefits of the 36,000 people with severe problems who are in the Medically Needy program. "These are the folks who come to the hospital the most," says Rasmussen of the FHA. "If they're not covered, the hospitals will pay."

-- Nursing Shortage -- The Florida Nurses Association says a lack of faculty in nursing schools means many qualified student applicants are turned away.

"An associate professor with a doctorate can make $55,000 to $60,000 -- but they can make much more than that working in the private sector," says FNA lobbyist Barbara Lumpkin. The group wants legislators to boost salaries "to realistic levels."

Another way to reduce the nursing shortage is for Florida to join 18 other states in an agreement so that a nurse licensed in one can simply get a job in another state without going through a complex round of exams.

-- ER Charges -- Blue Cross and Blue Shield of Florida once again is asking the legislators to do something when someone ends up in an out-of-network ER and hospital.

At present hospitals bill at gross charges -- up to five times what an in-network carrier pays. BCBS wants the Florida Legislature to come up with a definition of "reasonable and customary" charges that should become a standard for out-of-network charges. The matter died in committee last year.

-- Nurse Practitioners -- They're already able to prescribe antibiotics and many other drugs. The nurses association wants them to be able to prescribe controlled substances, such as pain medication.

The FMA is adamantly opposed, saying such pills need to be very tightly controlled.

Lumpkin of the FNA counters that 44 states allow nurse practitioners to dispense pain medication. This measure died in committee last year and will be at risk this year because many legislators are concerned that addictive pain medications are already too commonly dispensed by some practitioners.

-----

To see more of The Miami Herald -- including its homes, jobs, cars and other classified listings -- or to subscribe to the newspaper, go to http://www.herald.com.

(c) 2005, The Miami Herald. Distributed by Knight Ridder/Tribune Business News. For information on republishing this content, contact us at (800) 661-2511 (U.S.), (213) 237-4914 (worldwide), fax (213) 237-6515, or e-mail reprints@krtinfo.com.

Source: The Miami Herald

More News in this Category