Comments due Nov. 10 on Florida’s waiver request for Medicaid managed care

Florida is seeking federal approval to extend the waiver that allows it to have most of its Medicaid population in managed care.

The current waiver has been in place since 2014 and expires June 30, 2017. The state wants a three-year extension. Florida is collecting comments on its proposal through Nov. 10.

Advocates have raised some concerns about the managed-care program in the state. The Georgetown Center for Children and Families surveyed pediatricians in the state and found children are being reassigned to other managed-care plans and/ or physicians without their knowledge.

In that June report, doctors also said there are serious barriers to getting their patients prescription and overthe-counter medications due to managed-care plan requirements for prior authorization.

“Pediatricians responding to the survey were frustrated with low reimbursement rates, delayed payments, considerable administrative burdens, and barriers to care for their patients,” the report concluded. “Pediatricians responding to the survey believed the system of care has worsened for their Medicaid patients.”

As of August 2016, Florida had enrolled more than 3.6 million individuals in Medicaid and CHIP—a net increase of 17.4% since 2013.

Since the state is a non-expansion state, the growth is attributed mostly to the so-called woodwork effect in Medicaid, which refers to increased enrollment of people already eligible for the program as a result of publicity for the Affordable Care Act.