Florida plans to seek HHS permission to test an overhauled Medicaid program that would allow beneficiaries to use Medicaid funds to buy employer-sponsored insurance and would require all other beneficiaries to enroll in managed-care plans or provider service networks. The state expects to submit a Medicaid waiver application to the CMS in 30 days and if the waiver is granted would then seek legislative approval to implement the pilot. The changes initially would be tested in Broward and Duval counties and then expanded to three additional counties. About two-thirds of Florida's 2.2 million Medicaid beneficiaries are covered by fee-for-service plans. Florida said it would use savings from the changes -- an estimated 3% of current spending on eligible beneficiaries -- to fund "enhanced benefit accounts" to help cover beneficiaries' out-of-pocket costs. Beneficiaries would become eligible for the accounts based on participaton in wellness activities. Read the waiver application.
Meanwhile, New Hampshire is poised to ship a Medicaid reform waiver to HHS despite Gov. John Lynch's objections. The waiver would allow the state to tighten loopholes that let people transfer assets to relatives in order to qualify for Medicaid long-term care. Although some of the provisions have been diluted since legislation was passed in June, the New Hampshire Hospital Association still has concerns, said Leslie Melby, the association's vice president of state government relations. Without an "undue hardship provision," New Hampshire hospitals likely will incur bad debt for services provided to seniors who would otherwise qualify for Medicaid, Melby said. Lynch expressed similar concerns to state Health and Human Services Commissioner John Stephen in a letter Monday. Nevertheless, a legislative committee approved the package Tuesday, and Stephen said he might send it to Washington knowing it could be changed subsequently, the Associated Press reported. -- by Melanie Evans and Cinda Becker