(March 2013) A new Special Report entitled Summary of Florida’s Long Term Care Managed Care Program summarizes important aspects of Florida’s long-term care managed care program. The Centers for Medicare and Medicaid Services (CMS) approved Florida’s proposal to provide Medicaid long-term services and supports (LTSS) through managed care in February.
As is generally the case in Medicaid managed care, Florida’s move to managed care is being promoted by the state as a way to provide care in a more coordinated fashion, but in practice may limit access to care for many Medicaid beneficiaries.
This paper summarizes some important aspects of the Florida program. Identification of potential problems is key. For Florida Medicaid beneficiaries and their advocates, now is the time for further systemic advocacy. Especially to the extent that the federal approval has not completely addressed important issues, the state has the authority to establish consumer protections through the contracts with the managed care organizations (MCOs) and other guidance.
These issues are relevant to beneficiaries and their advocates in other states as well. States across the country are considering the transfer of Medicaid LTSS to managed care, and advocacy on beneficiaries’ behalf, as soon as possible in the policy development process, will be vital if managed care systems truly are to provide care that is both coordinated and beneficiary-focused.
The special report can be downloaded here.