Category Archives: Medicaid

Pediatricians Say Florida Hurt Sick Kids To Help Big GOP Donors

CNN has done a great investigative job on this.  Here it is in short:

Now we find out Florida is a state that puts politics and money ahead of proper care for suffering, disabled children, according to this excellent investigative report. It’s because of extremely disproportionate donations to the Florida state GOP coffers by the medical insurance companies, as compared to their donations into other states’ GOP coffers.

A professionally-designed, approved questionnaire was used as a screening tool inappropriately to “filter out” children from the special Medicaid program which catered to those children.

Despite protestations from pediatricians,

“In the spring and summer of 2015, the state switched more than 13,000 children out of a highly respected program called Children’s Medical Services, or CMS, a part of Florida Medicaid. Children on this plan have serious health problems including birth defects, heart disease, diabetes and blindness.”

“Nearly half of all children in Florida, are on Medicaid, which has several types of insurance plans. The state switched more than 13,000 children into new plans, many of which did not have the same participating providers that treated these special kids.”

And so, too many of these kids did not get the special medical and surgical treatment they required, due to doctors in the new plans not having the needed additional education and/or experience or were not listed as providers.

“But some Florida pediatricians worry about children with special health care needs who, two years later, are still off the program.  The doctors aren’t just worried; they’re angry.”
  • The data analysis the state used to justify switching the children is “inaccurate” and “bizarre,” according to the researcher who wrote the software used in that analysis.
  • The screening tool the state used to select which children would be kicked off the program has been called “completely invalid” and “a perversion of science” by top experts in children with special health care needs.
  • In fall 2015, a state administrative law judge ruled that the Department of Health should stop using the screening tool because it was unlawful. However, even after the judge issued his decision, the department didn’t automatically re-enroll the children or even reach out to the families directly to let them know that re-enrollment was a possibility.

“These are the sickest and most vulnerable kids, and (changing their insurance) can mean life or death for them,” said Joan Alker, executive director of the Center for Children and Families at Georgetown University. “This is really very troubling.”

Six pediatricians from across Florida gathered to tell CNN their concerns about children losing CMS coverage. They accuse the state of hurting sick kids to help big GOP donors.

Dr. Rishi Agrawal, an associate professor of pediatrics at Northwestern University’s Feinberg School of Medicine, agreed, adding that Florida should have more carefully considered how the insurance switch would affect the children’s health care.  “The process in Florida was particularly abrupt and poorly executed,” he said.
“It was a scam job,” added Dr. Nancy Wright, a pediatric endocrinologist in Tallahassee who said that dozens of her patients with diabetes were removed from the program.”
[ Header image from http://www.freewebheaders.com ]
[ Photos from http://www.cnn.com ]
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