Home
Medicaid pilot plans are yanked
By MATT GALNOR, The Times-Union
Aug 28, 2008
The largest health care provider in the state Medicaid reform program in Duval County will stop providing service Dec. 1, records show.
The HealthEase and StayWell health plans will no longer be offered, according to a letter filed in Tallahassee by WellCare Health Plans, the parent company that runs both plans.
State officials had no answers Wednesday for how WellCare's 38,000-plus customers in Duval County would be cared for.
Medicaid officials with the Florida Agency on Health Care Administration will meet today to discuss options, spokesman Fernando Serna said.
Serna said nothing is official and the agency will be sending affected patients notification in the mail, likely in October.
WellCare serves more than half of the 74,000 Medicaid recipients in the county.
The next two largest plans in the Mediciad program are First Coast Advantage, run by Shands Jacksonville hospital, and United Health Care. United Health is considering leaving the market, but hasn't made a final decision, company spokesman Steven Matthews said.
A WellCare spokeswoman declined comment, and Matthews would not discuss reasons for potentially leaving the Jacksonville market.
"Suffice it to say, if we are considering pulling out, there are issues associated with it," Matthews said.
A Shands spokeswoman referred questions about the program's capacity to the state, which sets enrollment limits.
Serna said other providers have discussed coming into the Jacksonville market, but no decisions have been made.
Duval and Broward counties were chosen in 2005 as two pilot counties for state Medicaid reform.
The changes were designed to provide more options for consumers, but the WellCare announcement could limit choices significantly, said Joan Alker, senior researcher at the Georgetown University Health Policy Institute, which is studying the Florida pilot program.
"This is a major disruption and it raises questions about the future of the pilot," Alker said.
Serna said changes are to be expected in a pilot program.
The five-year pilot started in 2006 and any decision on canceling the program would have to be made by the Legislature.
matt@galnor@jacksonville.com
(904) 359-4550
Copyright 2008
Powered By Zebra Mobile