Florida Association of Health Plans plays defense in 2022 Session

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Retooling the state's mandatory Medicaid managed care program will be a Legislative priority in the 2022 Session.

The Florida Association of Health Plans’ 2022 legislative agenda sounds simple: Maintain the status quo.

“I think our Legislature has been moved by the improvement in quality and the care that has been provided,” FAMP President and CEO Audrey Brown said of her legislative agenda. “We want to continue to do business, but we want to continue to not have additional regulations or the removal of tools that are there to protect the taxpayer dollars.”

The association represents dozens of health insurers and managed care plans that provide health coverage to businesses and to those enrolled in Florida’s multibillion Medicaid program.

Brown said her organization doesn’t need to get any bills passed this Session. But to maintain the status quo, Brown said, the association will oppose what she described as “legacy bills” that get filed every year, such as prohibitions on step therapies or mandates for certain prescriptions to be placed on formularies used by insurers.

“We’ll probably always see these legacy bills,” Brown said. “Some of those services are in place to ferret out fraud.”

Meanwhile, all indications are that the 2022 Legislative Session will be the one in which lawmakers will make serious changes to the operation of the state’s Medicaid managed care program.

Enrollment in the Medicaid program during the COVID-19 pandemic has spiked to slightly more than 5 million people as of Nov. 30, the most current available data from the state. Of those, 3,954,826 are enrolled in Medicaid managed care plans. 

Sen. Jason Brodeur sponsored a managed care rewrite bill just before the start of the Session, and House Speaker Chris Sprowls said this week he wanted the House to take the lead on retooling the Medicaid managed care program that was initially pushed by the House.

Brown said Brodeur’s bill contains ideas that have been bandied about by state Medicaid staff and health plans, and the proposed changes “feel like a natural evaluation of the procurement” process.

The most divisive issue in the Medicaid managed care rewrite may be over dental services. Brown is unapologetic in her belief that dental services are best provided by the underlying health plan that offers general health care as opposed to having it go through a separate provider.

“Comprehensive coordinated care and not fragmented care is what we believe is the best for overall health outcomes,” Brown said.

But the association is not actively taking a stance on the current bills.

The initial Senate bill rolled out this week does not propose eliminating the freestanding dental managed care program. Brown anticipates the House bill will. She said her group is not lobbying the dental issue because “it is purely a policy decision for the Legislature to decide whether or not to carve back in dental.”

Christine Jordan Sexton

Tallahassee-based health care reporter who focuses on health care policy and the politics behind it. Medicaid, health insurance, workers’ compensation, and business and professional regulation are just a few of the things that keep me busy.

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