Medicaid managed care handling of sickle cell patients could be under microscope
Bryan Avila. Image via Colin Hackley.

FLAPOL113021CH047
The health care spending plans for Fiscal Year 2022-23 are being negotiated in Tallahassee.

The state may take a closer look at Medicaid beneficiaries with sickle cell disease and how contracted managed care plans provide care for them.

During an afternoon budget conference meeting, Rep. Bryan Avila offered a budget proviso to Sen. Aaron Bean. If agreed to, the change would require the Agency for Health Care Administration (AHCA) to conduct a review of the numbers of Medicaid enrollees diagnosed with the blood disorder. The analysis also would look at the subset of those who have had two or more emergency room visits or inpatient hospital admissions in a 12-month period.

The Senate has not yet agreed to accept the offer.

Avila and Bean are negotiating health care spending plans for Fiscal Year 2022-23, exchanging offers on how much to spend across the state’s programs between July 1, 2022, and June 30, 2023.

Bean said he was hopeful the chambers could have an additional meeting or two before having to ”bump up” unresolved budget issues to House Appropriations Chair Jay Trumbull and Senate Appropriations Committee Chair Kelli Stargel to resolve.

The General Appropriations Act, — the budget — is the only bill Florida lawmakers are required to pass during the annual Legislative Session.

Sickle cell is the most common inherited blood disorder. It is inherited from both parents. According to UFHealth, sickle cell disease is much more common in people of African and Mediterranean descent. It also is seen in people from South and Central America, the Caribbean and the Middle East.

It is called sickle cell because red blood cells become crescent-shaped. That causes frequent infections, swelling in the hands and legs, pain, severe tiredness and delayed growth or puberty.

The proviso language requires the agency to provide detailed information on sickle cell patients, including age and population demographics, health care utilization patterns and expenditures for all pharmaceutical and medical services provided. The analysis also must include the number of clinic treatment programs that managed care plans contract with to coordinate care for Medicaid enrollees with sickle cell disease.

The agency would be required to submit a report by Feb. 1, 2023. That report would go to the Governor, legislative leaders, the Florida Department of Health Office of Minority Health and Health Equity and the Rare Disease Advisory Council.

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.



#FlaPol

Florida Politics is a statewide, new media platform covering campaigns, elections, government, policy, and lobbying in Florida. This platform and all of its content are owned by Extensive Enterprises Media.

Publisher: Peter Schorsch @PeterSchorschFL

Contributors & reporters: Phil Ammann, Renzo Downey, Roseanne Dunkelberger, A.G. Gancarski, Anne Geggis, Kelly Hayes, Joe Henderson, Ryan Nicol, Jacob Ogles, Scott Powers, Gray Rohrer, Aimee Sachs, Jesse Scheckner, Christine Sexton, Andrew Wilson, and Mike Wright.

Email: [email protected]
Twitter: @PeterSchorschFL
Phone: (727) 642-3162
Address: 204 37th Avenue North #182
St. Petersburg, Florida 33704




Sign up for Sunburn


Categories