Florida Legislators Limit Medicaid Patient’s Pain and Suffering

Governor Rick Scott and the Republican controlled legislature concluded the legislative session by passing a number of anti-consumer bills, and of course lining the pockets of the insurance industry.

In a sweeping overhaul of the $21 billion Medicaid program, the Florida Legislature approved a bill Friday to shift nearly three million Medicaid recipients into managed-care programs in the hope of saving money and improving services.

If signed into law as expected, the bill will make Florida, with one of the largest number of Medicaid patients and a high rate of uninsured, one of the biggest states to jump almost entirely from a traditional Medicaid payment system into managed care. The wholesale shift would begin in July 2012.

Patients would be charged $10 monthly premiums and $100 if they showed up at the emergency room with a non-emergency.

The state and managed-care companies would control which services to provide to Medicaid patients.

The key handout to the insurance industry is a provision that limits the amount they would have to pay out in malpractice damages for pain and suffering to $300,000 for each Medicaid claimant, unless the damages award is punitive. Democrats said it would be unreasonable to charge poor patients fees and unjust to treat them differently in malpractice cases. “Why is it that their pain and suffering is devalued?” asked State Senator Arthenia L. Joyner, a Democrat of Tampa.

In 2003 the legislature also passed caps on pain and suffering that limits awards to $1,500,000, in the most catastrophic cases against hospitals and $500,000.00 in cases against doctors-up to a combined limit of $1,000.000.00 for all doctors. Thus, the most a non medicaid patient can recover for pain and suffering is $2,500,000. If the new law is approved by the federal government, the most a medicaid patient will be entitled to recover for pain and suffering is $300,000.00

Gov. Rick Scott, a wealthy former health care executive made revamping Medicaid a priority.

The proposed law cannot go into effect without the approval of the federal government, which pays more than half of Florida’s Medicaid tab. Last month, the federal government advised legislators to choose the payment system that would guarantee that a percentage of the money, in this case 90 percent, would go to patient services. Instead, the Legislature chose the other option: to share profits with managed-care companies.

Democrats and patient advocates said that they worried profit would get in the way of care and that some people would not be able to pay premiums. They expressed alarm that the bill is based on a five-year-old pilot program in five Florida counties that had decidedly mixed results. At least seven managed-care companies pulled out of the program in Broward County, and many patients — most of whom are low-income children or pregnant women — fled to networks run by hospitals.

Managed care is not new to Florida. About 60 percent of Medicaid patients are in some form of managed care but, outside of the pilot program, they must receive a mandated minimum level of benefits.

The Medicaid overhaul also extends into long-term care. Nursing home residents would shift into managed care, but the bill provides a separate provision for them. Payments would go directly to the nursing homes, bypassing managed-care companies, so money would not be deducted for administrative fees. Savings would come by shifting more people into home- and community-based programs.

Developmentally disabled people would be exempt from the managed care system for now. And each of the 11 managed-care regions in Florida would have to include a network run by a hospital or doctors. Those networks could continue to use the traditional payment system for three more years.

Those who already have insurance and are eligible for Medicaid would receive a voucher from the state to apply to their policies.

The 2011 legislative session will go down as the largest payback to insurance and special interest groups in recent memory. This Congress has elected to pass laws at the expense of the average Floridian. Unfortunately, most people are not informed, and do not understand that their rights have been stripped away until they themselves are the victims and look to the courts for redress.

The Medicaid plan makes no fiscal sense. I recently settled a medical Malpractice case for $5,000,000. The pain and suffering award for my brain damaged client with 2 young children was limited to $2,500,000. My client was a medicaid patient. The recovery will allow my client to pay back medicaid for the cost of the medical services they provided. My client will also pay all the medical services that would have been covered by medicare-a further relief to the american taxpayers.

However, by limiting pain and suffering awards, Medical Malpractice attorneys will simply not be able to undertake medical malpractice cases, and thus the cost of medical care will remain with the american taxpayer as opposed to the hospital or doctor whose treatment fell below the standard of care.