Attached some food for thought regarding the mandatory drug testing for welfare recipients:
When Florida Gov. Rick Scott (R) signed the law requiring welfare recipients to pass annual drug tests to collect benefits, he justified the likely unconstitutional law by saying it would save the state money by keeping drug users from using public money to subsidize their drug habits. Drug use, Scott claimed, was higher among welfare recipients than among the rest of the population.According to preliminary results from the state’s first round of testing, however, has seemingly proven both of those claims false. Only 2 percent of welfare recipients failed drug tests, meaning the state must reimburse the cost of the $30 drug tests to the 96 percent of recipients who passed drug tests (two percent did not take the tests). After reimbursements, the state’s savings will be almost negligible, the Tampa Tribune reports:
Cost of the tests averages about $30. Assuming that 1,000 to 1,500 applicants take the test every month, the state will owe about $28,800-$43,200 monthly in reimbursements to those who test drug-free.
That compares with roughly $32,200-$48,200 the state may save on one month’s worth of rejected applicants.
Net savings to the state: $3,400 to $5,000 annually on one month’s worth of rejected applicants. Over 12 months, the money saved on all rejected applicants would add up to $40,800 to $60,000 for a program that state analysts have predicted will cost $178 million this fiscal year.
This should serve as an example that our government in Florida seems to base its decisions on ideological assumption instead on rational thought and consideration.
Yours
Bernd
Bernd Wollschlaeger,MD,FAAFP,FASAM
16899 NE 15th Avenue
North Miami Beach,FL 33162
Phone: (305) 940-8717
Fax: (305) 940-8871
Web Site: www.miamihealth.com
Blog: http://floridadocs.blogspot.com
Twitter: http://www.twitter.com/dadedoc
Saturday, August 27, 2011
Saturday, August 20, 2011
Primary Care Defunded
Attached you find a link to an article by John Dorschner titled "Clinics for poor threatened by cuts" http://www.miamiherald.com/2011/08/17/2366741/south-florida-clinics-threatened.html pointing out that " federal support of clinics [ community health centers] took a big hit in the recent deficit reduction deal in Washington and may be taking an even bigger one when Congress starts a new round of budget-cutting in the near future. At the same time, some free clinics in South Florida that also help the poor — often with little or no government support — are running out of funds and are in danger of closing."
Dorschner further reports that the creators of the federal healthcare reform act considered primary care such an important way to cut costs that the act authorized $11 billion to bolster care at “federally qualified health centers,” which include nine clinics with more than 30 locations in Miami-Dade and Broward. Congress authorized $1 billion for new federally qualified facilities or expansions of existing ones this year. But the $1 billion allocation was slashed to about $90 million for new facilities during the recent budget cuts. Only 67 of 2000 applications for new federally qualified centers were funded. More cuts may be coming as a new congressional deficit reduction committee gets under way.
In my opinion cutting primary care services is a penny-wise and pound-foolish decision . Now, those uninsured will be left with no other choice but to use the emergency rooms of local hospitals for their care resulting in far higher costs, poor care coordination and no continuity of care.
How can we talk sense to politicians who seem to ignore those facts? Are they really so detached from reality, or is is just about scoring points for their re-election campaigns? We must speak up and defend the rights of those who now do not have anyone left to speak up for them. Both parties in congress are at fault and our president doesn't dare to rock the boat. Enough is enough!!
Dorschner further reports that the creators of the federal healthcare reform act considered primary care such an important way to cut costs that the act authorized $11 billion to bolster care at “federally qualified health centers,” which include nine clinics with more than 30 locations in Miami-Dade and Broward. Congress authorized $1 billion for new federally qualified facilities or expansions of existing ones this year. But the $1 billion allocation was slashed to about $90 million for new facilities during the recent budget cuts. Only 67 of 2000 applications for new federally qualified centers were funded. More cuts may be coming as a new congressional deficit reduction committee gets under way.
In my opinion cutting primary care services is a penny-wise and pound-foolish decision . Now, those uninsured will be left with no other choice but to use the emergency rooms of local hospitals for their care resulting in far higher costs, poor care coordination and no continuity of care.
How can we talk sense to politicians who seem to ignore those facts? Are they really so detached from reality, or is is just about scoring points for their re-election campaigns? We must speak up and defend the rights of those who now do not have anyone left to speak up for them. Both parties in congress are at fault and our president doesn't dare to rock the boat. Enough is enough!!
Wednesday, August 17, 2011
Health Insurance Policy
Attached a link to an interesting article http://online.wsj.com/article/SB10001424053111904253204576512494056148396.html published in today's WSJ reporting that as part of the health-care overhaul law federal regulators are expected to unveil on Wednesday the proposed health insurance policy summary form of health insurance policies , that will lay out the details of each policy, from deductibles to how much it might cost to have a baby. The requirement is supposed to take effect next March. Currently, states mandate certain disclosures from health insurers, but they vary by state. The information often comes as part of a document known as the certificate of coverage or evidence of coverage, which can run to dozens of densely written pages and is often supplied ONLY AFTER a consumer has signed up for a policy. Employers offering coverage typically provide materials to their workers, but these also don't follow any common national format.
The proposed new summary is expected to closely follow a draft version from a committee convened by the National Association of Insurance Commissioners, people with knowledge of the matter said. Health and Human Services is expected to finalize the form after a public comment period. Insurers said they were concerned about the potential cost and administrative burden of the new requirement, particularly if they have to create different iterations of the form for every possible plan design a consumer could explore and for every single employer.
Of course they are concerned because for the first time the policies will be readable, comparable and can form the basis of rational decision making in a complex market place. Who does understand his/her current health care policy? I don't !! I still struggle to understand how much my insurance will cover for a colonoscopy and how much I have to budget for this procedure. If we want a free market place then we should allow for measures that create accountability and transparency. Currently, insurance companies will make every effort to maintain the status quo, which disenfranchises the consumer. We should support these new federal regulation and to express our opinions during the public comment period. Let's not miss this opportunity.
Yours
Bernd
The proposed new summary is expected to closely follow a draft version from a committee convened by the National Association of Insurance Commissioners, people with knowledge of the matter said. Health and Human Services is expected to finalize the form after a public comment period. Insurers said they were concerned about the potential cost and administrative burden of the new requirement, particularly if they have to create different iterations of the form for every possible plan design a consumer could explore and for every single employer.
Of course they are concerned because for the first time the policies will be readable, comparable and can form the basis of rational decision making in a complex market place. Who does understand his/her current health care policy? I don't !! I still struggle to understand how much my insurance will cover for a colonoscopy and how much I have to budget for this procedure. If we want a free market place then we should allow for measures that create accountability and transparency. Currently, insurance companies will make every effort to maintain the status quo, which disenfranchises the consumer. We should support these new federal regulation and to express our opinions during the public comment period. Let's not miss this opportunity.
Yours
Bernd
Monday, August 15, 2011
The Blues Treatment For Mental Health Providers
Attached a very troublesome article I just received today reporting that on July 27, 2011 Blue Cross Blue Shield of Florida began notifying ALL of their mental health providers (licensed social workers, licensed mental health counselors, psychologists, and psychiatrists) that effective November 30th, 2011 they would be terminated, without cause.
They were also notified that that if providers would like to join the new company they are partnering with, New Directions, so that they can provide services to their patrons, they would need to complete a new contract (sent under separate cover) within 15 days and agree to significant cuts (35-55%) in reimbursement rates, as well as other disturbing clauses such as only being able to refer to in-network providers, etc.
Since BCBS is considered to be one of the largest providers of insurance for mental/behavioral health in Florida, this termination could potentially place hundreds/thousands of providers in a position of being underemployed and/or unemployed, and worse, leave thousands of patients without coverage or access to mental health/psychological treatment.
CNN producer note
iReport -
On July 27, 2011 Blue Cross Blue Shield of Florida began notifying ALL of
their mental health providers (licensed social workers, licensed mental
health counselors, psychologists, and psychiatrists) that effective Nov 30,
2011 they would be terminated, without cause. That is, they will no longer
be providers for BCBS-FL. In this notice, current providers were also
instructed to notify BCBS subscribers/patients of this coming termination
directly and on behalf of BCBS-FL.
BCBS-FL also indicated that if providers would like to join the new company
they are partnering with, New Directions, so that they can provide services
to their patrons, they would need to complete a new contract (sent under
separate cover) within 15 days and agree to significant cuts (35-55%) in
reimbursement rates, as well as other disturbing clauses such as only being
able to refer to in-network providers, etc.
Interestingly, New Directions appears to be a subsidiary of BCBS-FL. So, as
if it isn't horrible enough that ALL of the mental/behavioral health
providers have been "fired" at the same time and patients will likely find
themselves with poor quality care or no care at all, it appears that they
(the same company-BCBS-FL) fired its contractors and then offered them the
oportunity to reapply for rehire within the same week, but only if they
agree to sign a new contract, with entirely different terms.
This action (termination of providers only in one area) also seems to be a
possible violation of the Federal Mental Health Parity Law which protects
against the discrimination of mental health services. It does not appear
that any of the other healthcare providers or "medical" providers had their
contracts terminated.
Since BCBS is considered to be one of the largest providers of insurance for
mental/behavioral health in Florida, this termination could potentially
place hundreds/thousands of providers in a position of being underemployed
and/or unemployed, and worse, leave thousands of patients without coverage
or access to mental health/psychological treatment.
The ripple effect of these actions by BCBS-FL could be deadly to the people,
communities, and businesses throughout FL. leaving many unable to make a
reasonable living and thousands (including Seniors with BCBS as a secondary
policy) unable to access and/or pay for mental health treatment and
psychological services.
--
Bernd Wollschlaeger,MD,FAAFP,FASAM
16899 NE 15th Avenue
North Miami Beach,FL 33162
Phone: (305) 940-8717
Fax: (305) 402-2989
Web Site: www.miamihealth.com
Blog: http://floridadocs.blogspot.com
Twitter: @dadedoc
They were also notified that that if providers would like to join the new company they are partnering with, New Directions, so that they can provide services to their patrons, they would need to complete a new contract (sent under separate cover) within 15 days and agree to significant cuts (35-55%) in reimbursement rates, as well as other disturbing clauses such as only being able to refer to in-network providers, etc.
Since BCBS is considered to be one of the largest providers of insurance for mental/behavioral health in Florida, this termination could potentially place hundreds/thousands of providers in a position of being underemployed and/or unemployed, and worse, leave thousands of patients without coverage or access to mental health/psychological treatment.
CNN producer note
iReport -
On July 27, 2011 Blue Cross Blue Shield of Florida began notifying ALL of
their mental health providers (licensed social workers, licensed mental
health counselors, psychologists, and psychiatrists) that effective Nov 30,
2011 they would be terminated, without cause. That is, they will no longer
be providers for BCBS-FL. In this notice, current providers were also
instructed to notify BCBS subscribers/patients of this coming termination
directly and on behalf of BCBS-FL.
BCBS-FL also indicated that if providers would like to join the new company
they are partnering with, New Directions, so that they can provide services
to their patrons, they would need to complete a new contract (sent under
separate cover) within 15 days and agree to significant cuts (35-55%) in
reimbursement rates, as well as other disturbing clauses such as only being
able to refer to in-network providers, etc.
Interestingly, New Directions appears to be a subsidiary of BCBS-FL. So, as
if it isn't horrible enough that ALL of the mental/behavioral health
providers have been "fired" at the same time and patients will likely find
themselves with poor quality care or no care at all, it appears that they
(the same company-BCBS-FL) fired its contractors and then offered them the
oportunity to reapply for rehire within the same week, but only if they
agree to sign a new contract, with entirely different terms.
This action (termination of providers only in one area) also seems to be a
possible violation of the Federal Mental Health Parity Law which protects
against the discrimination of mental health services. It does not appear
that any of the other healthcare providers or "medical" providers had their
contracts terminated.
Since BCBS is considered to be one of the largest providers of insurance for
mental/behavioral health in Florida, this termination could potentially
place hundreds/thousands of providers in a position of being underemployed
and/or unemployed, and worse, leave thousands of patients without coverage
or access to mental health/psychological treatment.
The ripple effect of these actions by BCBS-FL could be deadly to the people,
communities, and businesses throughout FL. leaving many unable to make a
reasonable living and thousands (including Seniors with BCBS as a secondary
policy) unable to access and/or pay for mental health treatment and
psychological services.
--
Bernd Wollschlaeger,MD,FAAFP,FASAM
16899 NE 15th Avenue
North Miami Beach,FL 33162
Phone: (305) 940-8717
Fax: (305) 402-2989
Web Site: www.miamihealth.com
Blog: http://floridadocs.blogspot.com
Twitter: @dadedoc
Wednesday, August 03, 2011
Florida Turns Down Federal Money
Attached a link to a recent article published in the NYT http://www.nytimes.com/2011/08/01/us/01florida.html pointing out that despite having the country’s fourth-highest unemployment rate, its second-highest rate of people without insurance and a $3.7 billion budget gap this year, the Florida has turned away scores of millions of dollars in grants made available under the Affordable Care Act. And it is not pursuing grants worth many millions more.
Although Florida is the fourth most populous state, it ranks 12th in the amount of money received from health care act grants, according to the government’s grant-tracking Web site. The law has directed $46.4 million to the state out of $1.98 billion awarded nationally. Much of the money has gone directly to local governments, community groups and medical providers. The Florida government even went so far to deny funding for community health centers! Three of four grants to expand community health clinics in Florida went to medical centers that are beyond the reach of the governor and the Legislature. The fourth was to the Osceola County Health Department, which under Florida law is effectively a unit of state government. The Legislature used its power to not authorize a grant won by the county to expand two health centers and build a third.
This represents not only irresponsible ideology driven behavior but it also threatens the fragile health of our communities.
Its time to raise our voices and to act as responsible citizens of our great state of Florida.
Yours
Bernd
Although Florida is the fourth most populous state, it ranks 12th in the amount of money received from health care act grants, according to the government’s grant-tracking Web site. The law has directed $46.4 million to the state out of $1.98 billion awarded nationally. Much of the money has gone directly to local governments, community groups and medical providers. The Florida government even went so far to deny funding for community health centers! Three of four grants to expand community health clinics in Florida went to medical centers that are beyond the reach of the governor and the Legislature. The fourth was to the Osceola County Health Department, which under Florida law is effectively a unit of state government. The Legislature used its power to not authorize a grant won by the county to expand two health centers and build a third.
This represents not only irresponsible ideology driven behavior but it also threatens the fragile health of our communities.
Its time to raise our voices and to act as responsible citizens of our great state of Florida.
Yours
Bernd
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