I'm fed up with Medicaid as it is constituted here in Florida.
The insurance plan dropped my Primary Care Physician from it's network.

I found an ACLU lawyer on the internet that has handled medical insurance cases and sent him this:

I am a disabled Medicaid recipient in Saint Petersburg Florida.

I am writing you this short note as I see from the internet that you are one of the few activist lawyers to have taken on medical insurance issues.

I have no clue whom might be available to talk to here in Florida about the travesty that is Florida's managed care Medicaid 'Demonstration'.

Florida rolled this form of Medicaid statewide about 24 months ago and in this time my own experience has been horrendous. I am certainly not alone in having issues with the implementation of the 'Demonstration'.

I am very facile in the ways health insurance and the federal program administration of same. (I learned well from my late father who was Deputy Insurance commissioner for health insurance regulation for the state of Pennsylvania).

It becomes very technical but here are a few programmatic issues that cross the line to violations of Medicaid recipient's rights:

1. The state of Florida was granted certain 'waivers' to Federal regulation by the CMS. These appear on the surface to violate equal protection provisions under the law.

2. The State of Florida has entered into agreements with private for profit health care plans The nature of these health care plans and the agreements that established them raises serious anti-trust issues as well as issues with respect to access rights of patients to competent providers of their medical care.

3. The state of Florida amended it's agreement with the CMS to make participation in the 'Demonstration' mandatory. Further. in lieu of a patients pro-active selection, the state assigns them automatically to one of the for profit plans.
There are no 'opt-out' provisions with in the Medicaid program (a return to 'fee for service'). Most patients end up taking what they are given.
5.. This lack of 'opt-out' provision appears to be a violation of Medical ethics and the law. The program is designed to save the state money but part of its metrics are the healthcare outcomes of the patients. This clearly places the program into a category of 'medical experiment'. Such an experiment must have the informed consent of the participants or it is illegal.
Mandatory participation appears to make the program illegal.
6. Endemic with the concept of 'managed care' is the network of providers. Patient choice is severely limited in such situations. In fact, in the absence of pro-active effort by a patient, a Primary Care Physician are automatically assigned by the plans.
With a network of providers comes the issue of providers being dropped from a plans network. A patient has little or no recourse in this eventuality. Dropped from network is considered a commercial matter between provider and plan and the patient is not privy to it.

This is a few of the issues impacting patients rights under Medicaid in Florida, (Most I have experienced first hand).

If you know someone in Florida who is up on medical insurance matters please forward this and my information to them.

Any suggestions you might have please feel free to reply.

Thanks for your time reading this,

I am so pissed right now at outsourcing/privatizing state functions to for profit cronies.

Can you feel the burn?