Health policy experts are highlighting a multitude of concerns regarding Florida's Medicaid Redetermination process, claiming it results in a lack of coverage for eligible children and families.

During a media call on Tuesday, advocates argued despite the Florida Department of Children and Families' stated plan to manage the unwinding of the public health emergency, the reality has been marked by chaos and confusion.

Official data released in late July by the U.S. Centers for Medicare and Medicaid Services show in the first month after federal continuous coverage provisions for Medicaid ended, 249,427 Floridians were disenrolled, 82% of whom had their cases closed for procedural or "red tape" reasons, such as failure to respond to a notice.

Erica Monet Li, policy analyst for the Florida Policy Institute, said the state's call center wait time ranks among the worst of the 17 states initiating redeterminations in April.

"48% of the calls made to DCF were abandoned and the average wait time for an initial contact was 40 minutes before being pushed to another helpline," Monet reported.

The Florida Department of Children and Families has issued guidance on its website, however, advocates say some links to legal aid are not working, language translation from English to Spanish is confusing and needs improvement, and they said the website needs to be modernized with a mobile-friendly option to make it easier for Floridians to navigate.

According to the Centers for Medicare and Medicaid Services, every state must unveil a strategy to streamline re-enrollment and reduce coverage losses.

Joan Alker, executive director of the Georgetown University Center for Children and Families, noted a mechanism called "ex-parte" renewals, intended to simplify income-based verification and auto-renewals, is only being implemented in Florida at approximately 19%.

She expressed concern the state's processing methods might warrant investigation.

"Because Florida has a low ex-parte rate and a relatively high share of children, certainly Florida may be one of the states that is being investigated for this issue and we expect CMS enforcement to follow," Alker noted.

Advocates said it is difficult to navigate such a complex process and are calling on Florida officials to issue a pause in redeterminations until they fix the problems or able to properly execute the state's plan.

Lynn Hearn, staff attorney for the Florida Health Justice Project, which has a dashboard on its website for tracking the redetermination process, said the group is hearing many stories of people being confused about notices from the state.

"The notice also does not clearly indicate how to appeal or correctly," Hearn asserted. "The appeal instructions are deep in the notice, after a multipage notice, after a full page of QR codes for potentially other irrelevant other programs."

Florida is the only state to not take advantage of the flexibilities offered by the Centers for Medicaid to remedy common issues and the groups are urging Florida's leaders to focus on fixing current problems to ensure the state's eligible children and families are not cut out of any needed coverage.

Law enforcement officers and drug prevention advocates in Missouri are joining forces to tackle prescription drug misuse.

As part of the Drug Enforcement Administration's "National Prescription Drug Take Back Day," five collection sites will be set up across Taney and Stone counties on April 26.

Data from two years ago showed around 190,000 Missourians misused opioids, including 180,000 who misused prescription pain relievers.

Marietta Hagan, project coordinator at Cox Health, warned prescription drug misuse contributes heavily to opioid use disorder.

"People would get prescription medication that didn't belong to them as easy as walking into their parent's medicine cabinet and pulling it out of there, or pulling it out of the side night table at bedtime," Hagan explained.

Volunteers will be at the sites offering free safety tips and disposal kits, making it easy for families to clear out their medicine cabinets.

Hagan emphasized "Drug Take Back Day" is about more than just safe disposal. It is also a reminder to store medications properly to prevent misuse. She shared guidance on how to safely get rid of unwanted medications.

"Previously government agencies had encouraged actually the flushing of medications," Hagan noted. "But we now know thanks to environmental science, that is not recommended. Those medications end up in our water supply, in our lakes and our streams."

Most prescription and over-the-counter medications will be accepted, including pills, patches, and vapes without batteries. National Prescription Drug Take Back Day is held twice a year, typically in April and October.


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A Tennessee nonprofit is warning that potential Medicaid cuts could threaten crucial support for the state's nearly 1 million family caregivers.

Medicaid supports 4.5 million individuals through home health-care services nationwide.

Megan Schwalm, president and CEO of the Tennessee Caregiver Coalition, said more than half of its funding comes from the now-dismantled Administration for Community Living - which has been folded into the Department of Health and Human Services.

Schwalm said federal funding cuts have affected the coalition, which provides respite services for people caring for loved ones with dementia or other serious conditions.

"Our state typically reimburses at $23.44 an hour for respite, and so us being able to provide at about $5 an hour is a huge cost savings," said Schwalm. "But with those cuts to Medicaid and the Administration for Community Living, we won't be able to provide those services any longer."

She said the funding cuts have already forced the loss of a staff position and nearly all outreach efforts for respite services across Tennessee.

Medicaid is jointly funded by states and the federal government, but Congress is proposing cutting Medicaid spending by $880 billion over 10 years.

According to AARP, Tennessee already ranks poorly among states for its lack of supports and services for caregivers and people with disabilities.

Schwalm acknowledged that Medicaid could benefit from reform, but she said dismantling it without a clear, comprehensive plan would be detrimental to the people of Tennessee.

"These cuts to Medicaid are coming, but there is no safety net in place," said Schwalm. "There is no alternative. And so it is very unclear what will happen to these folks in these programs."

She emphasized the importance of Tennesseans letting their elected officials know how they feel about safeguarding these safety net programs.




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A bill in the Tennessee General Assembly is reigniting debate over how rural hospitals can staff anesthesia providers. House Bill 979 would address the shortage of anesthesiologists in rural Tennessee by allowing hospitals in counties with fewer than 105,000 residents to directly employ physician anesthesiologists.

Hospitals now have to use third-party anesthesiology services.

Dr. Louis Chemin III, anesthesiologist and physician with Tennessee Anesthesiology Consultants Exchange, supports physician supervision in what's known as the "Anesthesia Care Team" model. He said anyone hired as an anesthesiologist would be required to follow strict medical guidelines.

"Currently under state law, a hospital cannot employ an anesthesiologist, a radiologist, a pathologist or an emergency medicine physician. If this bill were to pass, it would allow hospitals in these rural communities the option to hire an anesthesiologist," he contended.

Chemin said the bill would allow a hospital anesthesiologist to perform anesthesia in one operating room, or to supervise the process in up to four operating rooms.

On Wednesday, the bill passed the House with a vote of 72 to 5, with 11 members "present but not voting." It now heads to the state Senate.

When a physician anesthesiologist provides medical direction to Certified Registered Nurse Anesthetists or Anesthesiologist Assistants, Chemin explained, they must comply with seven steps outlined by the Centers for Medicare and Medicaid Services to qualify for reimbursement under Medicare.

"This law means that if a hospital employs an anesthesiologist, that they must allow the anesthesiologist to practice in a way that is safe and is in agreement with these seven steps," he continued.

Chemin added that these requirements would ensure the anesthesiologist's active involvement in the patient's care and safety.


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