5 Things Florida: Medicaid flexibilities ending, Q&A w/Alison Yager, Suicide Task Force

While DJ is out trying to get in a well-deserved vacation, I’ll be bringing you this edition of 5 Things We’re Watching. I’m the managing editor here at State of Reform where I have my eye on health care and health policy in Florida and a number of other states.

Feel free to email me any feedback or tips on what you think we should be covering!


Emily Boerger
State of Reform

1. Behavioral health system changes

As the state begins to plan for life after the pandemic, Dr. Christine Cauffield, CEO of LSF Health Systems, says it’s time to invest in effective behavioral health support systems. This, she says, includes easing licensing restrictions for certified recovery peer specialists.

“What we’re doing, legislatively, is working to remove some of the restrictions that prevent certified recovery peer specialists from easily entering the workforce. Because for many, they have criminal backgrounds involving substance use, possession, and drug usage, and that often prevents them from passing a background screening.” Cauffield also says state funding for behavioral health and investments into community-based recovery programs are critical.


2. Medicaid flexibilities ending this month

A series of Medicaid flexibilities introduced during the COVID-19 pandemic are expiring, or have already expired, this month. The list includes this rollback which will reinstate Medicaid prior authorization requirements for behavioral health services on July 15, and already reinstated service limits on the 1st.

The state has also changed the frequency for supplemental wrap-around payment requests for FQHCs – which helped with cash flow during the pandemic – and has rolled back the provisional provider enrollment flexibilities put in place to address workforce shortages in the state.


3. Q&A: Alison Yager on health equity

Alison Yager is the executive director of the Florida Health Justice Project, one of the state’s leading advocacy organizations for reducing health disparities. In this Q&A with State of Reform Reporter Nicole Pasia, Yager discusses COVID-19 data, the state’s disinvestment in public health infrastructure, and the policies she would like to see both federally and locally to address disparities.

In addition to Medicaid expansion, Yager says she would like to see the state legislature prioritize access to high quality data related to access to care and disparities in health outcomes. Federally, she hopes to see significant funding dedicated to home and community-based services. Their full conversation is available here.


4. Suicide task force discusses barriers to care

According to a recent Vox article titled “The doctors are not all right,” Florida is one of 33 states where medical license boards ask doctors to disclose mental health conditions or treatments. These types of questions, states the article, can act as a barrier for physicians who want to receive behavioral health treatment but fear it will put their jobs in jeopardy.

It appears other first responders face these same fears, according to comments made during Florida’s First Responders Suicide Deterrence Task Force meeting last month. One task force member with the Department of Law Enforcement said: “They would rather hurt in silence, rather than speak up and look for health. The only way to get cops to [seek care] is if there are mandatory requirements, mandatory training…that’s the only way to get rid of the stigma.”

5. Acquisitions accelerate during pandemic

As of January 2021, hospitals and other corporate entities owned close to half of all physician practices in the United States and employed close to 70% of all physicians in the country. This information was part of a recent study from the Physicians Advocacy Institute which found an acceleration in physician practice acquisitions during the pandemic.

Between 2019 and 2021, over 48,000 physicians left independent practices to become employees of hospitals or other corporate entities. Nearly half of those left after the onset of the pandemic. During this time, hospitals and other corporate entities acquired close to 21,000 additional physician practices.