Legislative Update - July 2009

Taking On Health Care Fraud & Prescription Drug Abuse

With the Obama Administration's current effort to find a way to make quality health care accessible and affordable for all Americans, there's been a great deal of talk lately on the topic of health care. While a national health care program is beyond the authority of the Florida Legislature, we have been working in Tallahassee to rein in health care costs and crack down on fraud and abuse in our health care system.

This past legislative session, we passed important bills related to Medicaid fraud and to regulation of so-called "pain management clinics." I supported both of these bills, and believe they will make important reforms to our state health regulations. Given the health care debate that's now underway in Washington, I thought it would be helpful to tell you a little about each of these bills.

Medicaid Fraud
Unfortunately, South Florida has become ground zero for Medicaid fraud in our state. While Miami-Dade County is home to only 20% of the state's Medicaid population, it accounts for 90% (about $55 million) of the home health care dollars spent by Medicaid in Florida. In fact, there are more Medicaid home health providers just in Miami-Dade County, which has a population of 2.5 million, than there are in the entire state of California, which has a population of 38 million.

While many Medicaid home health companies are honest, and provide urgently needed care for their patients, there are also many who see Medicaid as nothing more than a license to steal. And when dishonest providers overbill Medicaid, or bill the program for services that aren't actually provided, that means funds are being taken away from people who genuinely need Medicaid services.

In order to root out fraud in the Medicaid program, particularly in Miami-Dade County, I supported SB 2658, which recently became law. This bill will place a moratorium on new home health care businesses for one year in Miami-Dade County, which will give the Agency for Health Care Administration time to review records of existing businesses to determine which may be defrauding the system.

In addition, once new companies are able to open again in July 2010, there will be new requirements that such businesses have a $500,000 bond to ensure they can meet their financial obligations. Also, non-citizens will be required to be legally in the country at least five years before receiving a license.

This new law will reduce state funds lost to Medicaid fraud by an estimated $6 million to $10 million each year, and leave more funds available for Medicaid services for people who really need them.

Cracking Down on "Pill Mills"
Another health-related problem that has plagued South Florida lately is the proliferation of "pill mills." In Broward County alone, there are about 90 of these so-called "pain management clinics," which offer prescriptions for large quantities of potent drugs like oxycodone, vicodin, Xanax, valium and morphine.

The U.S. Drug Enforcement Administration estimates that about 7 million Americans abuse these types of prescription drugs, and that more people now die each year (about 8,500) from prescription drug overdoses than from cocaine and heroin overdoses combined.

While 38 states have electronic monitoring programs to keep tabs on prescriptions of these powerful controlled substances, Florida had no such system. This made Florida a magnet for addicts and drug dealers from around the U.S. But this year, the Florida Legislature passed SB 462 (which I supported), that will create an electronic monitoring system to keep track of certain controlled drugs being prescribed and dispensed in Florida.

When a patient presents a prescription for a controlled medication to a pharmacist, the pharmacist would be required to report information about the patient, the prescribing doctor and the quantity and dose of drug being dispensed. At the same time, pharmacists may check the database to see if the patient presenting the prescription has received an excessive amount of controlled medications. Privacy safeguards will limit access to the records only to pharmacists, doctors and law enforcement officials. Hopefully, this new tracking system will enable health care and law enforcement professionals to stop the abuse of prescription drugs in our state and reduce the number of deaths from overdoses.

These are just two of the good health care reform bills we passed in Florida this year. As always, I welcome your questions or comments about these new laws, or about any matter relating to state government. Please feel free to contact me by calling (954) 747-7933 or e-mailing me at rich.nan.web@flsenate.gov.

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	Senator Rich Addressing Seniors at the Daniel Canter Senior Center
	Nan Rich with Gradutes of Weston University
	Senator Rich with the Final Graduting Class of Weston University 2010

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