Volume 2 Number 49 December 5, 2005

The Florida Legislature is meeting this week in a special session called by the governor to address two specific issues, one of which is Medicaid reform.  Our state’s Medicaid program serves as a healthcare safety net for more than 2.2  million low-income, elderly and disabled Floridians.    In response to ballooning program costs and patient dissatisfaction with care, the governor and several state lawmakers have promoted reforms to better target services to program participants and increase efficiencies by utilizing a managed-care approach.   Approximately one-third of Medicaid patients are already enrolled in managed-care plans. Without a complete overhaul of the program, the state’s Medicaid program is expected to consume more than 60 percent of the states’ annual budget by 2015. Costs have already spiraled to nearly $15 billion this year. In October, the federal government endorsed pilot projects in Broward and Duval counties.  There are more than 300,000 Medicaid participants in these two counties alone. The next step is anticipated this week with final approval from the Legislature.    Without a fix, escalating Medicaid costs will threaten our state’s ability to fund other critical services and the quality of care could be compromised. Recommended reforms deserve consideration.

GALLAGHER ANNOUNCES NEW OPTION FOR CONDOMINIUM COMMUNITIES TO RESOLVE HURRICANE CLAIMS Tom Gallagher, Florida’s Chief Financial Officer, announced a new mediation program to help condominium associations resolve disputes with their insurance companies over their hurricane claims.  Gallagher said the mediation program, set up for homeowners after the 2004 storms, has successfully helped more than 11,000 storm victims reach satisfactory settlements on their hurricane claims.  “Many condominium communities in our state have not yet started to rebuild because they are struggling with their insurance companies to get their claims paid,” said Gallagher, who oversees the Department of Financial Services. “My goal is to offer them a no-cost alternative to resolving their claims and help them successfully recover from catastrophic losses.” CONTINUED

RULING COULD PUT MONEY BACK IN DOCTORS’ POCKETS Florida doctors who had medical malpractice coverage with the former Caduceus Self Insurance Fund Inc. could potentially see reimbursements for assessments they paid to bail out the financially impaired company after a jury found the defunct company is owed nearly $18 million from a company that assumed some of the business. Caduceus, a Florida-domiciled medical malpractice insurer, was ordered into state receivership in January 2000.  Prior to being placed into receivership, Caduceus entered a contract with The Doctor’s Company (TDC) to be paid for policyholders who switched to TDC.  A jury found TDC owes Caduceus $17.9 million under that contract. TDC has appealed the decision. “We take our job very seriously to recover every asset that can go toward making affected Floridians whole,” said Tom Gallagher, Florida’s chief financial officer.  Gallagher oversees the Department of Financial Services, which includes the Division of Rehabilitation and Liquidation.  The judgment is one of the largest ever for a company in rehabilitation or liquidation with the department.| CONTINUED

GALLAGHER:  $32 MILLION IN HOMELAND SECURITY FUNDS HAVE BETTER PREPARED FLORIDA FOR DISASTERS, INCLUDING TERRORIST ATTACKS Tom Gallagher, state fire marshal, said that more than $32 million in federal Homeland Security funds have been funneled through the State Fire Marshal’s Office to fire departments throughout Florida, helping communities prepare to respond to natural disasters as well as chemical, biological, radiological or nuclear threats. “Florida has one of the most advanced response systems in the country thanks to hundreds of firefighters and other first responders who have trained and prepared for potential threats,” said State Fire Marshal Tom Gallagher.  “I applaud those on the front lines who have stepped up efforts to protect our communities, and who now have additional resources in place to ensure a rapid response after a catastrophic event.” CONTINUED

ORLANDO AGENT ARRESTED AGAIN FOR STEALING PREMIUMS An insurance agent whose license was suspended last year and has already been arrested twice this year by state insurance fraud detectives for stealing premiums has been arrested yet again. The most recent charges accuse Scott Wiggins, 42, who operated SRW Insurance Services out of his home, of pocketing approximately $100,000 in premiums from at least 10 victims, said detectives with the Department of Financial Services, Division of Insurance Fraud.  Wiggins allegedly never placed the coverage and issued forged certificates of coverage to cover his tracks.  Detectives suspect there are more victims. “We are continuing to investigate the scope of this individual’s operations,” said Florida’s Chief Financial Officer Tom Gallagher, who oversees the department.  “We are asking anyone who may have been a victim or knows anything about this operation to please come forward.”  CONTINUED