Latest news with #FloridaMedicaid
Miami Herald
10 hours ago
- Politics
- Miami Herald
Medicaid and SNAP benefits saved my life. Why would Congress hurt seniors like me?
Saving lives I am 65 years old and suffer from several chronic medical conditions, including high blood pressure, diabetes and cancer. I have also been hospitalized on several occasions, including for major surgery. When I received a hospital bill of more than $40,000, Florida Medicaid paid it entirely. This saved me from financial ruin and was lifesaving. Then, in 2021, due to a clerical error, my Social Security check was cut off. I had no income whatsoever for several months. I applied for and received Florida SNAP so that I would not go hungry. Medicaid and SNAP both saved my life. As the June 2 Miami Herald editorial revealed, ''Beautiful' bill cuts Florida seniors' food stamps. That's ugly,' the House's proposed cuts to Medicaid and SNAP will be devastating for seniors like me. These benefits are vital — they should never be cut, only expanded. Brian Douglas, Miami Worth saving As a U.S. Navy veteran, I'm always surprised when I hear people thank military service members for the 'rights that we all enjoy.' I considered it my job to protect Americans from foreign attacks. While my service might have protected life, the 'liberty and pursuit of happiness' part of the equation was and is provided by the U.S. Constitution. Rather than saying 'thank you for your service,' I wish more people would stand up to the daily attacks on our Constitution. Many in our country no longer enjoy some rights. Let's do something about it before some of those rights are not available to the rest of us. Tony Chifari, Miami Inhumane action I am Catholic Cuban American and member of organizations like Cuban American Women Supporting Democracy, the Pedro Arrupe Jesuit Institute and the Miramar Circle of Protection, all working toward a more just society. As has been reported, more than 500,000 individuals from Cuba, Venezuela, Haiti and Nicaragua will lose their legal status due to President Trump's order and a U.S. Supreme Court decision allowing it to proceed. This legal pathway, known as 'Humanitarian Parole,' was established because of our broken immigration system and reflects the desperate conditions in these nations, where violence and lack of basic necessities prevail. The order allows ICE to deport these immigrants back to the dangers they escaped. I vehemently oppose this. I urge everyone, especially Republicans who believed their loved ones were exempt from such policies, to speak out against this inhumane action. We must reverse this order and grant these individuals the opportunity to remain in our country. Silvia Munoz, Doral Beauty detoxed After seeing viral nail design videos online and how cheap it can be to do your own art, I was hooked and immediately bought the needed supplies. However, processes like Gel-X, which is what most at-home nail techs use, can be detrimental to our environment. Ten plastic nail extensions per person, per session, multiplied by millions of people worldwide is bound to take its toll, eventually. Further, the extremely harmful chemicals in acrylic or regular polish end up harming waterways and our health. To reduce this impact, more sustainable options are emerging. Brands like Manucurist offer plant-based, non-toxic polishes, while The GelBottle has a refill system and recyclable packaging to cut down waste. For those still interested in extensions, Bio Sculpture promotes biodegradable gel products with less harmful ingredients. Even small changes, like using reusable nail forms or acetone-free removers, can help reduce your beauty routine's footprint. Anagha Iyer, high school student, chair, Broward Sierra Group, Junior Team, Miramar Purging names President Donald Trump's Department of Defense plans to rename U.S. Navy ships to reflect what it describes as 'warrior culture.' The name of gay rights activist Harvey Milk will be stripped from a vessel — during Gay Pride Month, no less. Ruth Bader Ginsberg, Harriet Tubman, Thurgood Marshall, Cesar Chavez and others will also be removed from active ships named in their honor. Sadly, the administration doesn't recognize that these civil rights icons are in a warrior class of their own. The Navy has a long tradition of naming vessels after prominent people. To add to the list of indignities inflicted on the American people by this administration, buildings, roadways, even bodies of water are being renamed to align with the president's whims. This is consistent with the purge of DEI references from libraries and databases. These actions reflect a culture of repudiation not dissimilar to the sweeping transformation of Cuban society by Fidel Castro's government, which included the renaming of public buildings, institutions and landmarks to reflect revolutionary ideals and to erase symbols of the previous regime. Rosemary Ravinal, Doral Congressional failure Lots of good, bad and indifferent talk has occurred about the recent MAGA federal budget bill the U.S. House passed. What is truly annoying is our elected officials' constant stupidity in admitting their stupidity over voting for what they did not know or that they paid no attention to what was in the bill before approving it. A few years ago, U.S. Rep. Nancy Pelosi told America that Congress had to vote for a bill so they could then read it and see what was in it. Today's GOP representatives, by admitting that they did not know what was in the bill they had voted on and passed, is a call for their immediate impeachment. If this is not failure to do one's job, I am not sure what that might be. So I continue to fly the flag upside down, as we are in deep trouble. W.F. Cunningham, III, Fort Lauderdale Bondi complaint A recent article in the Herald revealed that prestigious lawyers and judges have lodged a formal complaint against Florida Bar member and current U.S. Attorney General Pam Bondi. The complaint is well-deserved because she either committed or came close to committing perjury during her confirmation hearing four months ago. Since winning an undeserved confirmation, Bondi has proved herself to be what many Floridians already knew of her: a political hack, provocateur, election result denier and prevaricating lawyer, unfit for the high position of a nation's chief law enforcement officer. David Kahn, Boca Raton Controversial hunt Florida's black bears deserve respect, not to be chased by dogs or shot over bait piles. Yet the Florida Fish and Wildlife Conservation Commission (FWC) just voted to allow a bear hunt using these exact methods. This decision flies in the face of overwhelming public opposition. At the hearing, people opposing the hunt more than doubled the number of those supporting it. In written comments submitted to the Commission, a staggering 75% voiced opposition. The FWC is supposed to manage wildlife in the interest of all Floridians, not just the less than one percent of the population who hold a hunting license. Commissioner Steven Hudson stood with the people and voted no, after voicing legitimate concerns over this travesty of a proposal. He deserves our gratitude. The rest of the commission failed in its duty. At the next meeting In August, we will return and stand up for ethical wildlife policy and for the future of Florida's wild bears. Jeffrey Konner, Aventura Political influence Florida had a chance to bring a well-known and respected academic, Dr. Santa Ono from the University of Michigan to help the state move forward, but a politicized Board of Governors (BOG) relied on comments by the likes of Donald Trump, Jr. and U.S. Rep. Byron Donalds to reject him. The last two BOG approvals for university presidents were termed-out politicians. Our State University System, as controlled by BOG, is being degraded and destroyed one appointment at a time. Culture wars should not be part of the decision-making process. Juan A. Galan, Jr., Coral Gables
Yahoo
02-06-2025
- Business
- Yahoo
A Medicaid Patient Had a Heart Attack While Traveling — He Owed Almost $78,000
On Christmas Day at the WaTiki indoor water park, Hans Wirt was getting winded from following his son up the stairs to the waterslides. Wirt's breathing became more labored once they returned to the nearby hotel where they and Wirt's girlfriend were staying while visiting family in Rapid City, South Dakota. Then he grew nauseated and went pale. Wirt thought the cause might have been the altitude change between his home in Deltona, Florida — 33 feet above sea level — and Rapid City, at the edge of the Black Hills. But his 12-year-old son was worried and called for an ambulance. 'I could tell by the look in his eyes that there was something a little more to this,' Wirt said. 'So I can kind of thank my son for saving my life.' It turned out the 62-year-old was having a heart attack. A 'lousy Christmas present,' Wirt said. Medics stabilized Wirt before taking him to Monument Health — the only hospital in Rapid City with an emergency room — where he was treated over two days. Then the bill came. Paramedics used a defibrillator to restore a normal heart rhythm. Doctors at the hospital gave Wirt various medications, used an electrocardiograph and other diagnostic and monitoring devices, and inserted stents into his arteries to improve blood flow to his heart. $95,523.73, including $32,998.90 for medical supplies, mostly related to the stents, and $28,879 for treatment in a cardiac catheterization lab. After unspecified hospital adjustments to the bill, Wirt owed $77,574.44. Wirt is covered by Florida's Medicaid program through Sunshine Health, a managed-care plan. But the South Dakota hospital refused to submit the bill to his out-of-state Medicaid plan, instead sending it to Wirt and eventually threatening to send the debt to a collection agency. Medicaid, the government health insurance program primarily for low-income people and those with disabilities, is jointly funded by the federal government and states. States are responsible for administering Medicaid, and most contract with private insurance companies like Sunshine Health. Federal law says state Medicaid programs must reimburse out-of-state hospitals for beneficiaries' care in an emergency. Many hospitals bill out-of-state Medicaid plans in such situations. If they don't, they risk not being reimbursed at all, since Medicaid recipients probably won't be able to afford large bills, said Katy DeBriere, who was legal director for the Florida Health Justice Project when she spoke with KFF Health News in April. But there's no federal law that requires them to do so, she said. Federal court opinions have noted that hospitals are not required to bill Medicaid for every individual beneficiary they treat, even if they generally accept Medicaid. Monument Health didn't bill Wirt's insurance because the hospital isn't enrolled as a health care provider with Florida Medicaid, said hospital spokesperson Stephany Chalberg. She told KFF Health News that Monument bills Medicaid plans only in South Dakota and four bordering states: Wyoming, Montana, Nebraska, and Minnesota. The hospital's website says Medicaid patients who are not enrolled in one of those states 'are responsible for any charges.' 'Due to the significant credentialing requirements of our multiple hospitals and hundreds of physicians we do not participate with all states,' a hospital representative wrote in a message to Wirt. According to Florida's Medicaid website, out-of-state providers who have treated one of its enrollees must submit five documents to bill the program, including a six-page application, a copy of the provider's license, and a claim form. The process is different in each state, and many Medicaid programs reimburse out-of-state providers at lower rates than those that are in-state, according to the Medicaid and CHIP Payment and Access Commission, a federal agency that advises Congress. Provider enrollment barriers leave 'beneficiaries in an untenable situation, preventing them from accessing the coverage to which they are legally entitled,' Chalberg said. Wirt decided to submit his bill to his Medicaid plan on his own. But he said Sunshine Health told him it can only process bills received directly from providers. Elizabeth Boyd, a spokesperson for Sunshine Health, told KFF Health News that its staff contacted the hospital on Wirt's behalf. She did not respond when asked why the plan can't process bills submitted by patients or what more it could have done to help Wirt. A few days after KFF Health News emailed officials at Monument Health for this story, Wirt noticed his balance due fell from more than $77,000 to $0. Chalberg told KFF Health News that Monument Health covered Wirt's bill through its charity care program. She said that 'appropriate patients' are told about the program and that 'before any bill is sent to collections, it is evaluated to determine whether the patient may qualify for our financial assistance policy.' To retain tax-exempt status, nonprofit hospitals must have programs that provide free or discounted care to patients who can't afford their bills. But Wirt said that when he first contacted Monument Health after receiving his bill and said he couldn't afford to pay it, officials didn't mention the program. He said they didn't share any resources when he asked whether there were outside groups that could help him pay the bill. Wirt said hospital officials just recommended setting up a payment plan, but the monthly bills were still too high for him to afford. 'There's a reason why I'm on Medicaid,' Wirt said. 'It's just beyond me how they can expect somebody who had Medicaid to come up with that kind of money. It's unrealistic.' Sarah Somers, legal director at the National Health Law Program, said the various 'cogs in the Medicaid system' didn't operate correctly in Wirt's situation. 'Nobody's exerting themselves enough to just smooth the way for this person.' States are responsible for managing Medicaid and are therefore the main 'cog,' Somers said. She said Medicaid managed-care companies are also supposed to intervene. Somers and DeBriere said Medicaid recipients who receive bills they don't think they owe should file a complaint with their state's Medicaid program and, if they have one, their managed-care plan. They can also ask whether there is a Medicaid or managed-care caseworker who can advocate on their behalf. The attorneys said patients should also contact a legal aid clinic or a consumer protection firm that specializes in medical debt. DeBriere said those organizations can help file complaints and communicate with the hospital. DeBriere said that, had she assisted Wirt, she would have immediately sent a letter to Monument Health ordering it to stop billing him and to either register with Florida Medicaid to submit his bill or offer him charity care. Wirt said the doctors who treated him and the medical care he received at Monument Health were excellent. He said he spoke out about the hospital's billing practices because he doesn't want others to endure the same experience. 'If I get sick and have a heart attack, I have to be sure that I do that here in Florida now instead of some other state,' he joked. The Patient Expected a Free Checkup. The Bill Was $1,430. Apr 30, 2025He Had Short-Term Health Insurance. His Colonoscopy Bill: $7,000. Mar 28, 2025A Runner Was Hit by a Car, Then by a Surprise Ambulance Bill Feb 28, 2025 More from Bill of the Month Bill of the Month is a crowdsourced investigation by KFF Health News and The Washington Post's Well+Being that dissects and explains medical bills. Since 2018, this series has helped many patients and readers get their medical bills reduced, and it has been cited in statehouses, at the U.S. Capitol, and at the White House. Do you have a confusing or outrageous medical bill you want to share? Tell us about it! KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF. Subscribe to KFF Health News' free Morning Briefing. This article first appeared on KFF Health News and is republished here under a Creative Commons license. The post A Medicaid Patient Had a Heart Attack While Traveling — He Owed Almost $78,000 appeared first on Katie Couric Media.
Miami Herald
30-05-2025
- Health
- Miami Herald
A Florida Medicaid patient had a heart attack while traveling. He owed $77,000
On Christmas Day at the WaTiki indoor water park, Hans Wirt was getting winded from following his son up the stairs to the waterslides. Wirt's breathing became more labored once they returned to the nearby hotel where they and Wirt's girlfriend were staying while visiting family in Rapid City, South Dakota. Then he grew nauseated and went pale. Wirt thought the cause might have been the altitude change between his home in Deltona, Florida — 33 feet above sea level — and Rapid City, at the edge of the Black Hills. But his 12-year-old son was worried and called for an ambulance. 'I could tell by the look in his eyes that there was something a little more to this,' Wirt said. 'So I can kind of thank my son for saving my life.' It turned out the 62-year-old was having a heart attack. A 'lousy Christmas present,' Wirt said. Medics stabilized Wirt before taking him to Monument Health — the only hospital in Rapid City with an emergency room — where he was treated over two days. Then the bill came. The medical procedure Paramedics used a defibrillator to restore a normal heart rhythm. Doctors at the hospital gave Wirt various medications, used an electrocardiograph and other diagnostic and monitoring devices, and inserted stents into his arteries to improve blood flow to his heart. The final bill $95,523.73, including $32,998.90 for medical supplies, mostly related to the stents, and $28,879 for treatment in a cardiac catheterization lab. After unspecified hospital adjustments to the bill, Wirt owed $77,574.44. The billing problem: Medicaid across state lines Wirt is covered by Florida's Medicaid program through Sunshine Health, a managed-care plan. But the South Dakota hospital refused to submit the bill to his out-of-state Medicaid plan, instead sending it to Wirt and eventually threatening to send the debt to a collection agency. Medicaid, the government health insurance program primarily for low-income people and those with disabilities, is jointly funded by the federal government and states. States are responsible for administering Medicaid, and most contract with private insurance companies like Sunshine Health. Federal law says state Medicaid programs must reimburse out-of-state hospitals for beneficiaries' care in an emergency. Many hospitals bill out-of-state Medicaid plans in such situations. If they don't, they risk not being reimbursed at all, since Medicaid recipients probably won't be able to afford large bills, said Katy DeBriere, who was legal director for the Florida Health Justice Project when she spoke with KFF Health News in April. But there's no federal law that requires them to do so, she said. Federal court opinions have noted that hospitals are not required to bill Medicaid for every individual beneficiary they treat, even if they generally accept Medicaid. Monument Health didn't bill Wirt's insurance because the hospital isn't enrolled as a health care provider with Florida Medicaid, said hospital spokesperson Stephany Chalberg. She told KFF Health News that Monument bills Medicaid plans only in South Dakota and four bordering states: Wyoming, Montana, Nebraska, and Minnesota. The hospital's website says Medicaid patients who are not enrolled in one of those states 'are responsible for any charges.' 'Due to the significant credentialing requirements of our multiple hospitals and hundreds of physicians we do not participate with all states,' a hospital representative wrote in a message to Wirt. According to Florida's Medicaid website, out-of-state providers who have treated one of its enrollees must submit five documents to bill the program, including a six-page application, a copy of the provider's license, and a claim form. The process is different in each state, and many Medicaid programs reimburse out-of-state providers at lower rates than those that are in-state, according to the Medicaid and CHIP Payment and Access Commission, a federal agency that advises Congress. More from this series The Patient Expected a Free Checkup. The Bill Was $1,430. Apr 30, 2025He Had Short-Term Health Insurance. His Colonoscopy Bill: $7,000. Mar 28, 2025A Runner Was Hit by a Car, Then by a Surprise Ambulance Bill Feb 28, 2025 More from Bill of the Month Provider enrollment barriers leave 'beneficiaries in an untenable situation, preventing them from accessing the coverage to which they are legally entitled,' Chalberg said. Wirt decided to submit his bill to his Medicaid plan on his own. But he said Sunshine Health told him it can only process bills received directly from providers. Elizabeth Boyd, a spokesperson for Sunshine Health, told KFF Health News that its staff contacted the hospital on Wirt's behalf. She did not respond when asked why the plan can't process bills submitted by patients or what more it could have done to help Wirt. The resolution A few days after KFF Health News emailed officials at Monument Health for this story, Wirt noticed his balance due fell from more than $77,000 to $0. Chalberg told KFF Health News that Monument Health covered Wirt's bill through its charity care program. She said that 'appropriate patients' are told about the program and that 'before any bill is sent to collections, it is evaluated to determine whether the patient may qualify for our financial assistance policy.' To retain tax-exempt status, nonprofit hospitals must have programs that provide free or discounted care to patients who can't afford their bills. But Wirt said that when he first contacted Monument Health after receiving his bill and said he couldn't afford to pay it, officials didn't mention the program. He said they didn't share any resources when he asked whether there were outside groups that could help him pay the bill. Wirt said hospital officials just recommended setting up a payment plan, but the monthly bills were still too high for him to afford. 'There's a reason why I'm on Medicaid,' Wirt said. 'It's just beyond me how they can expect somebody who had Medicaid to come up with that kind of money. It's unrealistic.' The takeaway Sarah Somers, legal director at the National Health Law Program, said the various 'cogs in the Medicaid system' didn't operate correctly in Wirt's situation. 'Nobody's exerting themselves enough to just smooth the way for this person.' States are responsible for managing Medicaid and are therefore the main 'cog,' Somers said. She said Medicaid managed-care companies are also supposed to intervene. Somers and DeBriere said Medicaid recipients who receive bills they don't think they owe should file a complaint with their state's Medicaid program and, if they have one, their managed-care plan. They can also ask whether there is a Medicaid or managed-care caseworker who can advocate on their behalf. The attorneys said patients should also contact a legal aid clinic or a consumer protection firm that specializes in medical debt. DeBriere said those organizations can help file complaints and communicate with the hospital. DeBriere said that, had she assisted Wirt, she would have immediately sent a letter to Monument Health ordering it to stop billing him and to either register with Florida Medicaid to submit his bill or offer him charity care. Wirt said the doctors who treated him and the medical care he received at Monument Health were excellent. He said he spoke out about the hospital's billing practices because he doesn't want others to endure the same experience. 'If I get sick and have a heart attack, I have to be sure that I do that here in Florida now instead of some other state,' he joked. Bill of the Month is a crowdsourced investigation by KFF Health News and The Washington Post's Well+Being that dissects and explains medical bills. Since 2018, this series has helped many patients and readers get their medical bills reduced, and it has been cited in statehouses, at the U.S. Capitol, and at the White House. Do you have a confusing or outrageous medical bill you want to share? Tell us about it! KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
