Latest news with #Medicaid-managed
Yahoo
30-05-2025
- Health
- Yahoo
RFK Jr. Swaps Made-Up Studies in His Report for More Made-Up Studies
Health Secretary Robert F. Kennedy Jr.'s error-laden Make America Healthy Again report was updated Friday to remove citations to several non-existent studies—as well as some perfectly real ones—and replace them with citations that still make no sense, NOTUS reported. A NOTUS investigation published Thursday found that Kennedy's report taking aim at childhood vaccines, ultraprocessed foods, and pesticides listed studies that authors said were either misinterpreted or had never even occurred, leaving artificial intelligence researchers partially blaming AI for the errors. Several studies cited in the original report identified by NOTUS as nonexistent were all replaced Friday, as well as some studies with which NOTUS had not identified any issues. But in some cases, the replacements weren't much better. One study that the original report cited to support the claim that psychotherapy was a better treatment for children experiencing mental health issues than medication was replaced by another 'systemic overview' by Pim Cuijpers, a widely referenced psychologist in Amsterdam. But Cuijpers told NOTUS that his study covered the use of psychiatric medication in adults, not children. The two 'cannot be compared, and this reference is therefore not usable in adolescents,' Cuijpers wrote in an email to NOTUS. He also noted that there was no evidence to support the report's claim that psychotherapy was more effective than antidepressants for adolescents. This wasn't the only detail that undermined the report's arguments that American children were over-medicated. Cuijpers pointed out to NOTUS that the report's claim that 'antidepressant prescription rates in teens increased by 14-fold between 1987 and 2014' was a little less convincing considering that antidepressants were only developed in the late 1980s. 'So it can also be said that these drugs were simply used for the adolescents who could benefit from them,' Cuijpers told NOTUS. Another faulty citation attributing work to the incorrect authors was fixed, NOTUS reported, but the new study cited also failed to support the claim that 'since the 1970s, recess and physical education (PE) have steadily declined.' Yet another incorrect citation referred to pulmonologist Harold J. Farber, but didn't cite an actual paper he'd worked on to support the claim that 'an estimated 25-40% of mild cases' of asthma were overprescribed drugs. The new citation referred to Farber's actual study, which had been about a Medicaid-managed care program study in Texas, but Farber told NOTUS that the notion that those results applied to the general population required a 'tremendous leap of faith.' After the initial NOTUS report, so many changes were made to the documents to remove evidence of AI-chatbot handiwork that White House officials stopped denoting changes to the document, and deleted references to prior corrections, NOTUS reported.
Yahoo
28-04-2025
- Politics
- Yahoo
What is Hope Florida and is there a scandal around charity run by Casey DeSantis?
A program spearheaded by Florida first lady Casey DeSantis continues to see scrutiny from Democrats and Republicans over a $10 million "donation." Under state law, money from settlements must be deposited into the state's general revenue fund and reported to the Legislature for oversight. The $10 million, which was part of a $67 million legal settlement between AHCA and Centene, wasn't. Instead, the Miami Herald reported that "the Hope Florida Foundation turned around and gave $5 million a piece to organizations that in turn gave millions to a political committee waging an anti-marijuana amendment campaign championed by the governor." The use of the $10 million 'looks like criminal fraud by some of those involved,' Republican state Rep. Alex Andrade, one of DeSantis' main critics, told the newspaper. "... (W)ho on Earth thought this was legal, moral or ethical?' Political analysts believe this could undermine Casey DeSantis' potential bid for governor in 2026, with reports claiming the former journalist seeks to succeed her husband Gov. Ron DeSantis. Here's what to know about Hope Florida and the controversy surrounding its foundation. Hope Florida was started by Casey DeSantis in 2021. It seeks to help Floridians move off of government assistance by connecting them to a clearinghouse of other services from nonprofits and faith-based communities. According to its website, Hope Florida is funded by donations from individuals and private businesses and provides financial services to local nonprofit organizations. Hope Florida "Navigators" are state employees who work with people to find solutions from the private sector, faith-based communities, and nonprofits to help them use all the local community resources available and reduce the need for the government's help. According to DeSantis, Florida's goal is to help and then stay "out of the way." A website says Hope Florida has served over 100,000 Floridians since its beginning, specifically helping more than 25,500 participants to "reduce or eliminate reliance on public assistance." No, they are not. In 2023, Hope Florida administrators created a separate nonprofit called the Hope Florida Foundation. The Tampa Bay Times reported that Casey DeSantis' name does not appear on corporate records for the charity. The foundation has yet to release records about its donors or recipients or any state-mandated records about its structure, ethics and oversight. The question is whether the $10 million was improperly solicited and directed. The controversy surrounding the Hope Florida Foundation came to light after news outlets uncovered a $10 million 'donation' as part of a settlement between the state's Agency for Health Care Administration and Centene, a Medicaid-managed care vendor for the state. The entire settlement, to resolve alleged overpayments, was $67 million but $10 million was directed to the Hope Florida Foundation in October. The Hope Florida Foundation then gave two $5 million grants each to two nonprofit organizations: Securing Florida's Future, chaired by Mark Wilson, who is also the chairman of the Florida Chamber of Commerce, and Save Our Society from Drugs. Those groups in turn gave $8.5 million to Keep Florida Clean, a political committee chaired by James Uthmeier, then DeSantis' chief of staff and current attorney general. Keep Florida Clean was set up to oppose an amendment on the 2024 ballot to legalize recreational marijuana. The group has given $1.2 million to the Florida Freedom Fund, another political committee chaired by Uthmeier and used by DeSantis to fight both the marijuana amendment and an amendment that would've installed a right to an abortion into the state's constitution. Ron DeSantis has voiced his opinions over the controversy, claiming these reports are 'fabricated' and a "smear campaign." During a press conference on April 24 in St. Augustine, which occurred an hour after Andrade's panel met, he advised those not to believe what they've heard about Hope Florida. 'They got a $10 million private donation on top of that, which is what the agency said from the beginning,' Ron DeSantis said. 'This is an attempt to try to manufacture a narrative where there's really nothing there. Why are they doing it? It's all because they want to try to impugn our Hope Florida program. That's why they're doing it. It's all political.' He also alleged the media was pushing "phony narratives" and smearing both the foundation and his wife. Joined by his wife, he added Casey was being targeted because she "is a threat." 'Some of these left journalists don't like it. They don't like you working with the faith-based community. Some of these people view it as a way to attack the first lady and all the great things she's done and they view her as a threat,' he said. Casey DeSantis also addressed the critics and allegations, telling those to never "let politics get in the way of purpose." 'What we are doing is good. What we are doing is just. Sometimes you have to put on the full armor of God and you fight, because you know what you're doing is righteous,' Casey DeSantis said. Andrade announced on April 25 that the panel is halting its probe into Hope Florida. According to the News Service of Florida, Andrade's panel will continue to dig into the DeSantis administration's spending and other issues when lawmakers return to Tallahassee for committee meetings this fall. The 2025 legislative session is scheduled to end next week. 'I'm not a prosecutor or an FBI agent. I know now that I will never trust Gov. DeSantis again with taxpayer money, let alone Medicaid money. So that's going to frame my policymaking decisions until I'm done in public office,' he said. Ron DeSantis was first elected in 2018 and began his term in office on Jan. 8, 2019. He was re-elected by a landslide in 2022. According to the Florida Constitution, he will be ineligible to run again in the next Florida gubernatorial election in 2026 and will leave office in January 2027. Could another DeSantis have their turn at governor? According to polls, Casey DeSantis is among the top picks for candidates. A Mason-Dixon Polling & Strategy survey released in March showed her with a 53% approval rating, polling slightly ahead of candidate Rep. Bryon Donalds at 48%. However, The Hill reported the allegations surrounding Hope Florida and the intraparty divide "could preview what a contested Republican primary would look like should Casey DeSantis launch a gubernatorial bid." 'It's a sign of other things to come,' Ford O'Connell, a Florida Republican strategist told the outlet. 'She is getting a shot across the bow and a taste of the type of slime that will be thrown around should she choose to run for governor.' 'People do not realize what bareknuckle, brutal campaigns it is to become the Republican nominee, whether it's statewide or in certain small districts,' he continued. 'It is war.' Casey DeSantis has not confirmed or denied a run for governor. Back in March, she told the audience at the National Review Institute's Ideas Summit that "we'll see" when asked about a potential bid for the role. Contributing: Gray Rohrer, USA TODAY Network – Florida Capital Bureau This article originally appeared on Florida Times-Union: Hope Florida controversy: What about Casey DeSantis' attempt for Gov?
Yahoo
24-04-2025
- Politics
- Yahoo
'Smear': Gov. DeSantis hits back as House, media probe Hope Florida funds
Gov. Ron DeSantis again condemned Florida House Republicans and the news media over continued questioning into the beleaguered Hope Florida initiative of his wife, First Lady Casey DeSantis. The DeSantises, state officials and program participants appeared at St. Augustine's Anchor Faith Church April 24 to defend and promote the program, billed as a conservative alternative to traditional welfare that connects needy Floridians with help from nonprofits and other charities. A House panel and news organizations have been digging into a $10 million dollar donation that was connected to a $67 million legal settlement between the state and Centene, a Medicaid-managed care vendor, over alleged overbilling. 'They're trying to smear this program,' DeSantis told the crowd in conservative St. Johns County, where Republicans outnumber Democrats 2½ to 1. 'Some of them, some of these lefty journalists don't like it. They don't like you working with the faith-based community." Funded by donations from individuals, private businesses, donations, grants, gifts and investments, Hope Florida serves as the support organization for the Florida Department of Children and Families. Its secretary, Taylor Hatch, accompanied DeSantis for the visit. Referring to his wife, now said to be eyeing a run for governor in 2026 when he is term-limited, he added: "Some of these people view it as a way to attack the First Lady and all the great things she's done. They view her as a threat. That's what's motivating this." The entire settlement was $67 million but $10 million was directed to the Hope Florida Foundation in October. The foundation, which raises money for the Hope Florida program, then gave two $5 million grants each to two nonprofit organizations: Securing Florida's Future, chaired by Mark Wilson, who is also the chairman of the Florida Chamber of Commerce, and Save Our Society from Drugs. Those groups in turn gave $8.5 million to Keep Florida Clean, a political committee chaired by James Uthmeier, then DeSantis' chief of staff. In February, DeSantis appointed him to be Florida's attorney general. Keep Florida Clean was set up to oppose an amendment on the 2024 ballot to legalize recreational marijuana. The group has given $1.2 million to the Florida Freedom Fund, another political committee chaired by Uthmeier and used by DeSantis to fight both the marijuana amendment and an amendment that would've installed a right to an abortion into the state's constitution. During the event's Q&A, DeSantis said the state's Agency for Health Care Administration (AHCA) sent documentation to the House that 'totally debunks the bogus media narratives.' 'Partisan journalists were told this was coming and they still tried to produce these phony narratives," DeSantis said, adding the documents show how AHCA 'negotiated' the funds. 'So that debunks the phony narrative.' Hope Florida has done 'an enormous amount of good, and I'm proud of the program, soup to nuts," the governor said. DeSantis is facing criticism because under Florida law, money from settlements must be deposited into the state's general revenue fund and reported to the Legislature for oversight. The $10 million donation was not. In an earlier press conference, DeSantis said the $10 million was not part of the $67 million agreement signed in September 2024, one not disclosed to the Legislature. "When you do settlements, you can try to get as much money as you can, but this was in addition to what they were getting," he told reporters at a press conference in Miami. He described it as "kind of like a cherry on top, where they agreed to make an additional contribution, and so we were served well by what AHCA did.' Jim Rosica of the USA TODAY Network – Florida Capital Bureau contributed. This story also contains previously reported material. This article originally appeared on St. Augustine Record: DeSantis defends $10M Hope Florida gift from House, media scrutiny
Yahoo
14-04-2025
- Politics
- Yahoo
Governor, lawmakers spar over $10 million donation. What is Hope Florida?
Tensions were high in the Florida Legislature over the last week as a panel of House lawmakers demanded answers about money for a program spearheaded by First Lady Casey DeSantis. The subject: What was called a $10 million "donation" to the Hope Florida Foundation, whose goal is to help Floridians receiving traditional welfare assistance to move on to services offered by nonprofits and religious organizations such as churches. The money was part of a $67 million legal settlement between AHCA and Centene, a large provider of services under Florida's Medicaid-managed care plans. The problem: Under state law, money from settlements must be deposited into the state's general revenue fund and reported to the Legislature for oversight. The $10 million wasn't. Gov. Ron DeSantis Thursday denied that the $10 million was part of the agreement, which was signed in September 2024 and not disclosed to the Legislature. "When you do settlements, you can try to get as much money as you can, but this was in addition to what they were getting," he told reporters at a press conference in Miami. He described it as "kind of like a cherry on top, where they agreed to make an additional contribution, and so we were served well by what AHCA did.' But on Friday, the latest revelation from the Miami Herald was that "the Hope Florida Foundation turned around and gave $5 million a piece to organizations that in turn gave millions to a political committee waging an anti-marijuana amendment campaign championed by the governor." The use of the $10 million 'looks like criminal fraud by some of those involved,' GOP state Rep. Alex Andrade, one of DeSantis' main critics, told the newspaper. "... (W)ho on earth thought this was legal, moral or ethical?' DeSantis' defenders on social media denied any wrongdoing by the administration. The governor had been pushing lawmakers to codify his wife's program into law. Casey DeSantis is said to be considering a run for governor in 2026 to replace her husband, who is term-limited. Here's what to know: Hope Florida controversy: Feud between DeSantis, Florida House deepens as governor blasts lawmakers' inaction Last week, members of the state House noticed that a legislative analysis mentioned problems with obtaining financial details from Hope Florida, Politico reported. On Wednesday, House lawmakers – led by Andrade as chair of the Health Care Budget Subcommittee – hammered Shevaun Harris, the secretary of the Agency for Health Care Administration, for over two hours. AHCA had directed health insurers to cooperate with Hope Florida as part of their contracts. The questions ranged from the Centene payment, which was described in the agreement as "a one-time donation," to Hope Florida getting preferential treatment in state contracts, and a lack of transparency regarding who is responsible for the organization. 'The Centene Entities' obligation to pay the Hope Florida Donation shall be fully satisfied and extinguished upon completion of the wire transfer deposit of such installment into the account of The Hope Florida Foundation, Inc., as directed by AHCA,' the settlement said, according to a copy acquired by Politico. 'I still can't understand how it is featured so heavily in the state's largest contract, yet I can't get an answer as to exactly how Hope Florida is operating,' Andrade said. 'I still can't get answers about a $10 million transfer of funds that was probably illegal.' Harris struggled at times to answer questions and later released a 4-minute video with other state agency heads who work with Hope Florida, calling Andrade's questioning an "ambush." On Thursday evening, Andrade appeared on former U.S. Rep. Matt Gaetz's One America News show to discuss the matter, and the two men compared it to "settlement slush funds," settlements that require a donation to a third group, according to Floridian Press. Gaetz pointed out that in 2016 Gov. DeSantis – then a congressman – co-sponsored a bill banning the practice, but it died in committee. Hope Florida, started by Casey DeSantis in 2021, tries to help Floridians move off of government assistance by connecting them to a clearing house of other services from nonprofits and faith-based communities. Hope Florida "Navigators" are state employees who work with people to find solutions from the private sector, faith-based communities, and nonprofits to help them use all the local community resources available and reduce the need for the government's help. According to DeSantis, the goal is for Florida to help and then stay "out of the way." A website says Hope Florida has served over 100,000 Floridians since its beginning, specifically helping more than 25,500 participants to "reduce or eliminate reliance on public assistance." In 2023, Hope Florida administrators created a separate nonprofit called the Hope Florida Foundation. The Tampa Bay Times reported that Casey DeSantis' name does not appear on corporate records for the charity. The foundation has yet to release records about their donors or recipients or any state-mandated records about its structure, ethics and oversight. As a nonprofit, the IRS also requires the Hope Florida Foundation to file tax forms that must be made public upon request by members of the public. Reporters from the Miami Herald/Tampa Bay Times Tallahassee Bureau have said they were turned away after making such a request at the Department of Children and Families headquarters in the capital. That's because they didn't exist. Joshua Hay, president of the Hope Florida Foundation, later told Florida's Voice it was 'in the process of creating its relevant tax documents" and "expect(ed) to have the documents available for public inspection within the next 10 days." Harris told lawmakers there was no executive director of the Hope Florida program, which she said uses state employees at many different agencies to help connect those in need with services throughout state government and with nonprofits, including churches, who can provide food, clothing and shelter for those in crisis. Hay is CEO of Indelible Solutions, a Tallahassee-based management consulting firm, Harris said. Other officers listed on the nonprofit's annual report, released Wednesday, are Jake Farmer, Fatima Perez, Tina Vidal-Duart and Stephanie White. Farmer is director of state and local government relations for Walgreens. Perez is a director of state government affairs for Koch Industries. Vidal-Duart is the CEO of CDR Health Care, Inc., based in Miami. White is an adoption attorney in Pensacola. According to its website, Hope Florida is funded by donations from individuals and private businesses and provides financial services to local nonprofit organizations. The group serves as the direct support organization for the Florida Department of Children and Families but accepts donations and grants, gifts, holds, invests, and administers the money under its own name. Gray Rohrer of the USA TODAY Network – Florida Capital Bureau contributed reporting. This article originally appeared on Tallahassee Democrat: Hope Florida $10 million donation at heart of Florida lawmaker battle
Yahoo
10-03-2025
- Health
- Yahoo
What mental health parity means for your insurance coverage
In the past, many health insurance plans didn't cover mental or behavioral health treatments. This is because these services weren't viewed as healthcare in the same way that things like having surgery or getting an X-ray might be. The result was that many people couldn't access critical support from therapists, psychiatrists, or other mental health professionals. Paying out of pocket for mental healthcare can be costly, and many people simply can't afford out-of-network providers or treatments. However, thanks to the Mental Health Parity and Addiction Equity Act of 2008, today there are more protections for mental healthcare benefits. Rula shares information to help you learn more about your rights under this legislation and how they can help you and your family use your health insurance to access the mental healthcare you deserve. The Mental Health Parity and Addiction Equity Act of 2008 requires health insurance plans to provide coverage for mental healthcare that's similar to the coverage they provide for physical healthcare. Most health plans are legally required to ensure that copays, visit limits, and prior authorization processes for mental healthcare are comparable to those for physical healthcare. If you're concerned that your health plan isn't meeting parity requirements or has incorrectly denied coverage, you can file an appeal through your insurance provider's appeals process. You can also ask for help from your healthcare provider or a patient advocate, or you can contact your state's insurance department or the U.S. Department of Labor for assistance. The Mental Health Parity and Addiction Equity Act required insurance companies to change the way they cover mental healthcare. Some of the protections the legislation provides include: Your copays for mental health or substance use treatment must be similar in cost to copays for physical healthcare. Health insurance plans can't limit the number of times you receive outpatient mental healthcare within a benefit period (i.e., the number of times you go to therapy) if they don't have similar limits on the number of times you can access outpatient physical healthcare. If your health insurance plan requires prior authorization for mental health or substance use treatment, it must be comparable to those for physical health services. The parity law requires most health plans to include mental health benefits, including: Employer-sponsored health plans for employers with over 51 employees The federal employee health benefits program Medicaid-managed care plans State children's health insurance programs Some state and local government health plans All health plans purchased through the health insurance marketplace (also referred to as ACA plans) Most individual and group health plans purchased outside the health insurance marketplaces While there are some exceptions, under the Mental Health Parity Act, most health plans are required to cover: Outpatient mental and behavioral health treatment (i.e., therapy or counseling) Inpatient mental and behavioral health treatment (i.e., partial hospitalization programs) Substance use disorder (SUD) treatment programs (also referred to as rehab or addiction treatment) Care for all pre-existing mental health conditions, with access starting on the day coverage begins (no waiting period for individual or small group plans under the Affordable Care Act) Before accessing mental healthcare, it's important to understand your coverage so you can anticipate what costs you might be responsible for. If you have questions about your benefits, reach out to your insurer and ask for an explanation of your coverage for mental health services. There's usually an 800 number on the back of your insurance card you can call. If your health insurance company has denied coverage for mental healthcare, the following signs could indicate that it's not following the parity law, and you may have the legal right to demand payment or compensation. The cost of mental health services is much higher than physical health services under your plan. You're entitled to fewer covered mental healthcare appointments than physical health appointments. You've been denied coverage for mental healthcare because your plan deemed that it wasn't a "medical necessity." However, the insurer isn't able to provide the criteria it used to make that determination. There are plenty of in-network providers for physical healthcare. But your plan has few, if any, in-network mental or behavioral healthcare providers. Your plan doesn't cover inpatient mental health, substance use treatment, or intensive outpatient care. But it does cover that level of care for other health conditions. If you suspect that your health plan isn't following the parity law, start by contacting your insurer to discuss your concerns. They might be willing to give you more details about why your claim was denied. If you still think your plan might be in violation of parity requirements, contact your insurer's customer relations department to initiate a formal appeal. Follow each step of your insurer's appeals process and be sure to save copies of all the documentation you submit. If you need additional support, you can also use this guide to help fight coverage denials for mental healthcare from the National Alliance on Mental Illness. You can also ask for help from your healthcare insurers' patient advocate or contact your state's insurance department or the U.S. Department of Labor for assistance. This story was produced by Rula and reviewed and distributed by Stacker.
