More than six years ago, when Florida International University secured the green light to create a new medical school at its West Miami-Dade main campus, the affirmative vote by the states Board of Governors was hailed as perhaps the most important in the universitys history.
Leading up to that yes vote, FIU leaders presented a finely tuned sales pitch that highlighted the expected benefits of a new med school: significant economic impact, increased numbers of minority physicians and increased access to healthcare among the regions underserved populations.
We have the largest concentration in the state of underserved citizens, then-FIU President Modesto Mitch Maidique told the Board of Governors in a formal presentation prior to the key vote.
But now that FIUs medical school is up and running with a clinic that began seeing public patients in April the school has been placed on the defensive because of the limited access it provides to a key segment of the medically underserved: Medicaid patients.
The universitys on-campus Faculty Group Practice, comprising a handful of full-time FIU faculty physicians, does not accept Medicaid patients, and does not expect to do so for about six months. The clinic includes two family-practice physicians, an internist, four gynecologists and several other doctors, with plans to add specialists in areas such as neurology and cardiology.
The clinic is under an umbrella group known as FIU Health, which encompasses 119 full-time medical faculty members and more than 800 part-time volunteer faculty. A patient who calls the FIU Health main hotline seeking a doctor could be referred to any physician within the umbrella group, regardless of whether they are full- or part-time faculty.
Over time, FIU pledges that all its full-time faculty will honor all forms of insurance. Currently, the doctors at FIUs modest 6,000-square-foot Faculty Group Practice accept Medicare, AvMed and Blue Cross and Blue Shield of Florida, among others.
The university did confirm that its Faculty Group Practice does not currently accept Medicaid, but said it does not track what insurances are accepted by the 800-plus volunteer doctors under the network.
FIU provided the names of all volunteer faculty to The Miami Herald. That list was compared with the states database of local Medicaid providers, and revealed that almost one-third of those doctors do not accept Medicaid.
I was very disappointed, said Dr. Francisco Pita, a general practice doctor with an office a few blocks from the FIU campus.
At first, Pita was excited about FIUs opening its doors to the public, and he quickly contacted the university to arrange an appointment for one of his patients a Medicaid-insured senior citizen who needed a hematology specialist. Pita hoped to spare the patient, who has limited mobility, from having to travel across town to Jackson Memorial, the countys public hospital, which handles many Medicaid cases.
But Pita said he was told Medicaid patients were not being accepted at the FIU campus.
Pita said Medicaid recipients routinely have trouble obtaining specialist care, but added he expected more of a community-oriented university such as FIU.
FIU was supposed to be the peoples hospital, Pita said.
According to state figures, more than 590,000 Miami-Dade residents receive Medicaid just over 23 percent of the countys population. The Medicaid program, funded jointly by the state and federal government, provides health coverage to poor families and individuals, many of them under the age of 18.
FIU administrators insist that improving the health of less-wealthy citizens is a key part of the medical schools mission.
Dr. Fernando Valverde, associate dean of the medical school and CEO of the FIU Health provider network, said FIU always planned to accept any and all insurance plans, including Medicaid, at its clinic. Valverde said it has simply taken time for the university to fill out the time-consuming certification paperwork required by insurance companies and the federal government.
When FIU Health opened, some private insurers, and not just Medicaid, could not immediately be accepted because the paperwork was being assembled, Valverde said.
Theres a process to this, Valverde said. We want to be a provider to everybody.
According to Floridas Agency for Health Care Administration, FIU submitted its Medicaid provider application on June 5 almost two months after FIU announced the opening of its Faculty Group Practice . The state replied on June 18 that more information was needed before the application could be processed, including tax information and certain bank account documents.
FIU International Relations Professor Thomas Breslin is another who preaches patience on the Medicaid issue. Breslin helped craft FIUs initial medical school proposal and has served as Faculty Senate chairman for the past two years.
These things dont just happen overnight, Breslin said. Were still faithful to the commitment that we made, and were still building to that end.
Valverde notes that the curriculum for med school students includes a neighborhood health program in which doctors-in-training adopt one or two families from medically underserved neighborhoods. The program currently serves 184 families in areas such as Opa-locka, Miami Gardens and Little Haiti. As the medical schools enrollment grows, more neighborhoods will be added, with as many as 960 households taking part.
FIU also recently acquired a bus that will be driving around the community as a mobile clinic, treating patients regardless of insurance, Valverde said.
And for more than three years, FIU physicians have been treating patients at Jackson North Medical Center, a hospital that Valverde described as a predominantly Medicaid population.
The hospital was FIUs first foray into clinical care, Valverde said, with FIU doctors playing a key role in beefing up the hospitals roster of specialists, particularly in cancer treatment.
For us, its a very sensitive subject that somehow were going to be portrayed as not caring for that population, Valverde said. The whole backbone of the medical school is the Medicaid underserved population.
Although FIU promises that its 119 full-time medical school faculty members will eventually take all types of insurance, Valverde said the school has no ability to force a similar policy on the volunteer faculty that dont accept Medicaid. Those doctors are doing FIU a favor by donating their time to teaching, Valverde said.
These are independent physicians in private practice, Valverde said. We have no say in who they take.