Gov. Rick Scott is planning on cracking down hard on hospitals that didn’t certify their contracts for Medicaid to comply with state law, and he’s getting the Agency for Health Care Administration onboard in his quest. On Monday, Scott penned a letter to AHCA Secretary Liz Dudek, requesting the agency to dispatch the Office of Medicaid Integrity to audit each hospital to make sure they’re complying with state law.
The deadline for hospitals to submit compliance information was Aug. 1.
“Any hospital or insurance plan that did not submit their compliance information to you by your August 1st deadline necessitates immediate further action to ensure taxpayers are not being overcharged,” Scott wrote to Dudek.
State law requires hospitals and insurance companies to certify that their contractual arrangements are below 120 percent of the Medicaid fee schedule.
“Let’s never forget that all Medicaid payments are paid for by the taxpayers of our state,” Scott said.
Dudek sent a letter to insurance companies last month demanding financial proof the hospitals are under the limit.
“The agency has grave concerns that hospital contractual arrangements may have ballooned to unreasonable proportions and higher than what is allowed by state law," Dudek's letter said. "During the rate-setting process earlier this year; several plans reported that the average hospital contracting rates in some regions exceed 120% of the posted Medicaid rate."
Scott also requested the agency inform nonresponsive hospitals and insurance plans that violating the 120 percent limitation in state law will be subject to an immediate corrective action plan.
The corrective plan would include modifying or terminating contracts found to be noncompliant with state law -- and that could be particularly impacting for hospitals.
Modifying or cancelling contracts could make hospitals ineligible for Low Income Pool funding, federal money which helps hospitals provide medical services to Florida’s uninsured and underinsured. Hospitals could also become ineligible for Florida’s Medicaid Managed Care program if they fail to comply.
Around 3 million Floridians are Medicaid patients in managed care plans as of July.
“The purpose of the Statewide Medicaid Managed care program is to provide high-quality care to Medicaid recipients while efficiently using taxpayer funds,” said Scott. “It is my expectation that all businesses that enter into agreements in our state follow the law, and if they fail to do so, they must be held accountable.”
Check out Scott’s full letter here.
Reach Tampa-based reporter Allison Nielsen by email at allison@sunshinestatenews.com or follow her on Twitter: @AllisonNielsen
Comments
It's a darned shame the
If anybody looking for fraud
Too funny!! -----------------
Ironic that Scott would be
Scott now speaks a language