129 hospitals in audit cross hairs
Scott wants Medicaid spending checked; 10 local hospitals on list.
Turning up the heat in a health care wrangle, Gov. Rick Scott says audits are justified for 129 Florida hospitals, including 10 in Palm Beach County, to see if their contracts for spending on Medicaid patients violate state law.
“These agreements may ultimately result in overcharging the state for Medicaid and other health care services; and in some instances, could constitute Medicaid fraud and even deceptive and unfair trade practices,” Scott wrote in a letter Monday to Florida Attorney General Pam Bondi.
One group representing hospitals and other South Florida health providers questioned the audit cost compared with potential benefits, considering hospitals are already audited regularly in a variety of ways.
“This new special set of state audits will require the use of already scarce taxpayer resources,” said Linda Quick, president of the South Florida Hospital & Healthcare Association. “At the same time, the governor and Legislature has cut the Agency for Health Care Administration’s budget and insisted the state cannot afford to expand coverage for the uninsured or pay plans and providers what it costs to provide care and treatment to Medicaid beneficiaries.”
Florida Agency for Health Care Administration spokeswoman Shelisha Coleman told The Palm Beach Post, “This type of analysis is within the normal scope of work for the Office of Medicaid Program Integrity.”
The developments unfold amid a fierce debate about whether Florida is adequately funding Medicaid, a federal program for the poor administered by states. Medicaid HMOs told legislators they needed an additional $400 million to serve people in managed-care programs, and have been informed they will get an average rate increase of 7.7 percent in 2016.
“We believe that the payments made to hospitals are adequate,” Coleman said. “Hospitals had $45 billion in revenue, and a net profit of $4.4 billion in 2014.”
A group representing health plans involved with hospital contracts said they will “continue to work with our state partners to ensure they provide quality health care and comply with all requirements in Florida law,” said Audrey Brown, president of the Florida Association of Health Plans.
Scott said he has directed AHCA Secretary Liz Dudek to have the state’s Office of Medicaid Program Integrity begin auditing hospitals and plans to ensure contractual agreements for Medicaid rates are compliant with state law. Scott
Gov. Rick Scott has called for an audit of Florida hospitals, including 10 in Palm Beach County. His focus is on contracts for Medicaid spending that “may ultimately result in overcharging the state.”