Budget talks settle on county Medicaid billing scheme

The following article was published in The Florida Current on March 7, 2012:

Budget talks settle on county Medicaid billing scheme

By Travis Pillow

House and Senate budget negotiators agreed Wednesday to a measure that would garnish county revenues to collect unpaid Medicaid bills.

The plan was approved during evening budget negotiations between budget chairs Denise Grimsley, R-Sebring, and JD Alexander, R-Lake Wales with changes that would allow counties to challenge the bills in administrative hearings. Counties that challenge the revenue deductions would risk paying their entire share of the backlog, rather than the 85 percent the Senate had originally proposed.

Counties have opposed the plan, arguing that the acceleration of payments could cost some of them millions of dollars in the first year, but senators supporting the measure said the state needs the money and that the counties owe the state more than $300 million in payments.

Alexander said that under the new language, if the counties did not feel it was fair to spot them 15 percent of the payment backlog to resolve any discrepancies from billing errors, they could challenge the payments in proceedings overseen by the Division of Administrative Hearings and win back more money.

“They should have been paying it all along, and it wouldn’t be a problem today,” he said.

Most of the backlog has has accumulated since the state switched billing systems in 2008. Cragin Mosteller of the Florida Association of Counties said the updated language did little to address their underlying concerns because the measure would force counties to challenge disputed payments rather than fix the underlying system.

“It just puts too much on the counties in too short a period of time,” said Nan Rich, D-Weston. “It doesn’t recognize that a lot of the problems emanated from the state and the errors in the billing.”

Rich won a victory on another front, however. The two sides agreed to language that would allow state employees to participate in the KidCare program, which would give their children another way to receive health insurance from the state.

Budget negotiators approved language for close to 20 bills on Wednesday, including a measure that would resurrect the Correctional Medical Authority, provisions allowing universities to raise student fees in order to pay for certain types of construction, and language that would scrap a plan to consolidate the state’s e-mail systems. Alexander and Grimsley said they might return Thursday to resolve some additional issues.

House and Senate rules bar changes to budget conference reports, meaning the only way for lawmakers to block a change agreed to in one of the conforming bills would be to vote the measure down in its entirety.

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