Local Government Medicaid Cost Saving Law Comes with a Pinch

BRADENTON --  The premise is, 'If you're not invested, you're not interested in what happens." The state wants the counties to be invested in Medicaid services enough to control what gets spent, so much that they are willing to shoot from the hip to get what they can back. Manatee County is facing budgetary shortfalls and the idea of laying out millions without accurate accountings to where, how, and when doesn't look too good.  

Florida's governor, Rick Scott, signed HB 5301, a bill aimed at recouping funds to resolve disagreements with the Agency for Health Care Administration on how much counties owe the state for Medicaid. The amount the state is shooting for is $326 million.

If counties don't dispute what slice of the pie they have been dished, they will get a discount of 15 percent. If they do, it's the whole shabang. Manatee County's part will most likely add up to three to four million dollars. But they won't know until they go through all of paperwork necessary to figure that out. That's where the discount looks attractive. 

Many blame Tallahassee's faulty Medicaid billing system, and see the nearly impossible audit as no more than a crap shoot. But to dismember the last five years of billing to get resolve, looks to be fruitless.

The many roadblocks to getting an accurate account to who owes what, to whom, won't happen. People from different counties often use services in their adjoining county. There are many cases of double billing, lost addresses, patient disputes and false identification. The counties don't have the staff or the finances to compensate what it might cost to save anything.

Manatee County Community Service Director Brenda Rogers said, "We can only track by claim number, matching names and Medicaid number." She also mentioned, "We get over bleed from Sarasota County and Sun City, and someone is getting ours, and duplicates are a real problem."

The bill shifts the burden of proof over to the counties, Rogers told the County Commission, "We are trying to substantiate just how much it is."

The counties are being held at check with the state, who now awaits their said due revenue. The bill permits the state to hold back sales tax revenue sharing from counties to cover past and future Medicaid cost.

Many groups, including TeaParty members have expressed disappointment with Scott for signing the bill. The counties will have little choice but to pay their tab and take a more proactive role in how Medicaid services will be handled.

In the future, Medicaid costs are expected to soar and the counties are sure to be feeling the pain.