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Counties Win Medicaid Billing Dispute; State Reduces Charges

Florida county officials are breathing sighs of relief after the state cut the amount of past-due Medicaid bills almost in half. The counties argued they didn’t owe the originally stated amount of more than $320 million and a state review of those bills show the counties were correct.

"You know, this is a teamwork moment. AHCA [The Agency for Healthcare Administration] worked with us, the Governor worked with us. This is the first administration that’s taken the time to delve into the issues to make sure we have a fair and accurate system, and that’s what this moment is," says Florida Association of Counties Spokeswoman Cragin Mosteller.

She says the counties have said all along that they don’t have a problem paying their bills, they just want to make sure the system is fair. 

After the review the state’s error rate fell from 25 percent down to 13 percent.

Earlier In the year state lawmakers ordered counties to pay their outstanding Medicaid bills before they could contest them in court, but the counties sued saying the law was unfair and that state’s billing system was full of errors. Governor Rick Scott ordered a review of those bills by the Agency for Healthcare Administration. AHCA’s Chief of Staff Karen Zeiler says the agency went through more than 1.6 million claims and eliminated more than 1.4 million of them:

“For the retrospective bills, we were looking at just over $316 million, and we adjusted off about $145.6 million. And our preliminary certification about is just over $172 million dollars.”  

The $170 million figure is now what counties must pay. One of the biggest complaints from the counties was that they were being charged for nursing home and hospital stays for residents that didn’t actually live there. And AHCA’s Zeiler says many of the reductions came from that issue alone.

Several lawsuits against the state over the Medicaid billing law are still pending.

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Lynn Hatter is a Florida A&M University graduate with a bachelor’s degree in journalism. Lynn has served as reporter/producer for WFSU since 2007 with education and health care issues as her key coverage areas.  She is an award-winning member of the Capital Press Corps and has participated in the NPR Kaiser Health News Reporting Partnership and NPR Education Initiative. 

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