Collier commission set to join counties' suit against state over Medicaid

According to numbers supplied by Collier County, as of Dec. 31, the county had disputed $2.3 million in Medicaid claims and had paid $1.85 million in Medicaid claims to the state in 2011.

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Lee County paid $5.7 million in Medicaid reimbursements in fiscal 2011. House Bill 5301 would cost the county about $2.3 million more a year than the county already pays.

— Several counties in Florida are fighting back against legislation that would require them to pay the state hundreds of millions of dollars in disputed Medicaid payments.

This week, Collier County leaders might join them.

Tuesday, the Collier County Commission will decide whether to join the Florida Association of Counties as a plaintiff in a lawsuit challenging the constitutionality of the Medicaid unfunded mandate.

Collier County staff members declined to comment on the issue until the commissioners vote Tuesday.

The lawsuit came about because, according to the Florida Association of Counties' analysis, the bill failed to gain a two-thirds vote of approval in either the House or Senate.

The Florida Association of Counties found that the vote thus violated the unfunded mandate constitutional provision — the state setting rules without the money to pay for them — in the following ways:

A two-thirds vote is needed in both chambers to require an expenditure of cities and counties in order for those local governments to be bound by the bill.

The Collier County Commission meets beginning at 9 a.m. Tuesday in the commission chambers at the county government complex, corner of Airport-Pulling Road and U.S. 41 East.

The Florida Constitution prohibits enactment, amendment or repeal of any general law without a two-thirds vote of each house of the Legislature when the effect is to reduce the authority that cities or counties have to raise revenue.

The Florida Constitution prohibits the enactment, amendment or appeal of any law that is anticipated to reduce the percentage of a state tax shared with counties and municipalities.

Since the Florida Association of Counties announced its intention to sue at its April 12 board meeting, 25 counties have joined the suit. If Collier joins, the county will be asked to pay a flat fee of $3,500 to help cover costs.

On Tuesday, Lee County commissioners voted unanimously to join the lawsuit.

The decision comes after Gov. Rick Scott signed House Bill 5301 into law last month. The law, which seeks to recoup $300 million in unpaid Medicaid bills over five years, would give counties two options: Pay 100 percent of what the state says the counties owe and have the opportunity to retroactively dispute claims, or give up the right to appeal, but only pay 85 percent of what the state says the counties owe.

Florida is one of the states in which counties are required to help the federal government cover the costs of Medicaid, the health program for low-income people.

The counties assert that the billing system, changed by the state Agency for Health Care Administration (AHCA) in 2008, is flawed.

Lee County Commissioner John Manning on NewsMakers 9-11-11

Lee County Commissioner John Manning on NewsMakers 9-11-11

"Lee County over the past four years has received bills that have been consistently wrong with issues like incorrect address information, duplicative billings, and incorrect rates," Lee County Commission Chairman John Manning wrote in a letter to Scott last month asking him to veto the legislation. "These inconsistencies have resulted in a backlog of disputed bills and a lack of trust in the state's system. By signing HB 5301 into law you would be codifying into statute a flawed system."

Lee County paid $5.7 million in Medicaid reimbursements in fiscal 2011. House Bill 5301 would cost the county about $2.3 million more a year than the county already pays.

Ann Arnall, director of human services for Lee County, told the Daily News last month the county's disputed amount for Medicaid payments has been, on average, 23 percent monthly.

According to numbers supplied by Collier County, as of Dec. 31, the county had disputed $2.3 million in Medicaid claims and had paid $1.85 million in Medicaid claims to the state in 2011.

In a report last week, AHCA sent out another round of detailed information to federal officials about how the plan would be carried out. The information indicates that the number of beneficiaries enrolled in HMOs and another type of managed-care plan is expected to double and possibly triple by the end of 2014.

The Legislature approved shifting to a statewide managed care system, arguing that the change would help control costs and better coordinate care for beneficiaries. But some advocates for Medicaid beneficiaries worried that it would be disruptive and make it harder for people to get care.

AHCA also gave assurances that health plans would have sufficient networks of medical providers and that it would require "reasonable" access to pharmacy services.

The News Service of Florida contributed to this report.

© 2012 Naples Daily News. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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Comments » 8

TheyPavedParadise2 writes:

Wasn't this some legislation sponsored by our state representative?

Sick writes:

Sue at will with taxpayer dollars. But when a taxpayer stands up and speaks during a commission meeting they are crucified.

Let alone sue Collier County.

I should run for commisioner. And then push a six lane road right through their front yards. With a special exception speed lane for people here working and not vacationing.

Special speeding permit up to 70 mph in a 45. And 100 mph in a 70 between 5 and 9 a.m. and then from 3 to 7 p.m.

unfatcat writes:

Since my non-medicaid medical bills are often wrong, I suspect that the discrepancies for which they want to bring suit are HUGE. This would also be the time to verify that each medicaid individual really qualifies for the program before just rolling them forward, because people's incomes have changed alot over weeks and months.

RainMan writes:

Hmmm... if Collier County commissioners hadn't wasted so much money on that one overpass at I75 and airport road, they would have had all the extra money the state needed that year.

Makes one wonder how much the county wastes each year.

Time for some common sense commissioners, the kind that won't spend money that they don't have.

CarpeVeritas writes:

Transfer costs from your budget and look fiscally prudent, and hoist the shortfall onto another's budget.

The point is that the state is playing a shell game. They get to crow about cutting spending, while forcing counties to pay more.

I'd love to do that, too. I'll stop paying some of my mortgage, and require my neighbor to cough up the rest.

There's a real dearth of honesty in Tallahassee.

Beachglow writes:

Good luck. You're going to need it. We should look at getting people who don't need Medicaid and are not citizens and cheating the system off of it, and then you wouldn't have these huge bills.

You can't continue to mask the problem and think it's going to get better. You have to do what is necessary, which is get the wrong people off the dole.

CarpeVeritas writes:

in response to Beachglow:

Good luck. You're going to need it. We should look at getting people who don't need Medicaid and are not citizens and cheating the system off of it, and then you wouldn't have these huge bills.

You can't continue to mask the problem and think it's going to get better. You have to do what is necessary, which is get the wrong people off the dole.

Of course you're correct about policing medicaid payments.

But how does that stop unfunded mandates by the legislature? I mean, even if every crook is removed from medicaid rolls, our county tax rates will still be supporting what the state is required to do.

Kish4Commish writes:

The transfer of medicaid to hmo status is almost done and has reduced coverage and providers for all recipients. Fighting federal and state medicaid for proper reimbursement is impossible. $3500 to try and reverse the ruling is money well spent to stop the state from taking millions from the county .

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