Note from Alisa Snow: Many therapy providers have been required by the state Agency for Health Care Administration, through its Medicaid Program Integrity office, to return hundreds of thousands of dollars in “overpayments” due in part to a glitch in the fiscal agent computer system.

Below is an article about a similar problem experienced by counties. A proposed bill in the Florida Senate would force counties to pay back the money, without much recourse.

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Editorial, South Florida Sun-Sentinel

What began as a dispute over Medicaid billing is wrongly mushrooming into a budgetary nightmare for the state’s 67 counties. If the Florida Senate gets its way, and it should not, the state will start withholding millions of dollars in revenue-sharing money from the counties in order to collect contested bills.

Doing so would amount to garnishment in an effort to force county governments to pay back disputed bills for nursing home and long term hospital stays. Unfortunately, four years ago, a change in the way the state bills the counties for Medicaid payments has resulted in a number of duplicative charges and incorrect billings that have county officials seeing red.

County officials have tried to work with officials at the state Agency for Healthcare Administration and the Florida Department of Revenue to resolve the billing errors. But with the introduction of SB 1988, it seems the state is more interested in collecting money than correcting its billing errors. That’s not helpful.

If the bill becomes law, the state will begin withholding more than $300 million annually in revenue-sharing payments earmarked for county governments, beginning July 1. The figure amounts to a roughly $148 million a year hike in what the 67 counties currently pay the state for Medicaid.

Broward County, for example, would see roughly $30 million withheld, including $6.7 million in garnishments, plus an estimated $23.3 million in new charges, which the state presumes is 100 percent accurate. In Palm Beach County, about $18.3 million will be withheld by the state, and that figure includes $2.6 million in disputed past charges along with an estimated $15.7 million in new payments.

No longer will the state simply send out bills in a process that allows counties the opportunity to evaluate and, if necessary, dispute questionable charges. Once SB 1988 becomes law, the new withholding process becomes permanent.

So, if a county is wrongly billed because the receiver of Medicaid services lives in another county, too bad. If a bill seeks payment for a person long ago deceased, no matter. The county’s only recourse in resolving dubious bills is to seek a refund by proving the state made the mistake. Don’t hold your breath.

Clearly, there’s a problem with incorrect billing. Ideally, state budget and Medicaid officials should be able to reach some agreement with the counties to ensure that more accurate bills are dispensed from Tallahassee, which would reduce the number of disputes and hasten full payments. That’s the sensible, adult way to resolve the problem.

SB 1988 offers neither correction nor partnership, just simple coercion to a flawed billing process. The bill’s provisions should not be part of a new state budget.

The Legislature should scuttle the withholding provisions in SB 1988 when lawmakers from the Florida House and Florida Senate meet in the upcoming budget conference. Barring that, Gov. Scott would have no choice but to veto the budget.