Governor Rick Scott (R) has directed the Office of Medicaid Program Integrity to scrutinize the contracts at Florida hospitals as well as several insurance companies after they refused to comply with a request for information on their Medicaid contracts, according to Politico.
Gov. Scott wrote in an Aug. 3 letter to Liz Dudek, secretary of the Agency for Health Care Administration, that any hospital or insurance plan that failed to respond to a July 17 request for information "necessitates immediate further action to ensure taxpayers are not being over charged."
Additionally, Gov. Scott said any contract between a hospital and insurance company that exceeds the legal 120 percent Medicaid cap will be placed on an "immediate corrective action plan," which would include amendment or termination of the contract, according to Politico.
In 2011, Florida legislature passed a law that directed most Medicaid beneficiaries into managed care plans. As of July, there are more than 3 million Medicaid patients in managed care plans, according to Politico.
The 2011 law also contained provisions that cap the amount hospitals could be paid by insurance companies to 120 percent of Medicaid, and anything beyond that requires approval from the Agency for Health Care Administration. The agency is currently renegotiating the rates it will pay HMOs for Medicaid beneficiaries in managed care plans. Ms. Dudek said in her July 17 letter that several plans reported their rates for hospitals in some Florida regions exceed the 120 percent cap.
If accurate, the high rates could threaten HMOs profitability, which could lead the health plans to ask the agency for higher state rate payments, Ms. Dudek wrote.