Agency for Health Care Administration

Medicaid Patients Face Changes In Health Plans

Sep 19, 2018
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About 600,000 low-income patients will be assigned to new Medicaid managed-care plans in the coming months after the state ended contracts with their existing plans.

Wikimedia Commons

A dispute over the the state Agency for Health Care Administration’s decision to award a Medicaid managed-care contract in Southwest Florida has turned into a court battle.

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Seven different companies want to establish new hospitals or offer new services at existing hospitals across Florida, but at least some of the proposals aren’t in areas where the state says there’s a need. 

Delay In Federal Approval Trims Medicaid Savings

Aug 7, 2018
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Nearly $100 million the state assumed would be saved by changing a policy about patient eligibility for Medicaid won’t come to fruition this year.

Judge Urges Denial Of Nemours Transplant Proposals

Aug 1, 2018
WMFE

Siding with a preliminary decision by state regulators, an administrative law judge Tuesday recommended denial of plans by Nemours Children’s Hospital to offer pediatric heart transplants and heart and lung transplants. 

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Tampa-based Argus Dental and Vision withdrew a legal challenge to recently awarded contracts in Florida’s new Medicaid dental program, clearing the way for the state to move ahead with what one official described as the “broadest dental package ever available” to Medicaid beneficiaries. 

Sammy Mack/Health News Florida

There’s one less Medicaid contract challenge the state Agency for Health Care Administration will have to try to fend off before an administrative law judge. 

Office of the Governor

The AIDS Healthcare Foundation filed a public-records lawsuit Thursday in Leon County circuit court alleging that Gov. Rick Scott’s staff refused to provide copies of his public calendar and travel schedule. 

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Twenty-seven legal challenges filed by managed-care plans protesting state decisions to award $90 billion in Medicaid contracts have been grouped into five cases that will be heard in administrative court next month.

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Florida’s top health-care regulator gave final approval last week to a pair of new hospitals for southern Sarasota County. 

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After a lengthy process that involved awarding tens of billions of dollars in Medicaid contracts, the Florida Agency for Health Care Administration now will have to try to fend off legal challenges from health plans that were denied contracts. 

Munroe Regional Medical Center's Twitter Account: @MunroeRegional

Three hospitals in Marion and Citrus counties are challenging a state decision to sign off on a new 66-bed hospital in Marion County, according to documents posted Thursday on the state Division of Administrative Hearings website. 

Sammy Mack/Health News Florida

Florida Medicaid officials announced plans Thursday to sign contracts with three managed-care companies to provide dental care. 

A move by state health-care regulators to avoid litigation has, instead, created more.

Attorneys for Best Care Assurance, a managed care plan affiliated with Lee Memorial Health System, notified the state that they plan to challenge a decision last week to award a Medicaid contract to Molina Healthcare of Florida in a seven-county region of Southwest Florida.

Kaiser Health News

Two health plans that would have been locked out of Florida’s Medicaid market for the next five years were awarded state contracts after they threatened legal action.

FloridaHealthFinder.gov

Asserting it would help hold down health-care costs, Gov. Rick Scott’s administration created a database of paid insurance claims that allows people to shop for costs of medical procedures.

Months after Gov. Rick Scott approved new rules for nursing homes and assisted living facilities, much of the industry is not in compliance as hurricane season gets underway.

A decision last week to award Medicaid contracts to two additional managed-care plans could mean more legal challenges for the state Agency for Health Care Administration.

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A South Florida hospital has agreed to reimburse the state more than $800,000 to settle Medicaid claims about care for undocumented immigrants who sought treatment.

Months after Gov. Rick Scott promised a hard line against nursing homes and assisted living facilities in the aftermath of Hurricane Irma, much of the industry is not in compliance with new rules as the state heads into the 2018 hurricane season.

Though describing it as a “close call,” an appeals court Friday upheld a decision by the Florida Agency for Health Care Administration to turn down approval of new hospice provider in Sarasota County. 

NPR

A Sarasota nursing home has agreed to pay $26,000 in fines and increased licensure fees after the facility failed to notify the daughter of a resident that her mother’s health was deteriorating.

Humana.com

After scoring a big victory in a statewide Medicaid managed-care procurement, Humana and Jon Bussey, who served as its regional director of corporate affairs, have parted ways. 

Agency for Health Care Administration Secretary Justin Senior is meeting with 12 managed-care companies that filed petitions with the state last week, as he tries to dissuade them from legal fights over the state’s decisions to award five-year Medicaid contracts that could be worth up to $90 billion.

With tens of billions of dollars in contracts at stake, a dozen health plans have told Florida officials they are challenging newly awarded Medicaid contracts.

The 12 managed-care plans at risk of being shut out of Florida’s Medicaid program have turned to 11 different law firms to represent them.

The Tallahassee-based firm Rutledge Ecenia has been hired by two managed-care plans unhappy with the state Agency for Health Care Administration’s decisions.

Attorney Stephen Ecenia is representing Magellan Complete Care, while Tana D. Story has been hired to represent Our Childen PSN of Florida.

The 12 managed-care plans at risk of being shut out of Florida’s Medicaid program have turned to 11 different law firms to represent them.

The Tallahassee-based firm Rutledge Ecenia has been hired by two managed-care plans unhappy with the state Agency for Health Care Administration’s decisions.

Attorney Stephen Ecenia is representing Magellan Complete Care, while Tana D. Story has been hired to represent Our Childen PSN of Florida.

The Weekly Check Up: Working Some Medicaid Magic

Apr 30, 2018
Humana.com

Humana is probably very happy right about now.

The insurer emerged from negotiations with Medicaid officials as one of the winners in the contest to deliver health care to poor, elderly and disabled Floridians over the next five years.

Wikimedia Commons

Managed care organizations that want to challenge the award of upward of $90 billion in Medicaid contracts to nine health plans across the state have until late Friday afternoon to launch protests. 

Florida officials on Tuesday announced the names of the nine health plans the state wants to ink contracts with to provide health care to nearly four million poor, elderly and disabled residents.

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