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Florida Medicaid Providers Complain About Late Payments

Deborah Franklin, director of operations for Florida Living Options Inc., shows state senators one patient's unpaid claim file.
SMueller/WFSU
Deborah Franklin, director of operations for Florida Living Options Inc., shows state senators one patient's unpaid claim file.

Having private insurance companies manage Florida’s Medicaid services instead of the state has been successful, said the Agency for Health Care Administration. But long-term care providers and advocacy groups disagree and they outlined problems to Florida senators on Wednesday.

The Florida Health Care Associations Deborah Franklin said provider payments are often late and complaining to the state doesn’t help much.

Deborah Franklin, director of operations for Florida Living Options Inc., shows state senators one patient's unpaid claim file.
Credit SMueller/WFSU
Deborah Franklin, director of operations for Florida Living Options Inc., shows state senators one patient's unpaid claim file.

“For instance, we pay a bed tax," she said. "The law says I will be fined if I don’t pay what I’m supposed to pay - the fee to the state of Florida. But to the managed care companies, it says ‘may.’ They ‘may’ get fined if they don’t pay us within the 10 days.”

Meanwhile the insurance industry says the managed care system has improved the quality of care. One of the state’s largest healthcare plans, Sunshine Health, said they pay within a week on average.

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Sarah Mueller is the first recipient of the WFSU Media Capitol Reporting Fellowship. She’ll be covering the 2017 Florida legislative session and recently earned her master’s degree in Public Affairs Reporting at the University of Illinois Springfield. Sarah was part of the Illinois Statehouse press corps as an intern for NPR Illinois in 2016. When not working, she enjoys playing her yellow lab, watching documentaries and reading memoirs.