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Medicaid Change Approved To Aid Hospital Capacity

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
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The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

In an attempt to increase hospital capacity, Medicaid officials have agreed to waive regulations that require hospitals to obtain prior authorization before transferring patients into long-term care facilities.

The Agency for Health Care Administration sent an alert Monday announcing that it was “waiving service authorization requirements” hospitals were required to obtain prior to transferring patients out of their facilities.

The change was made to “facilitate prompt hospital discharges and to ensure adequate inpatient hospital capacity in response to COVID-19,” according to the announcement.

The move came nearly a week after Dawn White, vice president of government and community relations for Baptist Health South Florida, asked  the state to consider changing the policy, saying doing so could expedite transfers from hospitals to long-term care facilities by at least two or three days.

It is not the first time that AHCA, which houses the Medicaid program, has agreed to waive prior-authorization requirements during the COVID-19 pandemic. On March 16, AHCA sent an announcement to Medicaid providers notifying them it was waiving prior-authorization requirements for all services, except pharmacy services, necessary to appropriately evaluate and treat Medicaid recipients diagnosed with COVID-19.

The agency reinstated prior-authorization requirements - with the exception of requirement in behavioral health services - effective June 19.

As the numbers of COVID-19 cases has surged in recent weeks, the numbers of people in hospitals also has increased.

Statewide, nearly 23 percent of hospital beds were available Monday morning. But bed capacity differs by county. In Flagler County, for example, just 5 percent of the beds at AdventHealth Palm Coast - or five beds - were unoccupied, according to state data. In Broward County, about 19 percent of hospital beds were available Monday morning, and in Miami-Dade County about 20 percent of beds were available.

But hospital staffing also has become an issue amid the surge in COVID-19 cases. Gov. Ron DeSantis has asked the Federal Emergency Management Agency to send 1,500 nurses to the state. As of Monday morning, FEMA had not approved the request. DeSantis, meanwhile, said he is sending 100 nurses under contract with the state to Miami-Dade County.