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FL hates health law, but plans for it in $700K study

While Florida waits to see whether the Supreme Court will kill the Affordable Care Act, a state agency is laying the groundwork to carry it out, just in case.

The Agency for Health Care Administration today will answer questions from  companies that have shown an interest in competing for a $700,000 study on creating a modern Medicaid information system. The IT system needs to be able to  handle not just the current job, but the health insurance exchange called for under the federal health law.

Answers to the questions will help guide whether the companies will respond to the bid by the May 22 deadline. The agency plans on awarding the contract by June 12. It wants the study completed by July 30.

That leaves the winner only seven weeks  to do the work. If the company can’t meet the deadline for the final report it could be fined upward of $5,000 per day. There also are fines if the vendor misses weekly meetings with the agency or  draft report deadlines.

The tight time line isn't the only difficulty, industry experts say.

Companies are barred from participating if they  implement any information technology systems, conduct any project management or provide technology integration services. The conflict-of-interest language in the request for proposals is taken directly from the law the Legislature passed.

Danny Jordan, a lobbyist for 180 Consulting in Tallahassee, said that while it may be a laudable goal to have no potential conflict, most technology companies do some of the work that is banned, including project management.

“If you look at those requirements, I don’t have anybody who can do (the feasibility study),” said  Jordan, who represents KPMG, CGI Technologies and Solutions, and Ciber, among others. “They all do at least one or all three of those things.”

The money for the study, as well as the $30 million in state revenue needed to build the IT system, was included in the budget that Gov. Rick Scott approved in April.

Florida is updating the computer system that determines whether applicants for Medicaid or Florida KidCare are eligible because it is out-of-date and no longer complies with federal requirements.

The system being planned also needs to be capable of serving as the platform for a health insurance exchange, as called for under the federal health law.  Florida is leading a multi-state challenge to the law, now pending before the U.S. Supreme Court.

While loathe to implement a law they think is unconstitutional, Florida’s Republican lawmakers passed language allowing the state to establish an exchange if the court lets the law stand.

“I have to prepare for every scenario,” said Rep. Matt Hudson, Naples Republican who chaired the House Health Care Appropriations Subcommittee.

And lawmakers let die a Senate Memorial--1840-- urging Congress to stop funding planning grants that make state operated health insurance exchanges a possibility.The measure was sponsored by Senate Health Regulation Committee Chairman Sen. Rene Garcia, R-Hialeah.

Under the Affordable Care Act, every state is required to have an exchange, a place where those who don’t have employer-sponsored insurance can shop. If the state does not implement one, the federal government will.

Those who shop on the exchange can get subsidies if their income falls below certain limits, which depend on the size of the family.

After the 2010 elections, the Republican-led Legislature and Gov. Rick Scott had ordered the state to halt any efforts associated with implementing federal health reform.  Prior to Scott’s election Florida health care planners had applied for, and received, a $1 million planning grant for an insurance exchange. After Scott got elected, the state never used the grant money.

The new system must be completed by October 2013 and be operational by January 2014, dates that dovetail with requirements for the federal health insurance exchange.

Specifically, AHCA’s request for proposals requires the winning vendor to study whether to invest money to improve Florida’s current eligibility determination system  or scrap it and develop a new one. The current system is called ACCESS, for Automated Community Connection to Economic Self Sufficiency Florida.

AHCA asked vendors to submit any questions regarding the $700,000 contract in writing to the agency by May 1. Spokeswoman Shelisha Coleman said the agency received some questions, but she declined to discuss them until their release today.

--Christine Jordan Sexton, an independent journalist in Tallahassee, can be reached at 850-251-0358 orby e-mail. Health News Florida is an independent online publication dedicated to journalism in the public interest.


Carol Gentry, founder and special correspondent of Health News Florida, has four decades of experience covering health finance and policy, with an emphasis on consumer education and protection.