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AHCA Auditing Hospitals Over Medicaid Costs

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
Agency for Health Care Administration
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

  The Florida Agency for Health Care Administration will audit 31 hospitals to determine whether their contracts with Medicaid managed-care plans comply with state law, according to a list released Wednesday by Gov. Rick Scott's office.

AHCA Secretary Liz Dudek on July 17 sent a letterthat requested hospitals and insurers certify that they did not exceed a limit on Medicaid payment rates. That limit is 120 percent of a Medicaid fee schedule.

The hospitals that will be audited did not respond to the request or did not meet an Aug. 1 deadline. The hospitals are scattered throughout the state.

Most Medicaid beneficiaries are required to enroll in managed-care plans, as lawmakers and Scott have sought to better control the costs of the program.

But in the July 17 letter, Dudek wrote that the agency has "grave concerns that hospital contractual arrangements may have ballooned to unreasonable proportions and higher than what is allowed by state law."

According to the Governor’s Office, the following hospitals will be audited by the Office of Medicaid Program Integrity for either not responding to the request, indicated by an asterisk, or for failing to provide information by the deadline:

·         Cleveland Clinic Hospital *           

·         Baptist Hospital Physicians Regional Medical Center – Collier Boulevard

·         Physicians Regional Medical Center – Pine Ridge              

·         Flagler Hospital

·         Venice Regional Bayfront Health

·         Bay Medical Center an affiliate of Sacred Heart Health System (Editor's note: an earlier version of this story incorrectly identified this facility.)

·         Bayfront Health Punta Gorda

·         Calhoun-Liberty Hospital

·         Campbellton-Graceville Hospital *

·         Doctor’s Memorial Hospital

·         Healthmark Regional Medical Center

·         Kindred Hospital – Melbourne

·         Kindred Hospital – Ocala

·         Kindred Hospital – The Palm Beaches

·         Kindred Hospital – Bay Area – St. Petersburg

·         Kindred Hospital – Bay Area – Tampa

·         Kindred Hospital – Central Tampa

·         Kindred Hospital – North Florida

·         Kindred Hospital – South Florida – Coral Gables

·         Kindred Hospital – South Florida – Ft. Lauderdale

·         Kindred Hospital – South Florida – Hollywood

·         Martin Hospital South    Martin Medical Center

·         Tradition Medical Center

·         Lake Butler Hospital

·         Select Specialty Hospital – Orlando (North)

·         Select Specialty Hospital – Palm Beach

·         Select Specialty Hospital – Panama City *

·         Shands Live Oak Regional Medical Center *

·         West Gables Rehabilitation Hospital      

Originally founded in December 2006 as an independent grassroots publication dedicated to coverage of health issues in Florida, Health News Florida was acquired by WUSF Public Media in September 2012.