Univita Health Losing Medicaid Contracts

Jul 28, 2015

Univita Health, which gained control of the entire Florida Medicaid home-care market a year ago, has suddenly lost all of its HMO contracts.

The Florida Agency for Health Care Administration made the announcement in an e-mail blast late Tuesday afternoon. 

Univita, based in Miramar, stopped processing requests for home health-care services, durable medical equipment such as wheelchairs, and intravenous therapy “effective immediately,” AHCA said.

AHCA provided no reasons for its announcement, but released a statement this morning.

“We will continue to focus on ensuring Floridians have access to quality health care – this includes working to prevent any lapses in service for MMA health plan enrollees,” a spokeswoman said.

AHCA released a list of phone numbers for Medicaid providers, physician offices and health plan members to call in order to get authorization for equipment and services.

Earlier, United Healthcare of Florida and Sunshine Health had already announced their contracts with Univita were ending as of Aug. 1.

Several owners of mom-and-pop suppliers, who had regarded Univita as their nemesis, began celebrating as early as Monday, when rumors about what was happening began to leak.

As sole authorizer of home services for most Medicaid plan members, several suppliers said, Univita cut their Medicaid payments in half and redirected some of their business to its own home-care affiliate. Many said they had trouble getting paid at all.

Maria Schiavi tends to a child named Yamari at an Orlando home for medically needy children. Univita provides medical equipment to the home.
Credit Carol Gentry / Health News Florida

  They blamed the health plans for subcontracting with Univita and AHCA for failing to prevent it in the program rules.

“I hope they learned a lesson from what they did,” said Robert Junco of Miami’s Pediatric Suppliers Inc.  

While the home-care vendors said they feel sorry for employees of Univita, who are expected to lose their jobs, they reacted to the AHCA announcement with exultation.

“I’m having so much fun!” said Ivonne Gonzalez, president and CEO of Health Medical Equipment Inc. in Miami. “I’m having a couple of margaritas!”

Gonzalez noted that it was almost exactly a year ago that home-care providers learned they were losing a big chunk of their Medicaid income because almost all the HMOs were subcontracting with Univita to handle their home care.

As Health News Florida reported at the time, this created a virtual monopoly in the most fragile sector of Medicaid business. It also raised questions of conflict of interest, as Univita was one of the suppliers competing for the Medicaid business.

State Medicaid Director Justin Senior said at the time that while the situation looked bad, there was nothing in the law to prohibit it. He said his team would warn the health plans to make sure that Univita didn’t take unfair advantage or cause problems for patients.

Justin Senior
Credit Agency for Health Care Administration

It is unclear whether the about-face in Florida’s home care contracts this week was instigated by the plans, by Medicaid officials who were tired of complaints, or the company itself deciding it could not make ends meet.

One home-care organization, the Florida Alliance of Home Care Services, sent a notice to its members Tuesday afternoon suggesting that Univita may be preparing to file for bankruptcy. The federal court bankruptcy files in South Florida offered no listing for Univita as of Tuesday.

Most company officials were unavailable. Robert Alonso, Univita marketing director, said at mid-afternoon that the company would release a statement, but nothing had appeared as of 6:30 p.m.

Vendors said their friends who worked at Univita were texting and calling, looking for a job.  And it remains unclear who will handle the continued need to authorization services for Medicaid patients and pay the bills – either the plans or a different subcontractor.

The Statewide Medicaid Managed Care program was created by Florida’s legislature in hopes of gaining control of Medicaid costs of its 3.5 million residents by ending fee-for-service payments.  Proponents argued it would improve quality of care because the state could hold plans accountable.

AHCA chose among the plans that bid for the business, and phased in the program over 2013 and 2014.

Here is the list the state provided that patients and health-care providers can call for more information:

Amerigroup Florida, Inc.

For Prior Authorizations and Provider Contracting:

Phone: 1-800-454-3730

Fax: 1-800-964-3627

 

Better Health, LLC

For Prior Authorizations and Provider Contracting:

Phone: 1-877-915-0551

Fax: 1-855-461-0629

 

Clear Health Alliance

For Prior Authorizations and Provider Contracting:

Phone: 1-877-915-0551

Fax: 1-855-461-0629

 

Coventry Health Care of Florida

For Prior Authorizations and Provider Contracting: 1-800-470-3555 

 

Humana Medical Plan, Inc.

For Prior Authorizations: 1-800-523-0023

For Provider Contracting: 1-800-626-2741

 

Magellan Complete Care

For Prior Authorizations and Provider Contracting: 1-800-327-8613

 

Molina Health Care of Florida, Inc.

For Prior Authorizations and Provider Contracting: 1-855-322-4076

 

Prestige Health Choice

For Prior Authorizations and Provider Contracting:

Phone: 1-800-617-5727

Fax: 1-855-398-5610

 

Simply Healthcare Plans, Inc.

For Prior Authorizations and Provider Contracting:

Phone: 1-877-915-0551

Fax: 1-855-461-0629

 

Staywell Health Plan of Florida (WellCare)

For Prior Authorizations:

Phone: 1-800-351-8777

Fax: 1-877-426-7091

For Provider Contracting: 1-800-768-6144

 

Sunshine State Health Plan, Inc.

For Prior Authorizations: 1-866-796-0530

For Provider Contracting: 1-813-284-1322

 

United Healthcare of Florida, Inc.

Prior Authorizations:

Phone: 1-866-604-3267

Fax: 1-866-607-5975

For Provider Contracting: 1-877-842-3210

Carol Gentry is a special correspondent for WUSF in Tampa. WUSF is part of Health News Florida, which receives support from the Corporation for Public Broadcasting.