hospital costs

AHCA Auditing Hospitals Over Medicaid Costs

Aug 13, 2015
Agency for Health Care Administration

  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 letter that 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.

 Patients heading to hospital emergency departments covered by their health insurance company are increasingly getting a rude and costly awakening, the Tampa Bay Times reports. ER physicians who work as contractors may not be in network, and patients are stuck with the bill.

South Florida's Miami Children's Hospital has revised its pricing documents given to patients to better reflect the costs of medical care, according to the Miami Herald. The documents, called chargemasters, don't detail specific out-of-pocket expenses, but officials say the added details better reflect negotiated prices paid by insurers and will help families better understand what they will have to ultimately pay.

A nurses' union says some hospitals are charging exorbitant rates, in certain cases more than 10 times more than what they need to cover costs, according to its analysis of Medicare Cost Reports.

Florida Orange Park Medical Center tops the list for Florida, the Florida Times-Union reports.

Florida rates in the top 10 on spending per-person for prescription drugs and doctor visits, according to a Wall Street Journal analysis of federal health data by state.

On drugs, Florida ranked fourth among the states at an average $1,213 per person. On clinicians' visits, Florida spending was No. 6, at an average of $1,950.  This state was also high on durable medical equipment.