Hispanic Chamber: Florida needs to keep its eyes on Medicaid rip-off artists
Florida is at a crossroads with Medicaid ― and it might be one of which that many Floridians are unaware.
Early this year, Florida’s Agency for Health Care Administration (AHCA) is set to make a decision on a process called re-procurement. Essentially, every six years Florida’s Medicaid managed care organizations must go through this process as Medicaid contracts, worth tens of billions, are re-evaluated and renewed.
Accountability and oversight will be key to this process, especially since our state seems to be mired in Medicaid issues.
First, our leaders should ensure that any providers chosen for these lucrative contracts will help provide Medicaid to those who need it. Several potential providers who are currently trying to win contracts have had questionable and worrisome issues come to the forefront. It came to light late in 2023 that Sentara Healthcare (a respondent trying to gain a Florida Medicaid contract) is under federal investigation for over $600 million in payments that possibly were inappropriately accepted by a subsidiary of the company doing business in Virginia. The growing controversy around Sentara in Virginia, centered on possible false statements and reimbursement rates with the Affordable Care Act, should serve as a cautionary red flag for Florida officials.
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In addition, in 2022, it was widely reported that Centene, a company currently being considered, was fined $9 million in Florida for incorrectly denying more than 120,000 Medicaid recipients in the state — something that occurred in at least 13 states that ultimately settled with Centene. We believe AHCA will make the right decision on who they ultimately choose to be responsible for these lucrative Medicaid contracts but we should ensure that there continues to be transparency and education about a process that will impact millions of Floridians.
Second, our leaders should ensure that our state’s Medicaid system overall is working for those whom it’s meant to work for — Floridians who need it the most. This process comes at a time when the state is facing issues with redetermination, with a record number of children being dropped from the rolls. The Florida Policy Institute’s coverage map on Medicaid loss for children provides a sobering look at coverage loss.
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And for Hispanic Floridians who rely on Medicaid, these problems are often felt exponentially. It was discovered earlier this year that Spanish speakers wait longer on average when it comes to phone assistance at Medicaid call centers, an issue that can ultimately lead to coverage loss as calls are never answered or callers have to simply give up on the wait. A recent report also showed that Latinos in the Southeast have lower rates of health insurance and, more specifically, lower rates of Medicaid coverage. All combined, this means that a large population of our state that needs Medicaid the most may not be getting the help they need, leading to gaps in coverage and care and ultimately, higher costs to Florida’s healthcare system in the long run.
Florida is a state that continues to lead the nation in many areas ― its support of small businesses and entrepreneurs, job creation and low unemployment are just some of the areas in which Florida can be looked at as an example. Our state is known for not just welcoming innovation but encouraging it. But today we must do better for those who need more from our healthcare system. And we must demand our leaders put patients first. As we look toward a new year and new legislative fights, I hope our legislators will keep Floridians and their access to systems like Medicaid top of mind.
Julio Fuentes is the President/CEO of the Florida State Hispanic Chamber of Commerce
This article originally appeared on Palm Beach Post: Fuentes: Florida needs careful oversight of Medicaid contractors
