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Counties to Fight State over Medicaid Costs

In what it described as an “accounting mess,” the Florida Association of Counties said Thursday it will file a lawsuit challenging the state’s decision to try to tap counties for tens of millions of dollars in disputed Medicaid money.

The decision came two weeks after Gov. Rick Scott signed a bill that calls for the state to recoup the money — and more than a month after counties frantically tried to fend off the measure in the Legislature.

Legislative leaders contend that counties have failed to pay money that is owed to the state. But counties argue the state’s billing system has major flaws, which has led to payment disputes.

“From the outset, we’ve said that local taxpayers shouldn’t be forced to pay for Tallahassee’s accounting errors,” Chris Holley, executive director of the Florida Association of Counties, said in Thursday’s announcement of the upcoming lawsuit. “And to ensure that they are not, we will be pursuing legal action.”

Pasco, Polk, Manatee and Leon counties have voted to join the suit, and the association said it expects more counties to take part.

The dispute stems from a requirement that counties reimburse the state for certain hospital and nursing-home costs for Medicaid beneficiaries. The Agency for Health Care Administration bills the counties for the money.

Legislative leaders argue that counties during the past few years have substantially reduced the percentage of bills paid, with legislative staff analyses indicating unpaid billings totaled as much as $325.5 million as of Dec. 31.

The bill (HB 5301) calls for the state to gradually recoup money from the counties. A House staff analysis last month said the measure is expected to bring in $77.5 million for the state during the fiscal year that starts July 1.

In finalizing the budget last month, Senate Budget Chairman JD Alexander, R-Lake Wales, said counties could go through an administrative-hearing process if they want to contest the amounts that the state tries to collect. But he was unmoved by the counties’ objections to the bill.

“They should have been paying it all along, and it wouldn’t be a problem today,” Alexander said at the time.

But counties contend that the state started using a computer system in 2008 that has created inaccurate billings. As an example, counties say they have seen duplicative charges and incorrect rates.

In signing the bill March 29, Scott said AHCA staff would travel to all counties to try to resolve issues with the billing process. Information on the Florida Association of Counties website indicates those meetings started last week.

But in the statement Thursday, Holley said the counties still needed to go forward with the legal challenge, which will be filed in Leon County circuit court.

“We appreciate the governor’s promise to address these systemic Medicaid billing errors,” Holley said. “However, HB 5301 has made this multimillion-dollar accounting mess the law of the land — a reality we are forced to confront in the courtroom on behalf of Florida’s communities and taxpayers.”

By Jim Saunders

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