Florida counties challenge Medicaid payment law

The Florida Association of Counties and 47 individual counties sued the state on Thursday to challenge a new Medicaid law that’s expected to cost local taxpayers millions.

The new law will require counties to pay more than $300 million in disputed billings owed to the state-federal health care program for low-income and disabled people. Counties are required to pay a share of the expenses for their residents.

The lawsuit, which was filed in Tallahassee’s state circuit court, contends the counties are being made to pay for “rampant errors” by Florida’s electronic billing system. The law’s supporters say the counties simply are trying to avoid paying their fair share.

“Through this error-ridden scheme, the state is coercing counties into paying for lawfully time-barred back bills, as well as new Medicaid obligations, that cannot rightfully be traced to their communities,” the counties’ lawyers wrote in the lawsuit.

It alleges the law is invalid because it requires payment on disputed bills older than four years, which is as long as records were required to be kept under a previous statute.

The suit also contends the law was not passed by a two-thirds majority in the House and Senate, which violates two sections of the Florida Constitution dealing with what are known as “unfunded mandates.”

One requires super-majority votes to reduce state revenue sharing to local governments. The law would withhold revenue sharing from counties that don’t pay disputed Medicaid bills.

Such margins also are required for laws that require cities or counties to “spend funds or take an action requiring the expenditure of funds.”

The House passed the law 73-36, which meets the two-thirds requirement, but it fell short in the Senate. The roll call there was 23-17 – four votes short.

The suit seeks an immediate order to prevent the state from withholding revenue sharing, which is scheduled to begin May 7.

It lists two state agencies as defendants.

“We have received a copy of the lawsuit, and our legal team is reviewing it,” Agency for Health Care Administration spokeswoman Michelle M. Dahnke wrote in an email. “The agency is continuing with our plan to implement the law until otherwise directed.”

Florida Revenue Department spokeswoman Rene Watters said her agency had no comment.

The suit lists several examples of faulty billing:

– Alachua County gets billed for applications that do not list a billing code apparently because it is first on alphabetical lists of the state’s counties.

– Escambia County gets billed for residents from a neighboring Alabama county with the same name.

– Manatee County consistently receives bills for residents of Sun City Center in neighboring Hillsborough County.

– Marion County routinely gets claims for residents of surrounding counties and has experienced an average error rate of 51 percent on nursing home bills and 37 percent on hospital bills.

– Indian River County audited 10 months of bills and found zero dollars in Medicaid claims for its largest medical facility, a clear indication of billing problems.

– Sarasota County records show more than 40 percent of nursing home and nearly 24 percent of hospital and health maintenance organization billing addresses could not be verified.

All except one of Florida’s 67 counties – Hernando – are members of the state association.