Florida providers push hard to safeguard Medicaid

TALLAHASSEE, Fla. – Providers in Florida believe new legislation aimed at improving the state’s Medicaid managed care program will provide much-needed stability in a state that has had a troubled relationship with the program in the past. 

Introduced in January, House Bill 1165 and Senate Bill 1540 would require payers to reimburse providers at 100% of the state’s fee schedule for durable medical equipment and complex rehab technology.  

“The cost of goods, gas, staffing, surcharges (have all gone up),” said Gene Sego, president and owner of Sego's Home Medical Equipment in Titusville, Fla., and past president of the Florida Alliance of Home Care Services. “The current reimbursement we are getting from the MCOs is so low it’s a struggle to be able provide equipment.” 

Currently, many payers discount the fee schedule – itself long outdated – by as much as 40%.  

The bill would also require that Medicaid beneficiaries be allowed to pick their provider and prohibit managed care plans from self-referrals, a situation that providers here are all-too familiar with. In 2015, Univita Health, which controlled much of the market, collapsed, leaving the industry in chaos. 

“The state doesn’t want to go through what they went through (before),” said Fino Randazzo, owner of Florida Home Health in Orlando. “I think the insurance companies are now smarter about whether they want to put all their eggs in one basket.” 

Stakeholders will push hard during FAHCS’s upcoming conference on Feb. 16 and 17 to get the bill passed before Florida’s legislative session wraps up on March 11. 

“We will be having meetings with key legislators, and we have a reception, trying to get as much contact as we can,” said Laura Williard, senior vice president of payer relations for AAHomecare. “This has been several years in the making and we are pushing as hard as we can.”