Dive Brief:
- The federal government wants Florida hospitals to repay $267 million in Medicaid overpayments by the end of this year, which some safety-net hospitals say is a hardship. Federal auditors adjusted Florida's $1 billion in annual Medicaid Low Income Pool payments to hospitals, and are requiring $267 million back from appropriations given over the past eight years.
- Jackson Memorial in Miami stands to lose $47 million in Medicaid funding over the issue, while Tampa General would lose $13.3 million, according to the Tampa Bay Times.
- The latest standoff comes in a state where GOP lawmakers rejected Medicaid expansion under the Affordable Care Act that would have covered 764,000 uninsured Floridians.
Dive Insight:
After months of delay, the feds let Florida proceed earlier this year with a Republican priority: requiring Medicaid recipients to use private managed care companies. But the feds refused the state's request for additional LIP money for hospitals, instead saying a federal audit found they got too much money.
State Medicaid and hospital officials in Florida say one-year repayment is the most worrisome aspect of the situation. They have requested three years to pay it back instead, along with assurances that the federal audits are final. Some see it as payback for the state's refusal on Medicaid expansion—and worry the state lacks leverage now because of its holdout position on Medicaid expansion.
Hospitals have turned to Florida's congressional delegation for help. U.S. Rep. Kathy Castor (D-Fla.) said this is "an example where the failure to expand Medicaid is starving our hospitals." She has criticized Florida for rejecting Medicaid expansion even as it asked for more Medicaid LIP funds.
"Essentially it wipes out any profit we would have next year, so that's kind of why we're struggling with it," Mark Knight, Jackson Health System's chief financial officer, told the Tampa Bay Times, noting the state's largest public hospital had operated at a deficit for years before turning things around.
