Florida: Providers frustrated with Univita

Friday, September 26, 2014

TALLAHASSEE, Fla. – With Florida’s transition of Medicaid beneficiaries to managed care on track for an October completion, HME providers say their worst fears are being realized. 

At the heart of the problem, providers say: the state’s decision to contract with Univita to administer the program for 10 of the 14 participating plans. Univita is also an HME provider.

“A lot of providers are, No. 1, not getting paid or, No. 2, not getting referrals,” said Joan Cross, president of the Florida Association of Medical Equipment Suppliers (FAMES). “When you go through Univita to get authorization, Univita takes the patient.”

The transition to managed care began earlier this year.

It didn’t take long, providers say, before they were losing patients despite an any-willing-provider provision on the state record books.

“What they originally said is, anyone who participates in Medicaid would be able to get a contract directly with these HMOs,” said Chris Wallman, president of Ft. Lauderdale-based Galaxy Medical. “That’s not true. It was written like any-willing-provider language, but it turned out far different than that.”

Adding insult to injury: Even if providers subcontract with Univita, they say they have to accept 50% of the current Medicaid fee schedule.

“We are not able to take care of our existing patients,” said Ron Jenkins, CEO of Longwood, Fla.-based Respitech. “I’d rather just get rid of it and not even deal with it.”

The biggest losers are the beneficiaries, who lose their freedom of choice, providers say.

“It’s like saying only the Walmarts are going to be able to sell anything—you have to go to only one company,” said Ivonne Gonzales, FAMES board member and president of Miami-based Health Medical Equipment.

Unvita did not respond to requests for comment.