Florida reconsiders competitve bidding

Tuesday, September 30, 2003

TALLAHASSEE, Fla. - For Florida providers and competitive bidding, it’s deja vu all over again.

In January, providers won a lawsuit to stop Medicaid’s attempt to implement competitive bidding. At the time, they thought they had staved off the issue for the foreseeable future, but in its new budget for Fiscal 2004, Florida has proposed a competitive bidding demonstration project.

“It’s obvious to me that someone with a vested interest in this passing took our lawsuit, saw why we won, corrected most of the flaws, and then wrote specific language so the agency could move forward with this project,” said Javier Talamo, vice president of the Florida Association of Medical Equipment Services (FAMES).

State officials did not return phone calls.

Florida plans to hold the pilot program in one of the state’s other metropolitan areas. Only one provider can win the bid and the contract’s capitated rate will be no more than 80% of the current Medicaid fee schedule. The winning provider must be nationally accreditated and in good standing with Medicaid. Customized wheelchairs, prosthetics, ostomy and colostomy supplies will be exempt from the pilot. The state planned to issue a request for proposal (RFP) in September and implement the pilot program in early 2004.

In its earlier attempt, Florida divided the state into 11 regions, issued a RFP and selected five providers to cover those regions. FAMES won its earlier lawsuit by providing that Florida’s competitive bidding plan ran afoul of patient freedom of choice and other requirements. As of early September, the state had not received a federal waiver that would allow it to limit patient freedom of choice in the project area.

At the moment, FAMES doesn’t have another lawsuit in the works, but it plans to discuss its concerns. FAMES is concerned that if Medicaid chooses a single provider to service a large metropolitan area, other providers will be driven out of business. If that’s the case, what happens if the pilot fails? Who will service the patients then? asked Joan Cross, FAMES president.