Tag: Florida Medicaid

JACKSONVILLE, Fla. – A lawsuit filed by attorneys for the Florida Health Justice Project and Disability Rights Florida on behalf of two women with disabilities alleges that Florida Medicaid is improperly denying coverage for incontinence supplies, in violation of federal law and the Americans with Disabilities Act. The lawsuit, reported in Health News Florida, says the state stopped providing the supplies to Blanca Meza and Destiny Belanger once they turned 21. “Plaintiffs are medically...

TALLAHASSEE, Fla. - Fearing another Univita debacle, the Florida Alliance of Home Care Services has retained legal counsel to ensure that the state's Medicaid managed care contracts are aboveboard.In April, the Agency for Health Care Administration awarded contracts to 12 health plans in 11 regions, effective Jan. 1, 2019. Of concern to FAHCS and its members: Who will act as the third-party administrators, if any, for the health plans, and who will provide DME equipment and services?“We want...

ORLANDO, Fla. - Industry stakeholders are taking issue with Univita Health's role as both a third-party administrator (TPA) and HME provider in Florida's transition to managed care for Medicaid.Univita has been chosen as the network administrator for 10 of the 14 plans participating in the program, representing roughly 84% of impacted Medicaid recipients. That means it decides which providers are allowed into its network and which get referrals, according to Deanna Rollyson, president of the Florida...

TALLAHASSEE, Fla. - Providers here in December got hit with Medicaid letters seeking to recoup five years of overpayments.“Medicaid is saying, 'We accidentally paid you (money) that we shouldn't have and we want that back,” said Rob Brant, an adviser to the Florida Alliance of Home Care Services (FAHCS).What happened is this: In cases where Medicare patients have Medicaid as a secondary insurance, Medicaid makes a payment when its fee schedule amount is more than Medicare's; if it's less,...

TALLAHASSEE, Fla. - HME providers who fail to repay Medicaid for overpayments could get their Medicaid billing numbers yanked. Historically, providers have been allowed to have overpayments deducted from their next regular Medicaid payment, but new rules change that. A Jan. 13 alert from the Agency for Health Care Administration (AHCA), which oversees Florida Medicaid, states that it will now withhold all Medicaid payments beginning 30 days following the notice of an alleged overpayment. If the...