State backs off plan to single-out doctor who successfully sued to help sick kids
The Florida Department of Health said Thursday it is backing off an attempt to single out a Tallahassee pediatrician who was one of the administration's harshest critics and will instead postpone a decision to require him to pay the overhead costs of treating sick children at a state-owned clinic that serves the needy.
Dr. Louis St. Petery, who was a catalyst in an successful lawsuit against the state and its Children's Medical Services program and a vocal opponent of legislative confirmation of DOH secretary John Armstrong, was told in an email on March 31 that he must immediately start paying $1,397 a year in overhead to continue to see children at the Tallahassee clinic.
“We truly appreciate the work you do for children in our building, but we do have a need to document who has permission to use the space and also ensure that each licensee is paying their fair share of the costs to keep the building operational,” wrote DOH's chief operating officer Jennifer Tschetter wrote in an email to St. Petery. She attached a draft contract.
St. Petery responded to the demand with several questions, and noted it was Tschetter's last day at the agency.
"Am I to understand that all providers of health care services in the local CMS clinic will likewise be required to sign license agreements and pay rent? Is this true for the entire state?,'' he wrote.
He asked what role the nurses that care for the childre at the clinics will have and noted that he appears to have until the end of the month to comply with the agreement but wondered "what did you anticipate would happen with the children already scheduled to return to my clinic after that time?"
He provided copies of the email to the Miami Herald and several other news organizations on April 1. Politico Florida was the first to write about it Tuesday.
Department of Heath spokesperson Mara Gambineri said Thursday that the agency has "actually taken a step back and we are now not moving forward."
"To be fair, we want to make sure we have all the information before making all the decision,'' she said.
She said the decision to start charging for overhead was the result of a "legislatively-mandated review of CMS’ use of space throughout the state" and the letter to St. Petery was "based on initial feedback that was given to leadership here."
She confirmed that St. Petery was the only doctor working with CMS who was asked to sign a contract to pay for the overhead.
St. Petery has been one of the most outspoken critics of the administration in recent years. In addition to opposing Armstrong, whose confirmation was rejected by the state Senate, he was executive vice president of the Florida Pediatric Society when he spearheaded the lawsuit against the state that was recently settled by DOH, along with the Agency for Health Care Administration and the Department of Children and Families.
According to the settlement, the state must create an incentive program for doctors and specialists that serve the poor and in exchange the state must increase the rates paid to the doctors providing the care.
The settlement is in response to a ruling by a federal judge in Miami in December that the state had so underfunded programs serving needy children that it was operating in violation of federal law.
U.S. Circuit Judge Adalberto Jordan concluded the Florida Legislature and governor had for years set the state’s Medicaid budget at an artificially low level, causing pediatricians and other specialists for children to opt out of the insurance program and forcing parents in some areas of the state to travel long distances to see specialists. St. Petery was executive vice president of the Florida Pediatric Society when he spearheaded the lawsuit.
Under the agreement, the healthcare agency will require managed care plans to plow anticipated “program savings” into higher payment rates for primary care doctors who meet the incentives for the next three budget years, through at least September 2019.