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State bounces Medicaid bills back to Pasco

DADE CITY — Pasco got another dollop of bad budget news Wednesday when commissioners heard details about new state Medicaid legislation that was recently signed into law.

The upshot: The county likely must pay an extra $3.5 million next year to resolve hospital bills that county officials have argued for years that they didn't owe.

That's on top of a $5.3 million shortfall because of falling property values and potentially higher fuel, insurance and pension costs.

Counties are required to reimburse the state for a portion of hospital bills for Medicaid patients. The new legislation was spurred by $325 million in past-due bills that counties argued are flawed. The law would not only force counties to pay those old bills but would also charge them up front for future bills.

Many of the disputes arise over residency. For example, a Hernando County resident is treated at a Pasco hospital and Pasco gets the bill.

"Someone who is receiving treatment is shown to be a Pasco County resident, and we say, 'Oh no they're not,' " said County Attorney Jeff Steinsnyder.

Officials estimate spending $6.4 million in hospital bills in next year's budget, compared to the $2.9 million included in the current budget.

Next year's figure includes a third of the county's estimated $4.3 million in old bills. The remainder of the old bills would be paid over five years. The state will also withhold roughly a quarter of Pasco's half-cent sales tax revenue to cover current and future bills.

Counties argue many of the residency errors and duplicate bills began when the state rolled out a new electronic billing system in 2008.

"It's a broken system," Steinsnyder said. "And the Legislature said, 'It's the best we have, and it's not coming out of our pocket. It's coming out of the pockets of the 67 counties.' "

Based on his talks with the Florida Association of Counties, Steinsnyder said he expects the group to file a lawsuit challenging the law. One claim would be that the law is an "unfunded mandate" that didn't get a required super majority of votes in the Legislature.

Commissioners voted 3-0 (two commissioners were absent) on Wednesday to join any lawsuit that is filed. "I think it's something we need to fight," said Commissioner Jack Mariano.

Pasco's estimated increase in hospital payments next year would translate to an extra $8 in property taxes for the owner of a $100,000 home with standard exemptions.

When Gov. Rick Scott signed the bill late last month, he promised to send a representative from the Agency for Health Care Administration to each county to discuss past bills and how the changes would be implemented.

Assistant budget director Mike Howard said the agency has scheduled meetings with 10 counties but has not set a date with Pasco. Meantime, several deadlines on the new law are approaching over the next few months.

"There is a sense of urgency here," he said. "This is coming rapidly."

Lee Logan can be reached at or (727) 869-6236.

State bounces Medicaid bills back to Pasco 04/11/12 [Last modified: Wednesday, April 11, 2012 10:02pm]
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