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The Senate president's office contradicts the governor's office on new health law changes.

By John Dorschner

Miami Herald

A spokeswoman for incoming Senate President Don Gaetz said Monday that the Legislature does not have to take any action in order for Florida's primary care doctors to start receiving increased Medicaid payments starting Jan. 1 - the first time that providers will receive direct financial benefits from the new federal health care law.

That position directly contradicts statements last week from the office of Gov. Rick Scott and from the Agency for Health Care Administration, which said the Legislature or the Legislative Budget Commission needed to approve the increased payments.

"The increased payment is mandatory and the kind of change that can happen automatically," said Gaetz spokeswoman Katie Betta. "The funding is already included in the base as part of the outlook and the estimating conference. This is not unlike other examples of mandatory changes that were implemented automatically."

Last week, staffers of the U.S. Department of Health and Human Services in Washington told journalists the same thing: The payments could increase automatically.

On Friday, Scott spokeswoman Jackie Schutz said: "AHCA would need additional budget authority to receive the federal funds to pay the increased rates. The LBC has to grant that authority. We are waiting to hear if the LBC will meet in December."

Earlier, AHCA spokeswoman Shelisha Coleman said: "The Florida Legislature must provide authority for the Medicaid program to draw down federal funds to cover the fee increase."

The increased rates are mandated by the Affordable Care Act. Doctors' groups have long complained that Medicaid rates in Florida are so low that many doctors refuse to treat patients covered by the state-federal insurance for the poor.

The Obama administration wants to increase payments to provide better primary care so that patients don't wind up in emergency rooms, where care is far more expensive, and to increase the number of doctors willing to take Medicaid as the program expands in 2014.

Scott sent a letter to Washington last week, seeking to open negotiations with the Obama administration to find ways to lower health care costs - something Scott says the reform act does not do.

Gaetz has said he favors increased primary care payments but is concerned that the new health care law will end federal support for programs, leaving states with increased costs in the future.

In fact, increased Medicaid payments to doctors sunset in two years.