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Questionable Medicaid payments prompt audits of 31 Florida hospitals

Amid statewide concern about the ballooning costs of Medicaid, state Agency for Health Care Administration Secretary Elizabeth Dudek said Wednesday she had ordered audits for 31 hospitals that may be receiving more in Medicaid payments than is legally allowed.

The hospitals include Kindred Hospital Tampa and Kindred Hospital St. Petersburg.

"We want to help them," Dudek said. "We want (Medicaid) to be successful. But we can't if everyone is not doing everything they need to do to contain costs."

The move comes as the private health plans that serve Florida's Medicaid population seek a 12 percent increase in rates. The plans say the boost is necessary to help offset prescription drug prices. But last month, Dudek said some insurers had been paying hospitals more than is allowed under state law, and asked all hospitals to certify that they were in compliance by Aug. 1.

Those that failed to meet the deadline are now being audited, she said.

Dudek made the announcement at a meeting of Gov. Rick Scott's Commission on Health Care and Hospital Funding. The nine-member panel has been tasked with making recommendations to lower the cost of health care in Florida.

Medicaid is a particular concern. In addition to the rate increase sought by the private health plans, state economists recently predicted growing enrollment would cost the state an additional $500 million in 2016-17.

Scott has said the latest estimate would be "impossible for the state to fulfill."

On Wednesday, Commission Chairman Carlos Beruff said it was too early to tell what kind of recommendations the commission would make. But the panel's discussion on expanding ambulatory surgical centers hinted at the direction it might head.

Ambulatory surgical centers are licensed to perform planned, elective surgeries but cannot keep patients overnight.

Earlier this year, the Florida House passed legislation that would have allowed ambulatory surgical centers to keep patients for up to 24 hours, and created new recovery care centers to treat patients for up to 72 hours after surgery. But the bill met opposition from the hospital industry, and died in the Senate.

Speaking at Wednesday's meeting, House Health and Human Services Committee Chairman Jason Brodeur, R-Sanford, said he planned to propose the measure again.

Brodeur said the measures would drive down cost by increasing the number of choices available to patients. He also held up data showing that the average colonoscopy performed at a Florida ambulatory surgical center cost less than half what it cost at a hospital.

"We've seen these (policies) work in other places," Brodeur said. "This is not cutting edge here. This is simply an opportunity for us to introduce more choice and access for patients."