AHCA Slapped by Doctors Over Not-So-Transparent Procurement of Healthcare Transparency System

by | Jan 28, 2017

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A pair of doctor’s advocacy groups are blowing the whistle on Florida’s Agency for Health Care Administration (AHCA) over the agency’s decision to award a lucrative contract to an organization the doctors say has a blatant conflict of interest.

The multi-million dollar contract, intended to make health care costs more transparent for consumers, was awarded to the Health Care Cost Institute (HCCI), an entity which both the Florida College of Emergency Physicians (FCEP) and its parent group, the American College of Emergency Physicians, say has deep financial ties to the very companies they are supposed to monitor, raising significant questions about how actual transparency could be achieved without independence from insurance companies.

“It’s disturbing that the state of Florida would opt for this vendor that is principally owned by the insurance industry,” said Dr. Rebecca Parker, president of the American College of Emergency Physicians.

The two groups have filed an official protest claiming that AHCA didn’t act in the best interest of healthcare consumers by awarding the transparency contract to an entity with deep financial ties to the health insurance industry.

“The HCCI data come from the health insurance industry, and there is no transparency or independence,” said Dr. Jay Falk, with the Florida College of Emergency Physicians.

The protest casts even more doubt on a procurement process already deeply mired in controversy, after the Florida legislature appropriated the money and drafted bill language so restrictive that it appeared to some lawmakers that only one company – HCCI – might actually qualify for the contract in the first place. Language to make the bidding process competitive was removed in the final version of the bill, prompting media reports that legislators were steering the contract to HCCI . Reporters investigated but could not prove lawmakers had received any financial contributions from HCCI or any of its directors, but HCCI did retain a lobbying team that participated heavily in the fundraising process ahead of the 2016 session.

And the controversy didn’t end there. Next, project managers at AHCA forced one competing vendor, Fairhealth, to part ways with a key subcontractor in the middle of the bidding process on the grounds that the subcontractor had a conflict of interest due to close ties with another health care vendor that might be included in the transparency database. HCCI was ultimately chosen over Fairhealth by AHCA.

But the very same reasoning used by ACHA to force Fairhealth to jettison a strategic partner also forms the basis behind the doctor groups’ complaint filed against HCCI, which allegedly collects the bulk of its revenue from just one health insurance company that is similarly required to report financial data to HCCI’s database.

It is unclear how AHCA could force one bidder to part ways with a subcontractor for conflict of interest while awarding the multi-million dollar contract to another vendor with even deeper conflicts. More on this story as it develops.


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