Florida’s Community Health Centers Look to AHCA to Remedy Their Concerns Over new Medicaid Plan

by | Aug 15, 2017

Florida’s community health centers say the services they provide to Florida residents will be put at risk as the result of a state plan to administer a $1.5 billion pot of federal dollars intended to help care for low income patients.

Earlier this month the federal government approved a five-year extension of a statewide Medicaid managed care program for Florida. It also finalized the details for the use of the $1.5 billion intended for the Low Income Pool (LIP) program.

A portion of that money–$50 million a year for the next five years–is intended to go to help cover the cost of providing care to low income patients at Florida’s 49 community health centers.

“Fifty million dollars that we’re talking about is a tiny crumb of the $1.5 billion in LIP funding but it’s huge for our centers,” said Brad Herremans, the CEO of the Suncoast Community Health Center based in Brandon.

But the health care centers are concerned they will be hurt financially by the state’s plan to give managed-care plans the authority to administer the money in the LIP  program. All medical reimbursements would go through those managed-care plans which the community health centers said they have had problems with in the past.

The community health centers fear the new payment process could threaten  their ability to be reimbursed by the LIP program resulting in some centers being forced to shut down.

The clear intent of this money is to enhance care for low income residents,” said Andy Behrman, the president and CEO of the Florida Association of Community Health Centers (FACHC). “A regrettable byproduct of all of this will be a delay and an inefficiency that will stand in the way of patient care.”

Community health centers provide care to an estimated 1.4 million residents each year. Of those patients, 35 percent are uninsured and 43 percent are enrolled in Medicaid. Ninety percent  of patients reporting income are below 200% of the federal poverty level.

“A recent study by our state association shows that 13 of our centers or almost 73,000 patients were diverted  from the ER treatment at a cost savings of almost $669 million,” said Dr. Michael Gervasi, the CEO of Florida Community Health Centers based in West Palm Beach. “So, just think what would happen if community health centers weren’t there to care for those who need us.”

The Florida Agency for Health Care Administration is scheduled to hold a meeting about the LIP program on Wednesday. The community health centers are hoping the agency will take another look at the reimbursement plan under the new funding program.

The FACHC and its members plan to testify at the meeting to express their concerns with the new reimbursement plan.

 

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