INDIAN RIVER COUNTY — The Board of County Commissioners on Tuesday voted unanimously to pay the State of Florida $790,454 to settle a Medicaid billing dispute that began in March when Governor Rick Scott signed House Bill 5301, which required Florida counties to pay all state Medicaid claims denied by the counties during the past decade. That amount is less than 57 percent of the $1.23 million the state initially said was due, according to County Finance Director Jason Brown.
Under state law, counties are required to reimburse the state for 35 percent of certain Medicaid expenses provided to county residents. Over the past 10 years Indian River County has rejected some state claims for reimbursement, usually because the patient treated in Indian River County was not a resident of the county.
“The county person in charge of this checks each line of each bill we get from the state,” said County Attorney Alan Polackwich at an earlier meeting that dealt with the dispute. “If the background information shows the person lives in another county, we deny the claim and the state has never challenged our denials.”
That status quo was disrupted on March 29 when HB 5301 went into effect, requiring counties to pay charges they have denied since 2002.
“The legislature decided they simply wanted counties to pay all denied claims and they are using forced collection to get the money,” Polackwich said.
In May, the Commission agreed to join 54 other Florida counties in a lawsuit aimed at overturning the law.
At the same time, Brown, Polackwich and other county staff member undertook a review of all the denied claims to see if any money was truly owed. They also entered into negotiations with state officials about the amount of the settlement.
By mid-July the state acknowledged the county only owed $544,000 of the $1.23 million it was originally billed for.
At the same time, the state added $453,000 in new obligations in the form of expenses for Indian River County residents that had been billed to other counties, for a total bill of $997,000.
Subsequent appeals by the county reduced that amount to $939,000.
By agreeing to pay the final certified amount without any dispute the county got a 15 percent discount, which reduces the amount owed to $790,454.
Brown said he thinks the county is still being billed for some expenses it does not owe, but that the 15 percent discount more than makes up the difference.
Statewide the amount the governor is claiming counties owe has been reduced from $325 million to $172 million.
County Administrator Joe Baird said scrutiny of the state Medicaid billing process over the past five months seems to have improved system operations and that future bills should be more accurate.
“We think, moving forward, there won’t be the same problems,” he said.
