Audit: Florida Medicaid paid insurance companies for dead people

Florida’s Medicaid Program has come under criticism repeatedly in recent years for its failure to provide for the care of disabled and poor children in the state.

But it appears if you are dead, the state is willing to pay — especially if that money is landing in the pockets of insurance companies.

Florida is shifting all Medicaid recipients into managed care plans. First up: Nursing home and long-term-care recipients.
When Florida shifted all Medicaid recipients into managed care plans, it ended up paying HMOs $26 million for enrollees who had died.

A federal audit released Tuesday reported that over a five-year period the state’s Medicaid program overpaid HMS $26 million in monthly premiums for enrollees who had passed to the great beyond.

Florida Health News reports it appears monthly Medicaid premiums were paid for several thousands of Floridians who had died.

Medicaid is funded by the state and federal government — and the federal government wants its money back.

Officials with the Department of Health and Human Services said the Florida’s Agency for Health Care Administration needs to pay back $15 million in money lost through operational costs.

AHCA says it has already corrected the problem, recouping almost $24 million of the $26 million in overpayments — a 98 percent success rate.

The five-year period covers a time when Florida Medicaid was changing from a traditional fee-based model to a statewide managed care for all Medicaid participants. The state agency paid HMOs about $1.3 billion from July 1, 2009 through Nov. 5, 2014, the report found.

If you want to read more on the audit, click the Florida Health News Story here.

Health care refugees: Couple flees Florida after Medicaid nightmare

A Boynton Beach couple said they left Florida – a state they loved – because they could not get adequate health care for their ailing 5-year-old daughter through Medicaid.
CNN’s series on health care refugees started this week with Kim and Richard Muszynski. The couple in September packed their bags and took their ailing 5-year-old daughter, Abby, to Colorado.
Abby was born with a missing a piece of her brain and is subject to violent seizures.
Like Abby, nearly early half of all children in Florida get their health care through the state-run health insurance Medicaid. Abby ended up on Medicaid when Kim Muszynski left her job – and lost the health insurance that came with it – to care for her daughter full-time.
Abby ended up on Medicaid when Kim Muszynski left her job – and lost the health insurance that came with it — to care for her daughter full-time.
Florida Medicaid refused to pay for lifesaving medicines and initially denied payment for a wheelchair. CNN reported. Sometimes Medicaid took so long to pay some of her health care providers that they refused to treat Abby, CNN reported.
Sometimes Medicaid took so long to pay some of her health care providers that they refused to treat Abby, according to the cable news network.
The Agency for Health Care Administration, which runs Medicaid for Florida, disagreed with the CNN report. “The state has done everything in its power to support this family,” said Mallory McManus,  spokeswoman for the agency.
A federal judge ruled in a civil suit that 2015 that Florida had violated the law by underpaying doctors. The state later reached a settlement.
“Florida’s Medicaid program is currently operating at the highest level of quality in its history,” McManus said.
abruzzo
State Sen. Joseph Abruzzo
AHCA and CNN also have clashed in the past.
AHCA criticized the cable news network for its story on the pediatric heart surgery program at St. Mary’s Medical Center.
AHCA characterized the June 2015 story as “sensationalized reporting.”
St. Mary’s program closed down shortly after the story ran.
The network is currently being sued for defamation by the surgeon who established the program.
Now CNN is back in South Florida reporting on the Muszynskis.
In February, the family got word she was being kicked off Medicaid by the state of Florida until state Sen. Joseph Abruzzo interceded, CNN reported.
The couple was told by the state Abby was dropped because of a computer glitch but still the family had trouble getting coverage for her. So, they decided it was time to leave Florida.
To read the whole CNN story on the Muszynskis click here.