County Commission agrees to settle Medicaid payments lawsuit

The Sarasota County Commission approved paying a percentage of disputed Medicaid claims when it met during a budget workshop in August. Photo by Norman Schimmel

Upon advice of County Attorney Stephen DeMarsh, the Sarasota County Commission this week voted unanimously to settle the lawsuit it had filed against the state over efforts to collect disputed Medicaid payments.

However, commissioners said they believed the counties needed to continue to press the point that state billing methods had to improve.

DeMarsh pointed out that the 57 counties that had participated in the lawsuit with the Florida Association of Counties had succeeded in their effort to force state officials to address inefficiencies in the process used to obtain the Medicaid payments.

The collection effort was prompted by a Florida Legislature bill covering Medicaid bills from 2001 through April 2012.

On Aug. 20, the commission had voted to pay $3,570,168 in Medicaid bills state officials said it had linked to county residents, a 44% reduction from the original total the county had faced.

Although Pauline Tracy, the county’s human services policy coordinator, had said staff continued to believe Sarasota County was being billed $177,250 improperly, because of incorrect addresses, that was far less than the $536,134 discount on the total bill the county was getting by agreeing by Sept. 1 to pay the bills instead of going to mediation.

During their regular meeting on Sept. 11 in Venice, DeMarsh told the commissioners he did not believe the county had sufficient reason to stay in the lawsuit. In fact, he said, “It could be troubling to the Legislature if we are still engaged in the litigation. We might actually get an adverse reaction from the Legislature.”

County Administrator Randall Reid concurred with DeMarsh’s recommendation.

In response to a question from Commissioner Jon Thaxton, DeMarsh said only four counties had chosen to remain parties to the lawsuit, and they were going to continue working with the state’s Agency for Health Care Administration through December, to try to reduce their total backlog of disputed bills.

Even those counties might end up settling the lawsuit, DeMarsh said.

“I think this is a major accomplishment of the Florida Association of Counties,” DeMarsh pointed out. State officials were not willing to deal with the continued county complaints about improper billing, he said, until the lawsuit had been filed.

Reid said the state was unjust in its attempts to collect payments for bills that it could not prove were valid.

“I think it’s the proper step,” Commissioner Nora Patterson said of the settlement, but “I do have some thoughts in the opposite direction. … I haven’t really heard that [AHCA officials are] going to revise their [billing] processes for the next year and the year after and the year after.”

Patterson added, “I don’t want to fight this every year.”

If the majority of counties agreed to the settlement, she said she hoped they still would wield sufficient clout “so the state will stand ready to reform the process so it doesn’t happen again.”

DeMarsh responded, “I think there’s been some effort to improve the data for [billing] … and that likely would go forward.”

He added that he believed the counties needed to continue discussions with AHCA representatives, to keep the focus on improved billing methods.

He also pointed out that the lawsuit just allowed the counties to fight the bill the Legislature had approved to make collection of the backlogged payments possible.

County officials have maintained the bill passed without the necessary two-thirds majority.

DeMarsh repeated a comment he had made in August, that the 2013 Legislature would be able to remedy the earlier action.

“It also was a pretty remarkable event that came down upon the 67 counties,” Chairwoman Christine Robinson said of the bill, “and it happened very quickly in the Legislature.”

She added, “I think we really need to stay vigilant over this [issue]. I’m concerned that we’re going to see another version of this [legislative action] at some point.”
Robinson also pointed out that Sarasota County was “justified in our protest with taxpayer money.”

In July, when the commissioners voted unanimously to pay $3,500 to the Florida Association of Counties to participate in the lawsuit, DeMarsh explained the amount was based on the size of a county, and Sarasota fell in the middle range.

Robinson added on Sept. 11, “My gratitude goes to Gov. [Rick] Scott for making a commitment that AHCA [representatives] would come meet with us and provide the proof” that disputed claims belonged to Sarasota County residents.

Thaxton made the motion to approve the settlement. Vice Chairwoman Carolyn Mason seconded it.