U.S. Senator Bill Nelson

Serving Florida

Nelson, Democratic lawmakers urge CMS to deny Medicaid request

By Alexandra Glorioso, POLITICO
May 10, 2018

TALLAHASSEE — Sen. Bill Nelson (D-Fla.) and 11 Democratic lawmakers on Thursday urged the federal government to oppose Florida's request to eliminate the three-month look-back period for nonpregnant adult Medicaid recipients.

The letter to Centers for Medicare and Medicaid Services Administrator Seema Verma adds new pressure to a new policy pushed by state Senate Republicans during the legislative session that ended on March 9.

"As members of the Florida Congressional Delegation, we write to urge you to oppose provisions of the State of Florida's 1115 Medicaid MMA Waiver Amendment that would directly harm thousands of seniors and neighbors with disabilities in Florida," wrote Nelson and the other lawmakers.

State Senate leaders proposed the policy to save about $100 million, saying they needed that money for areas of the budget like school safety and mental health and substance abuse. It had originally been offered as a policy change by the state Agency for Health Care Administration during its required annual budget exercise after the Trump administration indicated it would be approved.

Under the new policy, AHCA is directed to pursue the change. As 60 percent of Medicaid money is from the federal government, any proposed changes to the state's program requires federal approval of an amendment to its current 1115 Medicaid Waiver.

"If approved, this decision could jeopardize the financial security of at least 39,000 of the most vulnerable Floridians and countless providers who treat them," wrote the lawmakers. "It will also cut at least $100 million from an already underfunded Medicaid program that is suffering from the state's continued choice to pass up more than $66 billion in federal funds by refusing to expand its Medicaid program."

The congressional lawmakers echoed nursing home and hospital providers when they said the elimination of the program would force people who visit those institutions to pay out of pocket. It's true that most of the recipients who would be affected are elderly patients seeking inpatient care, according to records released by AHCA.

But a hospital administrator in South Florida confirmed to POLITICO that it only takes half an hour to sign a patient visiting the hospital up for Medicaid. Patients become eligible from the day they sign up, not the day they are approved. While there's little known one way or another about the new measure, some health care officials believe the policy change will take affect when administrators sign patients up for the program but that it won't cause high levels of uncompensated care for hospitals and other providers.

This view, however, is not shared by Democrats.

"Importantly, this protection was also designed to minimize uncompensated care costs faced by hospitals and other health care providers who take care of our neighbors and are already challenged by the state's low reimbursement rates," wrote the lawmakers.

They added: "This proposal would not only wipe out many families' pocketbooks, but it would also place a financial burden on health care providers, the state and indeed all Florida taxpayers through increased uncompensated care costs."

AHCA recently filed a new letter to CMS that encompasses state Democrats' complaints on the matter. It had initially told the federal government in its amendment application that it wasn't aware of any concerns even though the caucus had raised several during a budget floor debate on March 9.