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Counties wary of proposed Medicaid billing system

Now that Florida is implementing a new system for billing hospitals for Medicaid, the state must also change the way it bills counties for their share of the costs. It's up to the Legislature to come up with that formula just one year after a massive Medicaid billing fight with counties that took months to resolve.

So far, only the Senate has released a plan, which was approved by the Health Policy Committee Tuesday. That proposal, currently known as SB 7156, would require counties to pay a share of the Medicaid costs proportionate to the percentage of Medicaid enrollees that reside there.

The Florida Association of Counties has expressed concern about how the new billing system would impact some smaller counties and has asked the Senate to revise its estimates and put a cap on how much a counties' Medicaid costs can increase from year to year.

Here is more from the News Service of Florida:

Despite objections that many counties would see increased costs, a Senate committee Tuesday approved a plan that would revamp the state's system of billing counties for Medicaid care. The Senate Health Policy Committee voted 9-0 to approve the measure (SPB 7156), which would lead to counties making payments based on their proportions of Medicaid enrollees.

During the upcoming 2013-14 fiscal year, counties would pay a total of $269.6 million to cover certain hospital and nursing-home costs for residents. The Florida Association of Counties estimates that 57 counties would see their costs increase under the new formula, while 10 would see lower costs. Leon County Commissioner Bryan Desloge, president of the Florida Association of Counties, asked the committee to take a measured approach that would involve such things as evaluating more data.

"What we're asking for is just to stop, take a deep breath, realize that this isn't going to be solved overnight,'' he said. Supporters said the proposal would create more predictability for counties, which currently pay based on the Medicaid expenses of their residents.

Bill sponsor Denise Grimsley, R-Sebring, said she is interested in finding a way to help ease the counties' transition into the new payment model. "I'm OK with the formula, but in order to make this transition it is creating a lot of angst for counties, particularly the small, fiscally-restrained counties," Grimsley said.

The bill comes a year after lawmakers --- arguing that counties owed money to the state ---passed a law aimed at recouping back payments and collecting money in future years. Counties, however, contended that the state's billing system was riddled with problems.