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Senate panel votes to confirm Florida's chief healthcare administrator

A Senate panel threw its support behind Florida’s top healthcare administrator Wednesday, but only after grilling her for more than 60 minutes about the deepening impasse over the healthcare budget.

The Senate Ethics and Elections Committee voted 8-1 to recommend that Agency for Health Care Administration Secretary Elizabeth Dudek keep her job.

Dudek faced a series of tough questions about her agency’s negotiations with the federal government over the future of the federal-state hospital funding program known as the Low Income Pool. The $2.2 billion program, which helps hospitals that treat low-income patients, is scheduled to expire in June unless the state and federal government agree on a successor program.

The confirmation hearing took place one day after the U.S. Centers for Medicare and Medicaid Services (CMS) sent Florida a letter saying the future of the LIP program was linked to whether lawmakers accept federal Medicaid expansion money –- something House Republicans are refusing to do.

Dudek told the panel she was surprised by the correspondence.

"From the beginning, we had an agreement with CMS that our discussions were only about LIP, and not expansion, and we stressed that LIP funding would be necessary, with or without expansion," she said.

Dudek said her agency had provided the federal government with three possible models for a LIP replacement program in late February or early March, and stressed that Florida needed an agreement in principal by early April. The agency later provided the model developed by the Senate.

But Dudek said CMS had not been responsive.

"It wasn't until yesterday that we received a letter advising us of their stance regarding our proposals," she said.

Dudek said her agency had taken the negotiations "very seriously."

"We have done all that we can, but we are not the ones in control," she said. "CMS has 100 percent of the control."

Former Senate President Don Gaetz, R-Niceville, brought up a letter from U.S. Sen. Marco Rubio and five Republican congressmen urging the federal government to keep the LIP issue separate from Medicaid expansion. 

Gaetz inquired if AHCA had anything to do with the correspondence.

"I believe we were involved in the crafting of that letter at a request to us," Dudek said. "It merely tried to continue to enhance the fact that we saw the two issues as totally separate."

Dudek said the letter had likely been written in March.

But if you didn't know the two programs were linked until Tuesday, Gaetz pressed, why bother writing the letter?

"We wanted to get support of the LIP program, which we saw as paramount," Dudek replied.

Dudek said there was a chance the federal government would not provide any LIP funding, as well as a chance that the money might be significantly less than what has been provided in previous years.

Gaetz asked if Dudek thought CMS would accept the Senate's LIP program.

"I don’t know," she said.

"Do we have a Plan B?" Gaetz asked.

"Not that’s formatted, no, sir," Dudek replied.

Still, the members of the Senate panel praised Dudek's professionalism, and said she had done a good job with the hand she was dealt. All but one member of the committee -- Democratic Sen. Jeff Clemens, of Lake Worth -- voted to recommend she stay on the job. 

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