A top Democrat is calling on federal officials to conduct a “thorough review” of the state’s request to shorten the window for Medicaid retroactive eligibility, after demanding its application be corrected to reflect some senators’ concerns about what she called an "ill-advised" policy change.
Incoming state Senate Democratic Leader Audrey Gibson wrote a letter Monday to the administrator of the federal Centers for Medicare and Medicaid Services, criticizing the state’s decision to save money by shortening how long non-pregnant adults can retroactively qualify for Medicaid coverage. Gibson also criticized the state Agency for Health Care Administration’s application for saying it was “not aware of any concern or opposition raised by any member of either party” during budget talks.
State lawmakers approved a budget in the final days of the legislative session which authorized shortening the current 90-day period those patients can retroactively have medical bills covered under Medicaid after they apply. The current policy allows eligible patients under Medicaid to have recent medical expenses covered and ensures facilities are paid for services they provide.
The proposed change, which must be approved by the federal government, would shorten that period to up to 30 days within the month that eligible patients apply for Medicaid coverage. The state agency estimated the change would save about $98 million and could impact about 39,000 people.
In its application to the federal government, the agency's Deputy Secretary for Medicaid Beth Kidder wrote that because the change does not alter any qualifying criteria, provider rates or benefits, the change "cannot accurately be described as a 'cut.'"
But opponents say it is just that, questioning the state's estimates and saying the new 30-day policy could harm patients who might miss the application window and be forced to bear high medical costs, as well as leave facilities with unpaid bills and pressure to submit applications more quickly.
Gibson, in her letter, called on the agency to conduct “a thorough review of grossly shortening retroactive eligibility for life-saving medical care.”
The policy, “if approved... will saddle senior citizens, veterans, those with disabilities, and all of their families, with massive medical debt even able-bodied individuals would find impossible to pay,” she wrote.
She also objected to the agency's assertion it was unaware of any objections from legislators during the budget discussion. Some Democratic senators — including Sens. Kevin Rader, D-Delray Beach, and Jose Javier Rodriguez, D-Miami — questioned how patients with sudden traumatic injuries might be affected in budget talks and on the Senate floor.
The Jacksonville senator first issued a press release Friday afternoon calling on the agency to issue a correction, which prompted Agency Secretary Justin Senior to call her that night and say changes would be made, she said in a statement.
“In justifying its request, the Agency for Health Care Administration (AHCA) falsified the record of events preceding the state legislature’s approval of the change during the debate over the upcoming state budget,” Gibson wrote Monday.
AHCA spokeswoman Mallory McManus said the agency wrote it was not aware of concerns “as no Senators contacted our Agency to ask questions or raise concerns." She said the agency would share Gibson’s comments with federal officials Monday but declined to clarify if it was submitting those comments as a correction.
“At the end of the day this was part of a budget that was passed by both the Florida House of Representatives and Senate, and is legislatively mandated,” McManus said.
If the request is approved, Florida would join four other states — including New Hampshire, Indiana, Arkansas and Iowa — in trimming the period of time patients have retroactive coverage. It would, however, be the first state that did not expand coverage under the Affordable Care Act to do so.
The state has until July 1 to have the change approved, when its budget goes into effect.
Photo: Florida Senate