Senators met with agency about audit of rehab center posted on 5/22/13

by David Bauerlein | Times-Union

State Sens. Aaron Bean and Audrey Gibson recently met with the head of the Agency for Health Care Administration about its audit that said Community Rehabilitation Center must repay almost $1.4 million in Medicaid payments.

Community Rehabilitation Center is run by Reginald Gaffney, who previously served on the Jacksonville Port Authority board. Community Rehabilitation Center is contesting the state’s audit which says the center overbilled the state’s Medicaid program.

Bean, R-Fernandina, said it would be “the death knell” for a small nonprofit like the center to have to pay the almost $1.4 million cited by AHCA.

He said he asked the state to work with Community Rehabilitation Center on a reasonable payment plan so the nonprofit can “continue being a vital service provider in north Jacksonville.”

“There are some things that were inappropriate that the state is going to bill him back for, and he’s agreed to pay back,” Bean said.

But Bean said he also is concerned about the methodology used by the state to conduct the audit and come up with the amount of overbilling.

Bean and Gibson joined officials from Community Rehabilitation Center in a meeting with AHCA Secretary Elizabeth Dudek about six weeks ago, the senators said.

A preliminary audit done last year pegged almost $2.6 million in Medicaid overpayments made to the center from September 2008 through February 2011. But AHCA scaled that back to about $1.4 million by the time it sent the March letter.

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Scott OKs $65M for Hospitals, Vetoes $368M in Projects posted on 5/21/13

by Staff | Health News Florida

In a press release, Scott said his budget included $25.2 million to alleviate the waiting lists on the Aged and Disabled Adult Medicaid Waiver Program and the Nursing Home Diversion Program.

The rejected projects include:

• $1 million for a crisis stabilization unit in Fort Walton Beach

• $2 million in extra Medicaid funding for Bethesda Hospital in Palm Beach County

• $4 million in additional funding for private home nurses

• $2 million for the ARC of Jacksonville

• $500,000 for homeless programs in Okaloosa and Walton County

The so-called “safety-net hospitals,” including Jackson Memorial and Tampa General, had lobbied hard for the payment during the past week after there were signs the governor might veto it.

The funds are designed to keep the hospitals afloat as they transition from a cost-based Medicaid payment system to one designed to reward efficiency. The change to "diagnosis-related groups," or DRG payments, is similar to the one that Medicare has been using for decades.

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Despite Snub, Tampa Bay to Get Jobs, Cash From 'Obamacare' posted on 5/10/13

by Carol Gentry | WUSF

Even though Florida officials tried to block the implementation of the Affordable Care Act at every turn over the past three years, the state will gain millions in grants and hundreds of new jobs this year from its implementation.

On Thursday, the Obama administration announced it will offer $8 million in grants to 48 community health centers in the state to help them enroll uninsured Floridians in insurance plans under the Act, also known as "Obamacare," beginning Oct 1. Other non-profits can apply for similar grants through a program for ACA navigators.

And according to Kaiser Health News, Florida is one of six states that will share 9,000 new call-center jobs to aid in the enrollment. It is not clear how many of the jobs will come to Florida.

The jobs will be added to a Tampa call center operated under a federal contract by Vangent, a General Dynamics Information Technology subsidiary.

Operators at the call centers, which already handle questions about Medicare, are to be trained to help enroll uninsured individuals and families in a choice of plans to be made available Oct. 1 on an online "marketplace." Details about the plan choices are not yet available.

The call centers, which will operate around the clock when the enrollment period begins, are designed to handle the 34 states -- including Florida -- that are relying on the federal government to provide an "exchange" or "marketplace." Sixteen states decided to develop their own online enrollment.

The operators will also help enrollees obtain up-front tax credits -- essentially the same as price discounts -- for those who qualify under the health law. A majority of Florida's uninsured residents are projected to be in the income range that will qualify for subsidies.

$8 Million for Health Centers

The grants announced Thursday that are available to 48 community health centers in Florida are part of $150 million nationwide for in-person enrollment assistance for the uninsured, Kaiser Health News reports.

The list of community health centers in Florida that are eligible to apply for the grants is posted on the Health Resources and Services Administration web site. Applications are due the end of this month.

A federally built online shopping site for the uninsured to enroll in a health plan is supposed to be ready by Oct. 1 for states that have decided not to build their own, including Florida. The coverage would begin Jan. 1. The rapid ramp-up has raised questions on whether the marketplace will be ready by Oct. 1, but USA Today reported Friday that unnamed officials are sending signals of reassurance.

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Hospice firm started by Sen. President Don Gaetz is target of justice department suit posted on 5/10/13

by Kelli Kennedy | AP

FORT LAUDERDALE - The Department of Justice is suing the hospice company founded by Florida's Senate president, accusing it of submitting tens of millions of dollars in fraudulent Medicare claims for more than a decade, including while Don Gaetz was vice chairman of the board.

Vitas Hospice and Vitas Healthcare submitted claims for emergency services for patients that weren't needed, weren't provided, or were provided to patients who weren't eligible under Medicare requirements, according to the DOJ. The companies set goals for the number of crisis-care days to be billed and pressured their employees to submit more claims so it would get more revenue, the lawsuit said. The agency said Medicare payments for crisis care can be hundreds of dollars greater than typical hospice care payments.

Vitas is the largest U.S. hospice care chain, and its parent company Chemed Corp. said the claims go back to 2002, two years before it acquired the company.

Gaetz told The Associated Press on Thursday that he has not been involved with the management of the company for about 13 years, saying he gave up a management role in 2000 when he became Okaloosa County's school superintendent. He founded the company in the early 1980s with Rev. Hugh Westbrook, a Democratic activist, and Esther Colliflower, a nurse. Starting with an $1,800 investment, they turned Vitas into the largest company of its kind before selling it for millions to Chemed in 2004.

That has made Gaetz, R-Niceville, one of the Legislature's wealthiest members with a net worth of about $25 million.

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Legislative leaders reap budget bonaza posted on 5/9/13

by JIM Turner | NEWS SERVICE OF FLORIDA

When asked about a $14 million line item for a college building in his home district that started out at $300,000, Senate President Don Gaetz, responded “I would expect it doesn’t hurt that the senator from Northwest Florida is also the president of the Senate."

The Niceville Republican often peppered his comments on his votes or views on an issue by saying he takes into account that he has to go home to the "folks" of northwest Florida.

As with other legislative leaders overseeing the state's purse strings, the Senate president departed from Capitol at the end of the legislative session with plenty for the folks back home.

EDUCATION

When budget leaders hammered out allocations for the Florida College System in the last weekend of the session, numbers jumped quickly for a couple of schools.

Gulf Coast State College in Panama City went from a $300,000 earmark to $17.5 million for the construction of a 70,000-square-foot STEM (science, technology, engineering, and math) classroom and lab building before both chambers settled at $14 million.

Gaetz said the $300,000 was a placeholder, seeking the increase – with his son Rep. Matt Gaetz, R-Fort Walton Beach, doing the same on the House side – after seeing how the budget was shaping up.

Sen. Joe Negron, R-Stuart, who chairs the Senate Appropriations Committee, snapped when asked about funding a project that wasn't in the list of priorities submitted by the Department of Education.

"If you check the Florida Constitution, it's the responsibility of the Legislature to write the state budget," Negron said.

In those same budget conferences, Fort Pierce-based Indian River State College - in Negron's backyard - landed $2 million to remodel buildings on its Ken Pruitt Campus in St. Lucie West.

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