Editorials

Manatee County should join litigation over unfair Medicaid payments

Manatee County should join the Florida Association of Counties in a lawsuit against state action to charge all Florida counties some $325 million in disputed Medicaid costs over the next few years.

Last week commissioners gave the county attorney authorization for such an action, should his professional judgment determine one or more valid reasons to support a legal challenge.

Manatee's commitment would only be a contribution up to $10,000 for the county's proportionate share of attorney's fees and costs for the litigation -- a pittance compared with the potential $4.4 million loss.

Commissioners also gave preliminary permission for the county attorney to pursue individual litigation, though final approval is required for that action.

Despite opposition from county governments across the state, Gov. Rick Scott signed the Medicaid legislation in to law in late March.

In an atypical move, the governor recognized county objections and pledged to resolve the years-long backlog of disputed payments with the state Agency for Health Care Administration and only charging for accurate bills.

But the Florida Association of Counties announced last week that a lawsuit would be filed soon in Leon County with several counties already on board in support.

The state's Medicaid billing system is broken. Glitches in the software have produced duplicate and error-ridden invoices.

County taxpayers should not foot the bill for the state's own accounting mistakes. Instead of fixing the defective system, installed in 2008, the Legislature decided to punish local taxpayers and balance the state budget on their backs.

This cost-shifting unfunded mandate also reflects the Legislature's ongoing assault on home rule. After years of slashing budgets, the new law also puts cash-strapped counties in a terrible bind. It goes into effect beginning on July 1.

Manatee County officials estimate the first-year impact at $2.3 million payment to the state. Then over the next three years, the state will reduce sales tax revenue-sharing funds with counties to capture the remaining bills.

A briefing paper to commissioners noted that the number of disputed bills has been multiplying over the years in some 20 counties, including Manatee.

The majority of contested bills are for patients who receive treatment in one county while residing in another. The county of residence must pay those bills.

The situation becomes clearly unfair in another regard: AHCA maintains that Manatee owes on bills dating back to 2001, but the county has no records documenting bills before 2007 because state public records procedures required their destruction.

Counties have no way to fight such unreasonable charges.

Florida's population centers face staggering losses. Dade County's total bill stands at some $64 million. Broward ($35 million), Pinellas ($28 million) and Hillsborough ($21 million) will also take a beating should this law withstand legal scrutiny.

With so much at stake, Manatee County should join the litigation.

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