- April 25, 2024
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According to the Florida Association of Counties, new Medicaid legislation (House Bill 5301; formerly named Senate Bill 1988), will force counties to pay undocumented medical bills from out-of-county residents.
If approved, the proposal will remove a county’s ability to question residency of those it is being required to support medically, the organization states, force counties to pay Medicaid bills currently in dispute and deduct Medicaid costs from a county’s half-cent sales tax.
In a recent letter to state delegates, County Administrator Craig Coffey echoed the association’s concerns, opposing the bill, which, he said, would increase Flagler’s annual Medicaid costs by more than $700,000.
His letter is as follows:
Dear Legislators:
Senate Bill 1988 is problematic for Flagler County on many different levels.
This year, Flagler County was presented with a bill from the American Health Care Association for $160,000, going back four years for (pending) Medicaid charges. This back-billing was primarily from disputed bills that had wrong addresses and other incorrect information. This amount was unbudgeted and in addition to the annual $450,000 we pay in valid county Medicare expenses. We were threatened with having other revenues reduced if these costs were not paid immediately, even though we adamantly disagreed with the residency claims and other information as determined by AHCA.
We, therefore, bit our tongues and paid the invoice.
The proposal currently before you only makes the situation worse and adds insult to injury. No mandated measure of this nature should be placed on counties until such time as the residency requirement and system for address determinations is overhauled. This measure does not correct the root cause of the collection problem. Under the current presentation, our taxpayers will bear a forced cost for an inaccurate, ineffective system.
For example, the Flagler County back-billing owed, according to AHCA records, is approximately $500,000. We would be forced to tell local tax payers that we will have to raise their taxes to pay these possibly fraudulent claims which, under this bill, would be mandated to pay under threat of lost revenue.
This bill makes an ineffective state-level government system in need of major reform even stronger. To us, there appears to be a total lack of credibility in residency criteria determination and systems used to track the legitimacy of the charges. We have been told by AHCA that to obligate Flagler County taxpayers for a bill, an out-of-state resident simply has to have the intent of moving to our county for us to be liable for their hospital stay. We have also had bills presented to us for payment for a service period occurring months after the individual passed away. We would refuse to pay these charges but this (legislation) would require us to, no matter what.
It appears to us that there is more concern about putting funds in the hands of a service provider rather than protecting taxpayer's funds from fraud.
This bill will do the following to Flagler County:
• This bill will increase our annual costs up to more than $700,000 per year, an increase of $200,000 to $300,000 for local taxpayers to bear which, in turn, will increase property taxes;
• Give an inaccurate system “teeth," to be used against local governments;
• Force local governments to pay first under threat of garnishment and then try through
attorney's and hearings in Tallahassee to try to get our funds back for erroneous bills;
• Allow AHCA to garnish sales tax, which in Flagler County is a committed revenue stream obligated for debt; and
• Do nothing to reform a broken system, the root of the problem.
Flagler County, respectfully, requests you vote NO on SENATE BILL 1988.
Sincerely,
Craig M. Coffey
County Administrator
