TALLAHASSEE, Fla. – Yesterday, some members of Congress sent a letter to the Centers for Medicare & Medicaid Services regarding Florida’s 1115 Medicaid Waiver Amendment. This letter was filled with inaccurate and misleading information in an attempt to politicize an issue that will save Florida taxpayers $98 million.

“The letter from some members of Congress was a clear attempt to distort the facts on Florida’s Medicaid system – which is currently operating at the highest level of quality care in its history. The request submitted by AHCA, which was passed by a bipartisan majority of the Florida Legislature, simply means that anyone who has received medical services who is eligible for Medicaid must apply for the program within the month they receive the service. If they do not apply within that month, health care providers will not be reimbursed for the services provided.

“This does not affect who is eligible for Medicaid at all, nor does this change the application process. In fact, providers such as hospitals which are making record profits, can be reimbursed through other sources of taxpayer funding after they provide uncompensated care. This new provision protects taxpayer dollars and can reduce unnecessary hospitalizations. At no point in this process will patient care be jeopardized. This is about paperwork, not patient care.” – John Tupps, Governor Rick Scott’s Communications Director

The Letter to CMS contains the following inaccurate and misleading claims:

CLAIM: If approved, this change could jeopardize the financial security of at least 39,000 of the most vulnerable Floridians and countless providers who treat them.

 This is not true. The only information a person needs to apply for Medicaid is a name, signature and an address. The person is eligible for Medicaid beginning the day they apply. And, is retroactively eligible to the first day of the month. This change simply means that a person must apply within the month that they receive the service. This change does not apply to children under 21 and pregnant women.

Hospitals are making record profits. People who are eligible for Medicaid will still receive services. The eligibility requirements for Medicaid will not change. The application process for enrollment has not changed.

CLAIM: Retroactive eligibility is designed to protect Medicaid beneficiaries – including seniors, pregnant women, individuals with disabilities and parents – and their families from steep costs of medical services and long-term care.

This is not true. People who are eligible for Medicaid will still receive services. The eligibility requirements for Medicaid will not change. The application process for enrollment has not changed. Also, zero retroactive eligibility changes are being made in terms of children and pregnant women. These changes have zero to do with Medicare which provides medical care to the elderly in hospitals. This is blatantly false.

CLAIM: Leaving Medicaid-eligible applicants without financial protection simply because they have not enrolled is cruel and in direct conflict with the goals of the Medicaid program. The proposal will directly hurt Floridians with disabilities and seniors in nursing homes.

Again, this is misleading. People who are eligible for Medicaid will still receive services. The eligibility requirements for Medicaid will not change. The application process for enrollment has not changed. AHCA will work to ensure these changes lead to better patient outcomes and taxpayer savings.

CLAIM: If CMS approves this proposal in its current form, it would likely prevent vulnerable populations, especially seniors in nursing homes, from getting the care they need. 

These members of Congress should quit trying to alarm Floridians and instead focus on the issue itself. AHCA’s submitted change will lower unnecessary hospitalizations. The proposed change will save taxpayers $98 million by increasing efficiency in government and the healthcare system. No services will be impacted, and hospitals who are making record profits will still have an overabundance of resources to provide care to those who need it. This is about paperwork, not patients.

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