With hundreds of millions of dollars at stake, local officials from across Florida sought changes Friday as the state moves forward with new plans for collecting Medicaid payments from counties.
The issue has become highly controversial, after lawmakers in March required that the Agency for Health Care Administration recoup disputed Medicaid charges to the counties going back more than a decade.
As of last week, 53 counties had joined a pending lawsuit that challenges the constitutionality of the Legislature’s move.
The agency held a hearing Friday on draft rules that offer details about how the state would seek payments from past years and make billing changes for the future.
Karen Lloyd, an assistant county attorney from Brevard County, said the draft rules are a “start” but need to include more critical information about issues such as the proof counties would need to dispute state billings.
“It’s a skeleton, if you will, in great need of some meat, some muscle, ligaments and tendons,’’ Lloyd said.
The controversy stems from a longstanding requirement that counties reimburse the state for certain hospital and nursing-home costs for residents who are Medicaid beneficiaries.
Arguing that up to $325 million has gone unpaid in the past, lawmakers approved a budget-related bill that calls for gradually recovering the money.
As a sign of the concerns about the issue, representatives of Alachua, Brevard, Broward, Hillsborough, Manatee, Orange, Pinellas, St. Johns, St. Lucie and Sarasota counties spoke during Friday’s hearing.