Medicaid Waivers- Florida Retroactive Decision

On Friday, February 1, Florida’s recent CMS-approved request to eliminate the existing three month retroactive eligibility obligation for many Medicaid recipients goes into effect.

By Centauri Health Solutions Staff

The Impact of the Florida Retroactivity Ruling

Federal law directs all state Medicaid programs to provide 90-day retroactive coverage to give people time to apply for coverage following traumatic incidents or diagnoses of illnesses. The new Florida policy allows the state to only pick up 30 days of existing health care bills for people who become eligible for Medicaid. This shortened coverage period does not apply to children or pregnant women.

Centauri’s Proactive Strategy

Since the federal government approved Florida’s request on November 29, we at Centauri have been working for the past two months to accommodate these key changes.

We understand the negative impact this ruling could have on the financial cycle of our Florida hospital clients – with a potential, unplanned for, big bump in uncompensated care.

Our Hospital Services and IT teams have worked together over the past several weeks to make sure our internal operating system was programmed to correctly address the new coverage rules on Day One – Feb. 1; to alter the Accounts Receivable (AR) processing for non-pregnant adults over the age of 21.

In addition to our technology updates, our team also developed and implemented an aggressive patient outreach strategy that involved written, call and text communications to get those eligible enrolled in Medicaid as soon as possible.

Just as we were able to program our operating system to automatically manage these changes for current clients, our flexible technology will retrospectively flag these AR accounts for future Florida hospital clients, as well. If previous vendors were not as proactive, Centauri can turn these accounts around quickly, to help secure and sustain Medicaid coverage for these patients moving forward.

Looking Ahead

Our strategy can be easily adapted for hospital clients in other states who may be faced with similar CMS decisions regarding retroactive coverage down the road. The new Florida rule will remain in effect until June 30, 2019, unless state lawmakers agree to extend it.

Centauri’s system – and teams – are poised to accommodate any future rulings regarding Medicaid coverage. We are a thought leader – and a partner in helping anticipate possible implications and solutions regarding impacts.