Regional News/South: Florida hospitals lobby state government to expand Medicaid, and other news

TALLAHASSEE, Fla.—Florida hospital officials are lobbying lawmakers to expand Medicaid coverage to roughly 1 million residents under the federal healthcare law. A rally last week in Tallahassee came a day after a Senate panel voted against traditional Medicaid expansion and instead proposed a voucher system where patients would obtain private insurance through Florida Healthy Kids. Patients may have to pay premiums and co-payments. State funds could be used to subsidize that. A House panel has also vetoed expansion. Hospital executives said they're less concerned about the details as long as Florida draws down an estimated $51 billion in federal funds and covers more uninsured residents. Hospitals will be hit doubly hard if the state declines to expand Medicaid because the federal funding streams that hospitals rely on to pay for uninsured patients will end. Gov. Rick Scott wants to expand Medicaid coverage to roughly 1 million of Florida's poorest residents by raising eligibility as envisioned under the Patient Protection and Affordable Care Act. Scott said he was in favor of expanding Medicaid for the three years that the federal government will fund 100% of the new coverage. State economists project Florida would receive more than $51 billion over the next decade, while spending about $5.2 billion.

—Associated Press

CORPUS CHRISTI, Texas—A South Texas children's hospital and a nearby radiology center agreed to pay a total of $2.3 million to settle whistle-blower allegations that they double-billed government healthcare programs for work on genetic ultrasounds. The physician practice owned by the health system that runs Driscoll Children's Hospital in Corpus Christi billed Medicare, Medicaid and other programs for both performing and interpreting pediatric genetic ultrasounds, according to the settlement agreement. But the government alleged the hospital had an agreement with an outside doctors' group called Radiology Associates on Corona Drive in Corpus Christi that was separately being paid to interpret the same test results, the government alleged. The double-billing was said to have occurred for several thousand ultrasounds between 2002 and 2007. The whistle-blower who filed the lawsuit in 2008 was Diana Kulwicki, a former revenue manager and coding compliance officer for Radiology Associates whose job included auditing radiology reports and coding. Driscoll Children's Hospital's wholly owned affiliate, Children's Physician Services of South Texas, will pay $1.5 million, and Radiology Associates will pay $800,000. The hospital said in a statement that a physician at the hospital believed his actions were legal, and had at one point contacted Medicaid officials about the issue, which led to the billing rules being changed in 2007. The settlement is not an admission of wrongdoing, the hospital said, and was entered “to avoid the delay, uncertainty, inconvenience and expense of protracted litigation of the claims that it feels were a matter of interpretation.” An attorney for Radiology Associates did not return a call seeking comment.

—Joe Carlson



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