A Miami-Dade County circuit judge has issued a preliminary injunction against a plan by the state Agency for Health Care Administration to slice millions of dollars in payments to facilities that serve people with developmental disabilities, reports Jim Saunders of the News Service of Florida.
Intermediate-care facilities throughout the state filed a lawsuit Dec. 21 to try to block AHCA from moving forward with the Medicaid funding cuts. The facilities argue that AHCA improperly approved the plan and that it will hurt the quality of care provided to people with severe disabilities.
“There’s no fluff in this program,” Steven Weinger, an attorney for the facilities, said Wednesday. “There’s no ability of the providers to make a profit.”
In an order dated Friday, Circuit Judge Valerie Manno-Schurr made clear that she was not ruling on the merits of the facilities’ arguments. But she ordered AHCA to “maintain the status quo” in payment rates until the case can be decided.
AHCA spokeswoman Michelle Dahnke said in an e-mail that the case involves what is known as a “trend adjustment” that was scheduled to take place in Medicaid rates. But she declined further comment because of the ongoing litigation.
The injunction, however, spurred questions during a meeting Wednesday of state analysts who were revising projected Medicaid costs for this year and the 2012-13 fiscal year. Tom Wallace, a top AHCA Medicaid finance official, told the analysts that it is unclear how long the lawsuit will take to resolve, which could affect projections used in drawing up next year’s budget.
The plaintiffs in the lawsuit include 19 providers and a client, referred to only as John Doe. The client is about 56 years old, has mental retardation and physical disabilities and is a longtime resident of a Sunrise Community Inc. facility in Miami-Dade, according to a document filed in the case.
Weinger said the rate changes, which AHCA issued in early December, would cost the facilities about $1 million a month. Also, the cuts would be retroactive to October, which would add to their impact on facilities during the rest of the fiscal year.
The facilities make a number of legal arguments in the lawsuit, including an argument that AHCA’s plan goes beyond cuts that lawmakers approved in the state budget.
Lawmakers in May approved spending $274.8 million on the facilities during the 2011-12 fiscal year. The budget said that total reflected a $6.3 million cut “as a result of modifying the reimbursement” for facilities, effective Oct. 1, and directed AHCA to “implement a recurring methodology” to carry out the reduction.
“The cuts challenged in this lawsuit result in reducing funding for ICF/DD services to far less than (the) dollar amount specifically appropriated by the Florida Legislature and, thus, is directly contrary to the Florida Legislature’s intent as expressed in the appropriations act,” the facilities argued in a court document.
The legal dispute comes amid efforts by state officials to hold down Medicaid costs as they grapple with budget shortfalls. Also, it comes as lawmakers and the state Agency for Persons with Disabilities look to trim costs in programs that have long run deficits.
But Suzanne Sewell, president of the Florida Association of Rehabilitation Facilities, said the rate cuts for intermediate care facilities are a separate issue from cost-saving moves in programs administered by APD. Those programs are intended to provide home- and community-based services that allow developmentally disabled people to live outside of facilities.
Sewell, whose group includes intermediate-care facilities, said her members were relieved by the preliminary injunction. She said the proposed cuts could affect staffing in the facilities, which ultimately could affect the quality of care that people receive.