Close Close
Sign In
Newsletters
Popular Financial Topics Discover relevant content from across the suite of ALM legal publications From the Industry More content from ThinkAdvisor and select sponsors Investment Advisor Issue Gallery Read digital editions of Investment Advisor Magazine Tax Facts Get clear, current, and reliable answers to pressing tax questions
Luminaries Awards
Podcast Center Video Center Webcasts Resource Center Events
About ThinkAdvisor Contact Us Advertise With Us Asset & Logo Licensing Sitemap Terms of Service Privacy Policy Copyright © 2024 ALM Global, LLC. All Rights Reserved.
ThinkAdvisor

Portfolio > Asset Managers

Florida hospitals blast reimbursement cuts

By Allison Bell

X
Your article was successfully shared with the contacts you provided.

The Florida Hospital Association isn’t happy with the feds. And it all because of slashed inpatient facility reimbursement rates.

In Florida, federal Pre-existing Condition Insurance Plan program managers tried to cut costs by switching to a provider network run by a unit of UnitedHealth Group Inc..

PCIP managers asked the hospitals to approve an amendment that would charge PCIP patients newly negotiated UnitedHealth network rates, rather than the old, higher rates that many hospitals had already negotiated with the carrier.

Bill Bell, FHA general counsel, said most of the hospitals that receivd the letter kept their old, higher UnitedHealth rates.

The fact that the PCIP program tried to make the change with an amendment “makes clear the lack of authority for unilaterally changing the reimbursement rates,” Bell said. PCIP agency “purports to do what a private party to an agreement could never get way with: pronouncing a unilateral change in reimbursement rates.”

Bell was commenting on  efforts by the Center for Medicare & Medicaid Services to slash PCIP program spending.

Congress provided $5 billion for PCIP as a stop-gap before PPACA coverage-access rules take effect next year.

The average level of claims per enrollee has turned out to be four times higher than expected, and managers began trying to save money earlier this year by re-vamping program rules and switching to smaller, cheaper networks.

See also:

NOT FOR REPRINT

© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.