Florida hospital system challenges state over Medicaid repayments

A Broward County hospital system has filed a potential class-action lawsuit alleging that the state improperly recouped Medicaid money that had gone to hospitals for providing emergency care to undocumented immigrants.

The North Broward Hospital District filed the lawsuit last week in Leon County circuit court against the state Agency for Health Care Administration. The lawsuit seeks class-action status on behalf of hospitals across Florida. It comes after other legal battles about Medicaid payments to hospitals for providing emergency care to undocumented immigrants.

While such payments are required by federal law, a key issue in the disputes has been determining what qualifies as emergency care. Medicaid is not required to pay for non-emergency care for undocumented immigrants.

The new lawsuit focuses, in part, on a 2010 change by the Agency for Health Care Administration in determining whether emergency medical conditions existed. The agency conducted audits of payments that had been made for such services from July 2005 through June 2010 and recouped money from hospitals that it said had been overpaid, the lawsuit said.

Early this year, the 1st District Court of Appeal agreed with Southwest Florida’s Lee Memorial Health System, which argued the Agency for Health Care Administration had improperly sought repayment of Medicaid money.

North Broward Hospital District attorneys wrote that the agency was required to refund money to Lee Memorial but did not refund money to other hospitals.

“Because AHCA was without authority to conduct the … audits and recoup what it erroneously deemed to be overpayments of Medicaid funds, plaintiff (the North Broward Hospital District) and the putative members of the class have been injured and continue to suffer injuries,” the lawsuit said.