State asks for more time on potential Medicaid boost
By Christine Sexton
News Service of Florida
Gov. Ron DeSantis’ administration is asking the federal government for additional time “to consider the potential impacts” of drawing down hundreds of millions of dollars in additional federal Medicaid money for home- and community-based services.
In an email to the federal Centers for Medicare & Medicaid Services, Karen Williams of the state Medicaid office said Florida wants a 30-day extension, which would give the state until July 12 to submit a plan to the federal government.
“Please consider this email as the state of Florida’s formal request for the 30-day extension. This additional time will allow the state of Florida to continue coordinating with all impacted stakeholders to consider the potential impacts of this increase,” Williams wrote in the email late Friday afternoon.
The American Rescue Plan Act, a stimulus package signed in March by President Joe Biden, included provisions that allow states to tap into additional federal Medicaid funding for a number of different groups and services, some of which Florida has taken advantage of, and others not.
For instance, the federal law provided incentives for 12 states, including Florida, to expand Medicaid to low-income childless adults. The law, at least in part, offers states a 5 percentage- point increase in their regular federal Medicaid matching rates for two years after expansion would take effect. But as they have done for years, Florida Republican leaders shunned the idea of expanding Medicaid during this spring’s legislative session.
The American Rescue Plan Act also allows states to tap into additional funds to extend by 10 months the length of time that postpartum women can qualify for Medicaid. Florida is taking advantage of that provision, with House Speaker Rep. Chris Sprowls, R-Palm Harbor, leading the charge.
The federal law also provided states with an opportunity to draw down a 10 percentage-point increase in federal Medicaid funds for home- and community-based services, such as services provided in Florida’s “iBudget” program for people with developmental and intellectual disabilities.
Tom Rice, a program manager with the state Agency for Persons with Disabilities, told members of the Florida Developmental Disabilities Council last month that the state was putting together plans to access the enhanced Medicaid funding. But advocates for people with disabilities grew worried that the state wouldn’t submit a plan to the federal government — or request an extension — by a Sunday deadline.
With the request for an extension filed last Friday, Jim DeBeaugrine, a lobbyist and former director of the Agency for Persons with Disabilities, said he remains hopeful that Florida can tap into the additional federal money.
DeBeaugrine, also a former staff member of the House Appropriations Committee, estimated that Florida could tap into an additional $450 million in Medicaid funds for services provided through the iBudget program.
“I am cautiously optimistic that we can work with AHCA (the state Agency for Health Care Administration) and APD and hopefully come up with a good plan to use the dollars, at least associated with our population,” DeBeaugrine said.
While the 10 percentage-point increase has been a focus of providers that care for people with developmental and intellectual disabilities, the increased funding would be available for all home- and community-based services.
According to guidance issued by the Centers for Medicare & Medicaid Services, states could use the increased funds for a number of other services such as medical or remedial services recommended by physicians, including mental health and substance-use disorder services; private duty nursing services; and programs for all-inclusive care for the elderly, what is known as PACE.
“This is potentially a lot bigger than the population I am concerned with,” said DeBeaugrine, referring to people with disabilities.