Florida failed to pay health claims for sick, needy children

Florida failed to pay health claims for sick, needy children


Florida failed for nearly three months to pay tens of thousands of healthcare claims for the state’s sickest and neediest children due to software glitches blamed on the corporate merger of its two largest payment vendors, officials and executives said.

Families with critically ill children who relied on Medicaid-paid health providers were stranded in some cases. A father in Lake Worth was forced to cut back his contractor work to remain home and care for his son when payments stopped. A mother in Ocala said the company that helped care for her 15-year-old disabled son temporarily shut down because of the payment problems.

“We had to find caregivers for him,” said AnnMarie Sossong of Ocala, whose son has a neuro-immune condition and profound autism. “You can’t do anything else. You can’t go to work, you can’t go to school, you can’t even make a phone call because you’ve got this kid with such high needs,” she said.

Payment problems panicked more families, especially as unpaid bills for nursing care and other home health services began stacking up over months with no quick resolution in sight.

Executives at Sunshine State Health Plan Inc. of Tampa, Florida’s largest Medicaid payment vendor, said the payment glitches stemmed from the company’s merger on Oct. 1 with the second-largest payment vendor, WellCare of Florida Inc. Combined, Sunshine and Wellcare have multi-year contracts worth $31.6 billion from the state’s Agency for Health Care Administration, according to figures from the state’s chief financial officer.

It was among the most serious technology meltdowns — affecting one of the most vulnerable populations — under the administration of Gov. Ron DeSantis since unemployment claims overwhelmed Florida’s Department of Economic Opportunity early in the pandemic.

“Nobody responded to all these cries for help,” said Lavette Gulley, owner of Serenity Companion Service Inc., which cared for Sossong’s son. She temporarily closed her company due to unpaid invoices, stranding families that relied on the services she provided. “Some of these kids I’ve been with six, seven years, and I never had to call those parents and say, ‘Hey, I’ve got to stop service because I’m not getting paid.'”

Dan Miller of Lake Worth is a single father of a 17-year-old son with autism and an electrical contractor. His son’s provider, Blessing Hands Services Inc. of nearby Palm Springs, stopped the family’s services after it went unpaid for months, forcing him to take time from work to care for his son full-time. He said he was at risk financially of losing his family’s home.

“I have jobs right now that I’m in fear of losing because I can’t get to them and can’t get them finished fast enough,” he said. “It’s very bad for me right now financially.”

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