U.S. District Court for the Middle District of Florida in Jacksonville. (Photo by Jackie Llanos/Florida Phoenix)
JACKSONVILLE — The federal judge handling the class action filed by clients kicked off Medicaid by Florida state agencies following the end of the COVID emergency warned both sides Friday that neither would be happy with her ruling and suggested they discuss a settlement.
“I don’t think either one of you is going to be totally thrilled,” U.S. District Judge Marcia Morales Howard said as she exited the courtroom on the last day of the bench trial. The judge, appointed by George W. Bush, suggested that the attorneys could come up with a better solution to the dispute, which involves notices the state sends people when they lose Medicaid benefits.
During testimony this week, Morales Howard asked state employees how the Florida Department of Children and Families figures out Medicaid eligibility and notifies people when their benefits end. On the last day of the trial, she didn’t appear convinced by an estimate from Deloitte, the contractor handling the system, that it would take 28,000 hours to update Medicaid termination notices to include case-specific information.
A rushed estimate
The estimated time required to make such changes, which would give Floridians more insight into information DCF uses to determine whether they qualify for Medicaid, is more than double the number of hours the state pays Deloitte to maintain the system annually, according to evidence presented on Friday. The consulting company took two days to come up with the estimate.
Hari Kallumkal, the Deloitte manager who works with DCF, said the state’s use of technology from the 1980s would make the process take longer. But he also testified that his team usually has more time to create estimates such as the one at issue here. Kallumkal was the last witness in case filed by Floridians arguing the notices revoking Medicaid benefits are confusing and lack enough information to allow them to appeal their loss of coverage.
“There was not a lot of time for us to do this,” Kallumkal said, referring to conversations Deloitte employees have with DCF before coming up with the number of hours required to complete the project.
He added: “I believe it was kind of rushed.”
Deloitte produced a alternative estimate, at the request of DCF, that it would take 12,000 hours to add income information to notices.
Attorneys defending DCF and the Florida Agency for Health Care Administration used Kallumkal’s and state employees’ testimony to argue that the changes plaintiffs requested in the suit would burden the state.
Other notices DCF sends clients include personalized information, such as income limits for food stamps, said Sarah Grusin, an attorney with the National Health Law Program representing the plaintiffs. She displayed evidence that Deloitte is working to add people’s income information to notices in Oregon.
“There is no other state that runs an older system like Florida,” Kallumkal replied.
More problems
Aside from changes to the notices, the plaintiffs want everyone the state kicked out of Medicaid without proper notice to get their benefits back. Attorneys for the state estimate it would cost $87 million per month to do so, according to a filing in the case. During the trial, an AHCA official placed the cost at $313 per person per month, although his estimate didn’t discount the portion the federal government would have to pay.
Testimony from DCF employees and documentary evidence has highlighted problems Floridians faced while DCF reviewed the Medicaid eligibility of millions after the end of the COVID-19 public health emergency, during which the federal government required states to keep people enrolled regardless of income.
Errors by the agency and its Deloitte-operated system led to children and postpartum women losing health care coverage to which they were legally entitled.
The problems have persisted this year. DCF blocked more than half of the calls from people trying to speak with a real person this April, according to evidence presented.
“These are constituents, hard-working Floridians who are trying to get access to care,” Acadia Jacob, Florida Voices for Health’s advocacy director, told Florida Phoenix in a phone interview. “Their lives are too busy to spend as much time as they’re being forced to on the DCF hotline.”
Problems stemming from Deloitte Medicaid systems are happening across the country, according to an investigation from KFF . In fact, the National Health Law Program filed a complaint against the consulting giant with the Federal Trade Commission in January, according to KFF.
In Florida, people couldn’t access their unemployment benefits in 2020 because of a failure in the Delloite system, Politico previously reported.
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