Florida has been limiting Medicaid patients to six emergency room visits a year even though federal officials consider such a cap illegal.
As a result, the federal government intends to penalize the state by withholding a portion of Medicaid funding.
“We hope the state will realign their Medicaid program with federal standards to avoid this penalty,” said Emma Sandoe, a spokeswoman for the Centers for Medicare and Medicaid Services.
The Florida Agency for Health Care Administration is in the midst of an appeal of the federal government’s rejection of the six-visit limit. A September hearing is scheduled.
But while the fight has been pending, the state agency went ahead with its plan.
“We are concerned that CMS is prejudging this matter by seeking to impose administrative penalties” before the appeal has played out, said spokeswoman Shelisha Coleman.
“It’s unfortunate that despite a September hearing to resolve the matter CMS is withholding matching funding,” said Frank Collins, communications director for Gov. Rick Scott.
Federal officials did not estimate how many people have been denied Medicaid coverage for emergency room visits.