State levies $950K in liquidated damages against Medicaid managed care plans

health care spending
Simply Healthcare was fined $422,250 in liquidated damages for the first quarter, more than any other health plan.

Florida health officials assessed $949,250 in liquidated damages in the first quarter of fiscal year 2021-2022, issuing final orders in 36 complaints against Medicaid managed care plans, Agency for Health Care Administration information shows.

Simply Healthcare was fined $422,250 in liquidated damages for the first quarter, more than any other health plan, and was responsible for about 44% of the overall amount of damages assessed in the three-month time frame. The damages were assessed in state-issued final orders settling four complaints.

While Simply Healthcare leads the Medicaid managed care plan pack in terms of the amount of liquidated damages assessed, Humana Medical Plan had seven final orders issued for the quarter, more than any other plan.

The state issued the orders between July 1 and Sept. 30 for Humana Medical Plan and levied $258,000 in liquidated damages against the health plan. Humana offers “comprehensive” health plans to Medicaid managed care enrollees throughout the state.

Staywell Health Plan had two final orders for the quarter and was levied $40,000 in liquidated damages. The managed care plan was acquired last year by Centene Corporation. Medicaid enrollment reports show that as of Aug. 31 Staywell had 23.5% of the Medicaid managed medical assistance market share.

Centene is the parent company of Sunshine Health, which offers a Medicaid managed medical assistance contract statewide and claimed 15.8% of the managed medical assistance market share in August, enrollment reports show. Regulators levied $80,000 in liquidated damages against Sunshine Health Plan for two complaints involving contract violations.

DentaQuest, a statewide Medicaid managed dental plan, had two complaints settled with final orders during the first quarter and had $3,500 in liquidated damages levied against it.

Florida contracts with Medicaid managed care plans to deliver health care services to enrollees in 11 Medicaid Regions across the state.

Christine Jordan Sexton

Tallahassee-based health care reporter who focuses on health care policy and the politics behind it. Medicaid, health insurance, workers’ compensation, and business and professional regulation are just a few of the things that keep me busy.


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