Florida lawmakers urged the Centers for Medicare & Medicaid Services (CMS) to reauthorize Florida’s hospital-directed payment program (DPP) as CMS seeks to strengthen Medicaid program integrity.
“We urge the Centers for Medicare & Medicaid Services (CMS) to swiftly reauthorize Florida’s hospital-directed payment program (DPP) for the 2025 Medicaid managed care contract rating period (October 1, 2024, through September 30, 2025),” the group of Florida lawmakers wrote in a joint letter, which was obtained by Breitbart News, to Health and Human Services (HHS) Secretary Robert F. Kennedy Jr., Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz, and Deputy CMS Administrator Daniel Brill.
They added, “The hospital DPP provides vital Medicaid funding to hospitals serving some of our most vulnerable neighbors, and we must avoid any delays or lapses to protect Floridians.”
The Big Beautiful Bill tasked CMS with greater scrutiny of Medicaid programs to ensure greater program integrity, including with the state directed payments program.
HHS Secretary Kennedy said last September that states have been contributing fewer dollars to the program.
“Medicaid is a federal and state partnership and for years states have skirted their responsibilities to draw down more federal funds while contributing less state dollars,” he said in a statement at the time. “President Trump’s One Big Beautiful Bill Act will hold states accountable and make sure the federal government isn’t left to pick up the tab.”
The Florida lawmakers believe that Florida’s DPP program provides access to critical services.
Their letter reads, in part:
Every year, Florida’s DPP helps to preserve access to critical services that may otherwise be eliminated due to inadequate reimbursement rates, including labor and delivery units, inpatient psychiatric services, and numerous other healthcare services. Florida’s state Medicaid rate for labor and delivery is 48 cents on the dollar; however, Florida’s directed payment program has historically mitigated these pressures and helped preserve vital access to healthcare services.
Historically, the hospital DPP preprints have been approved within six months of initial submission and within the rating period to which they relate. Unfortunately, approval for Florida’s DPP preprint for the period ending September 30, 2025, remains pending. Unlike other approvals, Florida’s DPP preprint is not new. It’s our understanding that the state also promptly submitted the DPP preprint and stays in contact with CMS regarding any outstanding items.
The United States Representatives from Florida who signed the letter are Reps. Aaron Bean (R), John Rutherford (R), Daniel Webster (R), Maria Elvira Salazar (R), Anna Paulina Luna (R), Jimmy Patronis (R), Mike Haridopolos (R), Byron Donalds (R), and Randy Fine (R).
“Because of this ongoing delay, Florida hospitals are increasingly concerned about the potential consequences for their patients, including limited access to essential health care services. We are now into the new year, and our hospitals are concerned about their ability to continue supporting vital healthcare services and the risk of reduced access for the millions of Floridians covered by Medicaid, including more than 2 million children,” they continued.
Mary Mayhew, the president and CEO of the Florida Hospital Association, told Breitbart News that she was “dumbfounded” that CMS has yet to approve the proposals from the Sunshine State.
She told Breitbart News in an interview, “Here you have an extremely conservative state that has been incredibly disciplined in its management of the Medicaid program. We’re 47th in the country in per capita Medicaid spending. So, it’s just completely irrational that states like Illinois, New York, California, are getting approvals, and we’re still waiting eight months later, at least in terms of this hospital directed payment program, eight months later for an approval, and this program has been approved over the last several years by CMS.”
She added, “Unlike the fraud that is being pursued in Minnesota, where you have storefronts with nothing going on behind them, and they’re billing fraudulent claims, I’m dumbfounded that we can’t get approval for a program that is helping to preserve labor and delivery units, inpatient psychiatric units and we’re taking care of in our Medicaid program the original foundational eligible populations, the elderly, the disabled children and extremely low income parents. It’s very straightforward.”
On the other side, CMS continues to work to ensure that there is program integrity in Medicaid programs, including the state directed programs.
“CMS works to ensure Medicaid resources are directed appropriately to strengthen program integrity and protect patient care. CMS reviews state directed payments (SDPs) to ensure compliance with federal requirements. Most SDPs are renewed on an annual basis,” a CMS spokesperson told Breitbart News.
The spokesperson added, “CMS is actively reviewing numerous SDP preprints submitted by states but does not comment on the status of specific states’ preprints or pending submissions until finalized. CMS continues to work closely with states to ensure proposed SDPs comply with federal requirements and advance Medicaid program goals, including improving access, quality, and value.”
One source said that the Big Beautiful Bill changes the way CMS approves state directed payment arrangements. The source said there are concerns that states are shifting the burden onto the federal government compared to the level the states provide to the program.
The source said that there are more questions about how the Florida proposal would work and the state is not providing answers as of yet.
“The state has functionally chosen not to engage in a good faith effort and to provide those answers,” the source said.
Read the lawmakers’ full letter:
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