DeSantis administration wants to inject Hope Florida into Medicaid program

TALLAHASSEE, Fla. — The DeSantis administration wants to do for Florida Medicaid recipients what it’s been trying to do for people on food stamps and welfare — use Hope Florida’s network of nonprofits to help wean them off government assistance.

The Agency for Health Care Administration, one of the agencies that falls under the governor’s authority, says it will accomplish that goal by stitching Hope Florida — a loosely-structured state program spearheaded by First Lady Casey DeSantis — into the contract for its Medicaid program, its largest federal contract at $143 billion over the next six years.

But several lawmakers, including House Speaker Daniel Perez, R-Miami, believe that may be a disastrous move that could jeopardize billions of federal dollars Florida receives each year to provide health care for Florida’s poor. They are alarmed by new language in the Medicaid contract forcing managed care plans to work with Hope Florida or face dire consequences.

The Medicaid developments deepen the ongoing controversy surrounding Hope Florida, long viewed as a potential centerpiece of Casey DeSantis’ possible run for governor but now the subject of legislators’ criticism and unwanted media attention regarding its unproven track record and seemingly loose record-keeping.

Rep. Alex Andrade, a Pensacola Republican who chairs the House Health Care Budget Subcommittee, last week called Hope Florida a “black hole”

He spent nearly three hours in a legislative hearing grilling officials with AHCA. The agency runs the Medicaid program for 4.2 million Floridians and has a checkered track record of managing those federal funds, racking up nearly $1 billion in fines.

Unsatisfied with their answers about Hope Florida, the Medicaid contract and other issues, Andrade promised to hold more hearings and use subpoena powers if necessary to get to the answers he wants.

“We had three state employees who couldn’t provide a straight answer to simple questions,” Andrade said.

For weeks, he and other lawmakers have been frustrated by the lack of details from the Hope Florida organization about the 30,000 people it claims to have gotten off welfare and the state and federal dollars being funneled into the program.

They also have grilled health officials over donations to the program, especially $10 million steered from a $67 settlement from Centene, the biggest Medicaid contractor in the country. That money went to two dark-money committees that quickly donated millions to defeat a ballot initiative to legalize marijuana that DeSantis opposed, which was first reported by Politico and The Tampa Bay Times

“So far it looks as though it could be illegal,” Perez told a group of reporters last week about the settlement agreement. “And I only say that because we were never notified of the $10 million.”

An enraged Gov. DeSantis called the questioning of Hope Florida’s finances “baseless smears” on himself and his wife.

“Shame on you in the Florida House and your terrible leadership,” DeSantis said during a news conference in Kissimmee Monday.

Perez said lawmakers had a right to hold Hope Florida and the state agencies that run it accountable.

The concerns raised by Andrade’s committee stemmed from a discussion of the state’s newest contract with Medicaid for its managed care plan, which is responsible for providing health insurance to most of the state’s Medicaid recipients.

Andrade focused on a section of the 414-page contract with the header “Prioritizing Hope Florida,” which requires managed care plans to work with Hope Florida to “enable eligible enrollees to gain the necessary education, job, and life skills to achieve independence and ‘graduate’ out of Medicaid.”

That raised red flags for Andrade, who said AHCA was unable to provide answers for how that would work since Hope Florida — essentially a referral service — provides no actual services and has offered few details to back up its claimed accomplishments. Why, he asked, do agency officials want to prioritize it “in the largest contract the state executes and the largest bank account the state issues funds from”?

He was also concerned about a requirement that the managed care plans provide Hope Florida with Medicaid client health data “to enhance the integration of case management and coordination of service delivery.”

Failure to provide such information could subject the managed care plans to “sanctions and corrective action plans, or liquidated damages … as determined by the Agency,” the contract states. Andrade noted that such harsh penalties were attached to other sections of the contract.

Brian Meyer, the deputy secretary for Medicaid at AHCA, told the committee the agency wanted to make it clear Hope Florida was part of its Medicaid work.

“With respect to the phrase ‘Prioritizing Hope Florida,’ you know, the agency would seek any action necessary if the plans flat out refused to integrate,” he said.

Rep. Marie Paule Woodson, D-Miami, said she was concerned about the money and the potential breach of data by sharing client information. “You are not connecting the dots for me to fully understand what is going on,” she said.

Shevaun Harris, who oversaw Hope Florida’s operations for four years while she was secretary of the Department of Children and Families, was questioned at the meeting and later complained in a video that she was “ambushed.”

Mallory McManus, who was her deputy chief of staff at DCF and followed her over to AHCA, said Andrade “purposefully misconstrued the structure and nature of the Hope Florida program, which is shameful.”

AHCA signaled its intentions to mesh Hope Florida into the Medicaid program as far back as September, when DeSantis Chief of Staff Jason Weida was still AHCA secretary. The agency negotiated a settlement agreement with Centene, the nation’s largest Medicaid provider, over allegations it overcharged the state for prescription billings.

The agreement, signed Sept. 27, ordered Centene to return $67 million in federal taxpayer dollars, with AHCA specifically directing Centene to pay $10 million of that as a one-time donation to the Hope Florida Foundation.

The settlement agreement states that “Hope Florida, through The Hope Florida Foundation, Inc., serves a mission that is important to the policy goals of the State of Florida” and that “AHCA desires an expanded role for Hope Florida in the Florida Medicaid program.”

A few weeks after the agreement was signed, the Hope Florida Board of Trustees turned over $5 million apiece to two dark-money committees.

Those organizations turned around a week later and donated millions of dollars apiece to Keep Florida Clean, a committee set up by DeSantis and run by his former chief of staff James Uthmeier to fight Amendment 3, a ballot initiative to legalize marijuana that failed to win the needed 60% of the vote in November.

Andrade and others said that $10 million should have gone into the general fund to pay for services to needy Floridians. They also said the deal could violate a state law that requires all settlements to be approved by the state’s chief financial officer and deposited in the state’s general fund bank account.

But Uthmeier, appointed attorney general by DeSantis in February, defended the settlement agreement as proper on Monday.

“These other nonprofit organizations that have helped you know, against the Amendment 3 effort, we should be thankful to them, to all of them, they stepped up in a big way, and because of that, we won,” Uthmeier said.

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