Health agency wants to raise lawyers’ pay to reverse high turnover rates

The state’s largest health care agency is facing a legal crisis. And this is not the result of any lawsuit.

The Agency for Health Care Administration’s (AHCA) legislative budget request for the state’s 2023-2024 fiscal year paints a dire picture of its General Counsel’s Officeas good as Medicaid Fair Hearings Unit within the office, with high turnover rates for lawyers working in either position.

Fifty eight attorneys have resigned from the agency since 2016, and there are 13 vacancies in the agency’s general counsel office, according to the legislative budget request.

Medicaid’s Fair Hearings Unit, which is where beneficiaries turn if their managed care plan has denied them services or changed their care, has just three hearing officers on board and six vacancies. , leading the agency to note that it’s not “feasible” for the unit to continue as is.

The AHCA attributes the turnover rate of its General Counsel’s office to the low salaries of its attorneys coupled with the demanding work.

Starting salaries for junior and senior attorneys are $41,186.08 and $54,404.48, respectively, according to the agency’s report. legislative budget request (LBR). On average, the state pays a junior attorney $52,217.25 and a senior attorney $74,250.37.

“OGC has had great difficulty attracting qualified candidates for these base salary positions, and OGC will continue to experience turnover unless it is able to provide rate increases for its current staff. and higher salaries for incoming candidates,” the agency wrote in the LBR.

In addition to asking for higher salaries, the state is asking that it be allowed to cut three administrative positions in the Attorney General’s Medicaid Fair Hearing Unit and use the $180,000-plus to hire additional senior attorneys to serve as Medicaid Fair Hearing Officers.

The unit currently has three senior counsel positions, including salary and vacation, and seven positions considered “other personnel services,” or OPS. This means that vacations and other benefits are not offered. The AHCA tried unsuccessfully to fill the positions, according to the budget. Since March 2017, it has experienced a turnover of 114.29% of its staff.

The unit’s attorneys act as “Medicaid Fair Hearing Officers,” who listen to complaints from Medicaid beneficiaries whose services have been changed or denied or when their request to change their health insurance plan for “good cause” has been denied.

There were 1,534 applications for Medicaid Fair Hearings in the 2021-22 fiscal year. And the requests for hearings continue. The AHCA noted that 321 Fair Hearing requests were made by recipients in the first quarter of the 2022-23 fiscal year.

The agency has failed to fill the positions and blames positions classified as OPS, which it says “do not attract candidates with the skills to conduct these types of hearings.

The LBRs signify the start of the annual credit allocation process. State agencies are encouraged to prepare legislative budget requests before regular legislative sessions. LBRs are wish lists, but they are also used by governors who rely on the documents when preparing their own legislative spending proposals.

In addition to asking for money to raise lawyers’ salaries, the AHCA also pushed for a raise. $390,003 to increase the salaries of the staff of its Office of Financial Services, which is responsible for the financial operations of the agency.

These operations include managing federal grants, analyzing agency trust funds, disbursing payments, maintaining accurate financial and accounting records, collecting fees and fines from licensed health care entities, and managing the agency’s budget operations, from the development of proposed budget changes to the completion of the annual legislature. budget requests.

Although the LBR does not discuss revenue, the agency wants to increase what it pays for nurse specialist (RN) positions and nurse consultant positions and wants $3.847 million to achieve this.

The money will be used to pay $65,000 a year to 141 RN specialists on staff and $70,000 a year to the 44 RNs he consults.

In addition to increasing the salary of RN consultants, the AHCA also wants lawmakers to approve $770,000 to augment its IT staff and hire a certified project management professional, advanced business analyst, and application developers to ensure SunFocus, the agency’s financial management system, coordinates with the Florida Accounting Information Resource (FLAIR) in the Financial Services Department.

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