The Medicaid managed care contracts in Florida have sparked a legal dispute. Industry groups and the Florida Agency for Health Care Administration (AHCA) have settled a legal issue tied to last year’s state budget, which might have led to legal challenges if Medicaid providers did not pay a $15 minimum wage to “direct care” workers.

Lawsuit Challenges Medicaid Managed Care Contracts

The extensive Medicaid managed care contracts are significant, with about 3.14 million Floridians receiving care through this system as of May. A lawsuit filed by a losing bidder aims to stop Florida health officials from finalizing new Medicaid managed care contracts while the legal disputes are ongoing.

ImagineCare LLC, which was excluded from the bidding process, filed the lawsuit in Leon County Circuit Court last week. The complaint alleges that ImagineCare was unfairly removed from the contract selection process and seeks an injunction to prevent AHCA from moving forward with new Medicaid managed care contracts until the protests are resolved.

The lawsuit claims, “Allowing AHCA and Secretary Jason Weida to proceed with contract execution while these protests are pending will cause significant harm to ImagineCare and other protesting entities, negatively impact Medicaid enrollees, and violate Florida law and the bidding process terms.”

Represented by the Panza, Maurer & Maynard law firm, ImagineCare disputes AHCA’s attempt to dismiss their protest over a bond requirement issue and intends to pursue their protest through the administrative-law system.

Overview Of Medicaid Managed Care Contracts

Since its establishment in 2011, Florida’s Medicaid managed care system requires most Medicaid beneficiaries to enroll in managed care plans. The current contracting process, which started in 2023, has led AHCA to propose awarding contracts to five organizations: Florida Community Care, LLC; Humana Medical Plan, Inc.; Simply Healthcare Plans, Inc.; South Florida Community Care Network, LLC (operating as Community Care Plan); and Sunshine State Health Plan, Inc. These contracts are scheduled to begin in January.

Additionally, Molina Healthcare of Florida has been awarded a contract for Medicaid services in Miami-Dade and Monroe counties, with Aetna Better Health and UnitedHealthcare also set to receive contracts, according to Florida Politics.