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Office of Program Policy Analysis and Government Accountability

Medicaid Field Offices Can Improve Efficiency and Effectiveness; State Could Outsource Some Activities, Report No. 04-30, May 2004
 
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  • Florida’s Medicaid field offices provide a variety of services to Medicaid recipients and providers.  The field offices could improve their efficiency and effectiveness by re-credentialing MediPass providers every three years instead of every two years, and taking steps to reduce exceptional claims.  The Agency for Health Care Administration should clarify field office roles and periodically review their staffing to ensure wise use of resources. 
  • The state could outsource some field office activities, namely processing exceptional claims, training providers, and managing the MediPass network.  Outsourcing these services could provide savings by consolidating activities now shared by the field offices and either the Medicaid fiscal agent or the central office.  The agency plans to begin developing specifications for a new fiscal agent contract in spring 2004.  The new contract should clearly delineate fiscal agent responsibilities and include performance expectations along with incentives and penalties to ensure contract compliance and achievement of expected performance.

Which Government Program Summaries contain related information?

Medicaid Health Care Services
Agency for Health Care Administration (AHCA)

What other OPPAGA-related materials are available?

  • Report No. 01-61 Justification Review: Expected Medicaid Savings Unrealized; Performance, Cost Information Not Timely for Legislative Purposes, published in November 2001.

Copies of this report in print or alternate accessible format may be obtained by telephone (850/488-0021), by FAX (850/487-9213), in person, or by mail (OPPAGA Report Production, Claude Pepper Building, Room 312, 111 W. Madison St., Tallahassee, FL 32399-1475).
e-mail address: oppaga@oppaga.fl.gov


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