Office of Program Policy Analysis and Government Accountability
Office of Program Policy Analysis and Government Accountability

Medicaid Field Offices Can Improve Efficiency and Effectiveness; State Could Outsource Some Activities

Report 04-30, May 2004




Report Summary

  • 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.


Related Reports
  1. Expected Medicaid Savings Unrealized; Performance, Cost Information Not Timely for Legislative Purposes
    Report 01-61 November 2001
Copies of this report in print or alternate accessible format may be obtained by email OPPAGA@oppaga.fl.gov, telephone (850) 488-0021, or mail 111 W. Madison St., Room 312 Tallahassee, FL 32399-1475.
Copies of this report in print or alternate accessible format may be obtained by email OPPAGA@oppaga.fl.gov, telephone (850) 488-0021, or mail 111 W. Madison St., Room 312 Tallahassee, FL 32399-1475.
social services, health, medicaid, pb2, medicaid, health care, managed care, cost savings initiatives, cost reductions, performance measures, health outcomes