Summary

The Department of Health is responsible for the State’s public health system.  Within this system, the Department has authority to screen newborns for various disorders, provide services to children with special health care needs through Children’s Medical Services (CMS) Programs, and provide access to physicians and health services through the Division of Health Access and Tobacco.  Our audit focused on activities and transactions for the period July 2004 through January 2006.

Newborn Screening

Finding No. 1:         While authorized in July 2004, the Department did not begin billing private insurance for the cost of newborn screenings until March 2006.  Additionally, the Department did not begin billing Medicaid until January 2005.  Uncollected revenue for the costs of newborn screenings totaled approximately $10.6 million.

Finding No. 2:        The Department collects a $15 live birth fee from hospitals and birth centers and transfers a portion of the fee to the Agency for Health Care Administration (AHCA) to share in the cost of the State’s Medicaid program.  However, there was no written agreement evidencing this arrangement.

Children’s Medical Services

Finding No. 3:        The CMS Early Steps Program is funded through the Individuals with Disabilities Act (IDEA), Parts B and C.  While authorized to do so, the Department had not established a sliding fee schedule for services provided under IDEA, Part C, for the Program due to the commingling of IDEA, Part B and C, funds.

Finding No. 4:        The Department had not established unique accounting codes in the Florida Accounting and Information Resource Subsystem (FLAIR) to appropriately identify the expenditures of each CMS program.

Finding No. 5:        The CMS Data System was, in some respects, not compliant with the Health Insurance Portability and Accountability Act (HIPAA).

Area Health Education Center Network

Finding No. 6:        The Department had not established effective procedures for monitoring the Area Health Education Center (AHEC) Network.

The Secretary's response is included in its entirety at the end of this report as Appendix A.