Mayor Sharief on Medicaid overbilling accusations

Broward Mayor Barbara Sharief wrote this response to publicized reports of the state Agency for Health Care Administration fining her business after alleging she overbilled Medicaid:

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SFPH provides private duty nursing services hourly to individuals in the home setting. SFPH cares for patients of all ages and provides them with skilled nursing and therapy services in their home. SFPH has been in business for over 12 years and enjoys an excellent reputation as a provider of the highest quality service to the seriously ill clients who require treatment outside of expensive hospital settings. I am very proud of the quality care we provide to our chronically ill patients.

Many of the services SFPH provides are covered by Medicaid. As you know, Medicaid has very complex, always evolving rules, regulations and handbooks covering the billing protocol. Periodically all healthcare companies, doctors’ offices, hospitals and other providers (even Broward County) are subject to regular routine audits which may result in some overpayment determinations.

Many times these overpayment determinations are for simple reasons such as change in interpretation of rules; the wrong billing codes being used etc. This is the exact same thing that Broward County was fighting with AHCA on the County’s Medicaid cost share retrospective audit, which recently settled. I helped the county fight that bill of 37.2 million and it was settled for 4 million. this resulted in a 1.8% milleage tax savings for Broward County residents.

SFPH recently went thru one of these routine audits which resulted in an alleged overpayment determination based on a re-interpretation of a handbook provision. As provided under applicable rules, SFPH sought administrative review of that determination.  With the assistance of counsel, a decision was made to settle the matter rather than fight and continue to mount legal fees which in the end could equate to as much as the alleged overpayment amount.

After further negotiations which reduced the amount of the alleged overpayment, a Settlement Agreement was reached and a re-payment structure agreed upon.

Paragraphs 10 and 14 of the Settlement Agreement clearly state that this is not an admission of any wrongdoing or error on anyone’s part; that the parties have different interpretations and contentions as to the facts and the law, and that this is a compromise and settlement of the issues.

There is simply no suggestion in the audit or in the Settlement Agreement that there was any wrongdoing, let alone "fraud," by SFPH.

In fact, were there to have been an allegation or determination of intentional wrongdoing, it would have resulted in immediate termination as a Medicaid provider.

Instead, SFPH proudly continues to provide quality homecare services to Florida’s medically needy population and continues to receive Medicaid reimbursement. In addition we provide jobs for over 600 professionals in Broward County and their jobs and family stability is what I value most our reputation in the community reflects that.



Barbara Sharief MSN, ARNP
South Florida Pediatric Homecare 2452 N. University Drive
Pembroke Pines FL 33024

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