Florida SB 2506: Health Care

Bill Text

2506 
Health Care 
2018-01-26T10:43:55Z 
Revising parameters relating to the prospective payment methodology for the reimbursement of Medicaid providers to be implemented for rate setting purposes; requiring the Agency for Health Care Administration to establish prospective payment reimbursement rates for nursing home services as provided in this act and in the General Appropriations Act; authorizing the agency to seek certain remedies from any nursing home facility provider that fails to report its total number of resident days monthly, including the imposition of a specified fine, etc. 
Proposed Bill 
2018 
S 
GB 
General Bill 
pb 

 Florida Senate - 2018 (PROPOSED BILL) SPB 2506 

 FOR CONSIDERATION By the Committee on Appropriations 

 576-01868E-18 20182506pb 
 1 A bill to be entitled 
 2 An act relating to health care; amending s. 409.908, 
 3 F.S.; revising parameters relating to the prospective 
 4 payment methodology for the reimbursement of Medicaid 
 5 providers to be implemented for rate setting purposes; 
 6 requiring the Agency for Health Care Administration to 
 7 establish prospective payment reimbursement rates for 
 8 nursing home services as provided in this act and in 
 9 the General Appropriations Act; conforming provisions 
 10 to changes made by the act; amending s. 409.9082, 
 11 F.S.; authorizing the agency to seek certain remedies 
 12 from any nursing home facility provider that fails to 
 13 report its total number of resident days monthly, 
 14 including the imposition of a specified fine; amending 
 15 s. 409.9083, F.S.; authorizing the agency to seek 
 16 certain remedies from any intermediate care facility 
 17 for the developmentally disabled provider that fails 
 18 to report its total number of resident days monthly, 
 19 including the imposition of a specified fine; 
 20 requiring the agency to seek authorization from the 
 21 federal Centers for Medicare and Medicaid Services to 
 22 modify the period of retroactive Medicaid eligibility 
 23 in a manner that ensures that the modification becomes 
 24 effective by a certain date; requiring the agency to 
 25 contract with a nonprofit organization in Miami-Dade 
 26 County, which must meet certain requirements, to be a 
 27 site for the Program for All-inclusive Care for the 
 28 Elderly (PACE), subject to federal approval of the 
 29 application site; requiring the nonprofit organization 
 30 to provide PACE services to frail elders in Miami-Dade 
 31 County; requiring the agency, in consultation with the 
 32 Department of Elderly Affairs, to approve up to a 
 33 certain number of initial enrollees in PACE at the new 
 34 site, subject to an appropriation; providing effective 
 35 dates. 
 36 
 37 Be It Enacted by the Legislature of the State of Florida: 
 38 
 39 Section 1. Effective October 1, 2018, subsection (2) of 
 40 section 409.908, Florida Statutes, as amended by section 8 of 
 41 chapter 2017-129, Laws of Florida, is amended to read: 
 42 Section 8. Effective October 1, 2018, subsection (2) of 
 43 section 409.908, Florida Statutes, is amended to read: 
 44 409.908 Reimbursement of Medicaid providers.—Subject to 
 45 specific appropriations, the agency shall reimburse Medicaid 
 46 providers, in accordance with state and federal law, according 
 47 to methodologies set forth in the rules of the agency and in 
 48 policy manuals and handbooks incorporated by reference therein. 
 49 These methodologies may include fee schedules, reimbursement 
 50 methods based on cost reporting, negotiated fees, competitive 
 51 bidding pursuant to s. 287.057, and other mechanisms the agency 
 52 considers efficient and effective for purchasing services or 
 53 goods on behalf of recipients. If a provider is reimbursed based 
 54 on cost reporting and submits a cost report late and that cost 
 55 report would have been used to set a lower reimbursement rate 
 56 for a rate semester, then the provider’s rate for that semester 
 57 shall be retroactively calculated using the new cost report, and 
 58 full payment at the recalculated rate shall be effected 
 59 retroactively. Medicare-granted extensions for filing cost 
 60 reports, if applicable, shall also apply to Medicaid cost 
 61 reports. Payment for Medicaid compensable services made on 
 62 behalf of Medicaid eligible persons is subject to the 
 63 availability of moneys and any limitations or directions 
 64 provided for in the General Appropriations Act or chapter 216. 
 65 Further, nothing in this section shall be construed to prevent 
 66 or limit the agency from adjusting fees, reimbursement rates, 
 67 lengths of stay, number of visits, or number of services, or 
 68 making any other adjustments necessary to comply with the 
 69 availability of moneys and any limitations or directions 
 70 provided for in the General Appropriations Act, provided the 
 71 adjustment is consistent with legislative intent. 
 72 (2)(a)1. Reimbursement to nursing homes licensed under part