Florida Senate - 2012                                    SB 1646
       
       
       
       By Senator Flores
       
       
       
       
       38-00911B-12                                          20121646__
    1  
    2                        A bill to be entitled                      
    3         An act relating to Medicaid hospital rates; amending
    4         s. 409.905, F.S.; revising the date for adjusting
    5         hospital inpatient rates; providing an effective date.
    6  
    7  Be It Enacted by the Legislature of the State of Florida:
    8  
    9         Section 1. Paragraph (c) of subsection (5) of section
   10  409.905, Florida Statutes, is amended to read:
   11         409.905 Mandatory Medicaid services.—The agency may make
   12  payments for the following services, which are required of the
   13  state by Title XIX of the Social Security Act, furnished by
   14  Medicaid providers to recipients who are determined to be
   15  eligible on the dates on which the services were provided. Any
   16  service under this section shall be provided only when medically
   17  necessary and in accordance with state and federal law.
   18  Mandatory services rendered by providers in mobile units to
   19  Medicaid recipients may be restricted by the agency. Nothing in
   20  this section shall be construed to prevent or limit the agency
   21  from adjusting fees, reimbursement rates, lengths of stay,
   22  number of visits, number of services, or any other adjustments
   23  necessary to comply with the availability of moneys and any
   24  limitations or directions provided for in the General
   25  Appropriations Act or chapter 216.
   26         (5) HOSPITAL INPATIENT SERVICES.—The agency shall pay for
   27  all covered services provided for the medical care and treatment
   28  of a recipient who is admitted as an inpatient by a licensed
   29  physician or dentist to a hospital licensed under part I of
   30  chapter 395. However, the agency shall limit the payment for
   31  inpatient hospital services for a Medicaid recipient 21 years of
   32  age or older to 45 days or the number of days necessary to
   33  comply with the General Appropriations Act.
   34         (c) The agency shall implement a methodology for
   35  establishing base reimbursement rates for each hospital based on
   36  allowable costs, as defined by the agency. Rates shall be
   37  calculated annually and take effect July 1 of each year based on
   38  the most recent complete and accurate cost report submitted by
   39  each hospital. Adjustments may not be made to the rates after
   40  October 31 September 30 of the state fiscal year in which the
   41  rates take rate takes effect. Errors in cost reporting or
   42  calculation of rates discovered after October 31 September 30
   43  must be reconciled in a subsequent rate period. The agency may
   44  not make any adjustment to a hospital’s reimbursement rate more
   45  than 5 years after a hospital is notified of an audited rate
   46  established by the agency. The requirement that the agency may
   47  not make any adjustment to a hospital’s reimbursement rate more
   48  than 5 years after a hospital is notified of an audited rate
   49  established by the agency is remedial and applies shall apply to
   50  actions by providers involving Medicaid claims for hospital
   51  services. Hospital rates are shall be subject to such limits or
   52  ceilings as may be established in law or described in the
   53  agency’s hospital reimbursement plan. Specific exemptions to the
   54  limits or ceilings may be provided in the General Appropriations
   55  Act.
   56         Section 2. This act shall take effect July 1, 2012.