Florida Senate - 2017                          SENATOR AMENDMENT
       Bill No. SB 2514
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                Floor: 3/AD/2R         .                                
             04/12/2017 06:40 PM       .                                

       Senator Flores moved the following:
    1         Senate Amendment (with title amendment)
    3         Between lines 390 and 391
    4  insert:
    5         Section 7. Paragraph (d) of subsection (2) of section
    6  400.179, Florida Statutes, is amended to read:
    7         400.179 Liability for Medicaid underpayments and
    8  overpayments.—
    9         (2) Because any transfer of a nursing facility may expose
   10  the fact that Medicaid may have underpaid or overpaid the
   11  transferor, and because in most instances, any such underpayment
   12  or overpayment can only be determined following a formal field
   13  audit, the liabilities for any such underpayments or
   14  overpayments shall be as follows:
   15         (d) Where the transfer involves a facility that has been
   16  leased by the transferor:
   17         1. The transferee shall, as a condition to being issued a
   18  license by the agency, acquire, maintain, and provide proof to
   19  the agency of a bond with a term of 30 months, renewable
   20  annually, in an amount not less than the total of 3 months’
   21  Medicaid payments to the facility computed on the basis of the
   22  preceding 12-month average Medicaid payments to the facility.
   23         2. A leasehold licensee may meet the requirements of
   24  subparagraph 1. by payment of a nonrefundable fee, paid at
   25  initial licensure, paid at the time of any subsequent change of
   26  ownership, and paid annually thereafter, in the amount of 1
   27  percent of the total of 3 months’ Medicaid payments to the
   28  facility computed on the basis of the preceding 12-month average
   29  Medicaid payments to the facility. If a preceding 12-month
   30  average is not available, projected Medicaid payments may be
   31  used. The fee shall be deposited into the Grants and Donations
   32  Trust Fund and shall be accounted for separately as a Medicaid
   33  nursing home overpayment account. These fees shall be used at
   34  the sole discretion of the agency to repay nursing home Medicaid
   35  overpayments or for enhanced payments to nursing facilities as
   36  specified in the General Appropriations Act or other law.
   37  Payment of this fee shall not release the licensee from any
   38  liability for any Medicaid overpayments, nor shall payment bar
   39  the agency from seeking to recoup overpayments from the licensee
   40  and any other liable party. As a condition of exercising this
   41  lease bond alternative, licensees paying this fee must maintain
   42  an existing lease bond through the end of the 30-month term
   43  period of that bond. The agency is herein granted specific
   44  authority to promulgate all rules pertaining to the
   45  administration and management of this account, including
   46  withdrawals from the account, subject to federal review and
   47  approval. This provision shall take effect upon becoming law and
   48  shall apply to any leasehold license application. The financial
   49  viability of the Medicaid nursing home overpayment account shall
   50  be determined by the agency through annual review of the account
   51  balance and the amount of total outstanding, unpaid Medicaid
   52  overpayments owing from leasehold licensees to the agency as
   53  determined by final agency audits. By March 31 of each year, the
   54  agency shall assess the cumulative fees collected under this
   55  subparagraph, minus any amounts used to repay nursing home
   56  Medicaid overpayments and amounts transferred to contribute to
   57  the General Revenue Fund pursuant to s. 215.20. If the net
   58  cumulative collections, minus amounts utilized to repay nursing
   59  home Medicaid overpayments, exceed $25 million, the provisions
   60  of this subparagraph shall not apply for the subsequent fiscal
   61  year.
   62         3. The leasehold licensee may meet the bond requirement
   63  through other arrangements acceptable to the agency. The agency
   64  is herein granted specific authority to promulgate rules
   65  pertaining to lease bond arrangements.
   66         4. All existing nursing facility licensees, operating the
   67  facility as a leasehold, shall acquire, maintain, and provide
   68  proof to the agency of the 30-month bond required in
   69  subparagraph 1., above, on and after July 1, 1993, for each
   70  license renewal.
   71         5. It shall be the responsibility of all nursing facility
   72  operators, operating the facility as a leasehold, to renew the
   73  30-month bond and to provide proof of such renewal to the agency
   74  annually.
   75         6. Any failure of the nursing facility operator to acquire,
   76  maintain, renew annually, or provide proof to the agency shall
   77  be grounds for the agency to deny, revoke, and suspend the
   78  facility license to operate such facility and to take any
   79  further action, including, but not limited to, enjoining the
   80  facility, asserting a moratorium pursuant to part II of chapter
   81  408, or applying for a receiver, deemed necessary to ensure
   82  compliance with this section and to safeguard and protect the
   83  health, safety, and welfare of the facility’s residents. A lease
   84  agreement required as a condition of bond financing or
   85  refinancing under s. 154.213 by a health facilities authority or
   86  required under s. 159.30 by a county or municipality is not a
   87  leasehold for purposes of this paragraph and is not subject to
   88  the bond requirement of this paragraph.
   90  ================= T I T L E  A M E N D M E N T ================
   91  And the title is amended as follows:
   92         Delete line 42
   93  and insert:
   94         regardless of the number of licensed beds; amending s.
   95         400.179, F.S.; providing that certain fees deposited
   96         into the Medicaid nursing home overpayment account in
   97         the Grants and Donations Trust Fund may be used by the
   98         agency for enhanced payments to nursing facilities as
   99         specified in the General Appropriations Act or other
  100         law; amending s.