Florida Senate - 2017 SENATOR AMENDMENT Bill No. SB 2514 Ì7963060Î796306 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) 2 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. 89 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.