Senate Bill 2284

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    Florida Senate - 2000                                  SB 2284

    By Senator Mitchell





    4-665B-00

  1                      A bill to be entitled

  2         An act relating to financial responsibility for

  3         indigent hospital patients; amending s.

  4         154.306, F.S.; requiring that counties accept

  5         specified documents, forms, and other

  6         information provided by participating hospital

  7         or regional referral hospital; providing for

  8         excluding active-duty military personnel and

  9         certain institutionalized county residents from

10         state population estimates when calculating a

11         county's financial responsibility for

12         hospitals' treatment of the county's indigent

13         residents; providing an effective date.

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15  Be It Enacted by the Legislature of the State of Florida:

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17         Section 1.  Section 154.306, Florida Statutes, is

18  amended to read:

19         154.306  Financial responsibility for certified

20  residents who are qualified indigent patients treated at an

21  out-of-county participating hospital or regional referral

22  hospital.--Ultimate financial responsibility for treatment

23  received at a participating hospital or a regional referral

24  hospital by a qualified indigent patient who is a certified

25  resident of a county in the State of Florida, but is not a

26  resident of the county in which the participating hospital or

27  regional referral hospital is located, is the obligation of

28  the county of which the qualified indigent patient is a

29  resident. Each county shall reimburse participating hospitals

30  or regional referral hospitals as provided for in this part,

31  and shall provide or arrange for indigent eligibility

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    Florida Senate - 2000                                  SB 2284
    4-665B-00




  1  determination procedures and resident certification

  2  determination procedures as provided for in rules developed to

  3  implement this part.  The agency, or any county determining

  4  eligibility of a qualified indigent, shall provide to the

  5  county of residence, upon request, a copy of any documents,

  6  forms, or other information, as determined by rule, which may

  7  be used in making an eligibility determination. Such

  8  documents, forms, or other information, if provided by the

  9  participating hospital or regional referral hospital to the

10  county of residence, shall be accepted by the county of

11  residence as valid and true and not require reverification by

12  the county of residence.

13         (1)  A county's financial obligation for each certified

14  resident who qualifies as an indigent patient under this part,

15  and who has received treatment at an out-of-county hospital,

16  shall not exceed 45 days per county fiscal year at a rate of

17  payment equivalent to 100 percent of the per diem

18  reimbursement rate currently in effect for the out-of-county

19  hospital under the medical assistance program for the needy

20  under Title XIX of the Social Security Act, as amended, except

21  that those counties that are at their 10-mill cap on October

22  1, 1991, shall reimburse hospitals for such services at not

23  less than 80 percent of the hospital Medicaid per diem.

24  However, nothing in this section shall preclude a hospital

25  that has a formal signed agreement with a county to treat such

26  county's indigents from negotiating a higher or lower per diem

27  rate with the county.  No county shall be required to pay more

28  than the equivalent of $4 per capita in the county's fiscal

29  year.  The agency shall calculate and certify to each county

30  by March 1 of each year, the maximum amount the county may be

31  required to pay by multiplying the most recent official state

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    Florida Senate - 2000                                  SB 2284
    4-665B-00




  1  population estimate for the total population of the county by

  2  $4 per capita. For the purpose of computing the maximum amount

  3  that the county may be required to pay, the agency must reduce

  4  the official state population estimates by the number of

  5  inmates and patients residing in the county in institutions

  6  operated by the Federal Government, the Department of

  7  Corrections, the Department of Health, or the Department of

  8  Children and Family Services, and by the number of active-duty

  9  military personnel residing in the county, all of whom shall

10  not be considered to be residents of the county. Each county

11  shall certify to the agency within 60 days after the end of

12  the county's fiscal year, or upon reaching the $4 per capita

13  threshold, should that occur before the end of the fiscal

14  year, the amount of reimbursement it paid to all out-of-county

15  hospitals under this part.  The maximum amount a county may be

16  required to pay to out-of-county hospitals for care provided

17  to qualified indigent residents may be reduced by up to

18  one-half, provided that the amount not paid has or is being

19  spent for in-county hospital care provided to qualified

20  indigent residents.

21         (2)  No county shall be required to pay for any

22  elective or nonemergency admissions or services at an

23  out-of-county hospital for a qualified indigent who is a

24  certified resident of the county if the county provides

25  funding for such services and the services are available at a

26  local hospital in the county where the indigent resides; or

27  the out-of-county hospital has not obtained prior written

28  authorization and approval for such hospital admission or

29  service, provided that the resident county has established a

30  procedure to authorize and approve such admissions.

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    Florida Senate - 2000                                  SB 2284
    4-665B-00




  1         (3)  The county where the indigent resides shall, in

  2  all instances, be liable for the cost of treatment provided to

  3  a qualified indigent patient at an out-of-county hospital for

  4  any emergency medical condition which will deteriorate from

  5  failure to provide such treatment if such condition is

  6  determined and documented by the attending physician to be of

  7  an emergency nature; provided that the patient has been

  8  certified to be a resident of such county pursuant to s.

  9  154.309.

10         (4)  No county shall be liable for payment for

11  treatment of a qualified indigent who is a certified resident

12  and has received services at an out-of-county participating

13  hospital or regional referral hospital, until such time as

14  that hospital has documented to the agency and the agency has

15  determined that it has met its charity care obligation based

16  on the most recent audited actual experience.

17         Section 2.  This act shall take effect July 1, 2000.

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20                          SENATE SUMMARY

21    Provides that, in using the formula set forth in s.
      154.306, F.S., to calculate a county's responsibility to
22    pay for hospital treatment of indigent residents of that
      county, the Agency for Health Care Administration must
23    subtract from the official state population estimate the
      number of active-duty military personnel residing in the
24    county and the number of inmates and patients who are
      residing in specified institutions in that county.
25    Requires counties to accept certain information provided
      by hospitals.
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