Senate Bill 0954

CODING: Words stricken are deletions; words underlined are additions.



    Florida Senate - 2000                                   SB 954

    By Senator Saunders





    25-341B-00

  1                      A bill to be entitled

  2         An act relating to health care; amending s.

  3         395.701, F.S.; providing for an assessment

  4         against hospitals for inpatient services;

  5         amending s. 408.904, F.S.; increasing benefits

  6         for certain persons who receive hospital

  7         outpatient services; amending s. 408.905, F.S.;

  8         increasing benefits furnished by Medicaid

  9         providers to recipients of hospital outpatient

10         services; amending s. 905.908, F.S.; increasing

11         reimbursement to hospitals for outpatient care;

12         repealing s. 395.7015, F.S., relating to

13         assessments against certain health care

14         entities; providing appropriations; providing

15         effective dates.

16

17         WHEREAS, the Legislature finds that the Public Medical

18  Assistance Trust Fund is not uniformly applied to all health

19  care entities, and

20         WHEREAS, the responsibility for indigent care is a

21  broad societal problem, not to be placed just on those who

22  provide or receive health care, and

23         WHEREAS, the economic conditions that exist today for

24  health care entities are different than those conditions

25  existing when the assessment was instituted in 1984, and

26  consequently this assessment places a greater burden on the

27  taxed entities, NOW, THEREFORE,

28

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

30

31

                                  1

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2000                                   SB 954
    25-341B-00




  1         Section 1.  Subsection (2) of section 395.701, Florida

  2  Statutes, is amended to read:

  3         395.701  Annual assessments on net operating revenues

  4  to fund public medical assistance; administrative fines for

  5  failure to pay assessments when due; exemption.--

  6         (2)  There is imposed upon each hospital an assessment

  7  in an amount equal to 1.5 percent of the annual net operating

  8  revenue for inpatient services for each hospital, such revenue

  9  to be determined by the agency, based on the actual experience

10  of the hospital as reported to the agency.  Within 6 months

11  after the end of each hospital fiscal year, the agency shall

12  certify the amount of the assessment for each hospital.  The

13  assessment shall be payable to and collected by the agency in

14  equal quarterly amounts, on or before the first day of each

15  calendar quarter, beginning with the first full calendar

16  quarter that occurs after the agency certifies the amount of

17  the assessment for each hospital. All moneys collected

18  pursuant to this subsection shall be deposited into the Public

19  Medical Assistance Trust Fund.

20         Section 2.  Paragraph (c) of subsection (2) of section

21  408.904, Florida Statutes, is amended to read:

22         408.904  Benefits.--

23         (2)  Covered health services include:

24         (c)  Hospital outpatient services.  Those services

25  provided to a member in the outpatient portion of a hospital

26  licensed under part I of chapter 395, up to a limit of $2,000

27  $1,000 per calendar year per member, that are preventive,

28  diagnostic, therapeutic, or palliative.

29         Section 3.  Subsection (6) of section 409.905, Florida

30  Statutes, is amended to read:

31

                                  2

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2000                                   SB 954
    25-341B-00




  1         409.905  Mandatory Medicaid services.--The agency may

  2  make payments for the following services, which are required

  3  of the state by Title XIX of the Social Security Act,

  4  furnished by Medicaid providers to recipients who are

  5  determined to be eligible on the dates on which the services

  6  were provided.  Any service under this section shall be

  7  provided only when medically necessary and in accordance with

  8  state and federal law. Nothing in this section shall be

  9  construed to prevent or limit the agency from adjusting fees,

10  reimbursement rates, lengths of stay, number of visits, number

11  of services, or any other adjustments necessary to comply with

12  the availability of moneys and any limitations or directions

13  provided for in the General Appropriations Act or chapter 216.

14         (6)  HOSPITAL OUTPATIENT SERVICES.--The agency shall

15  pay for preventive, diagnostic, therapeutic, or palliative

16  care and other services provided to a recipient in the

17  outpatient portion of a hospital licensed under part I of

18  chapter 395, and provided under the direction of a licensed

19  physician or licensed dentist, except that payment for such

20  care and services is limited to $2,000 $1,000 per state fiscal

21  year per recipient, unless an exception has been made by the

22  agency, and with the exception of a Medicaid recipient under

23  age 21, in which case the only limitation is medical

24  necessity.

25         Section 4.  Paragraph (a) of subsection (1) of section

26  409.908, Florida Statutes, is amended to read:

27         409.908  Reimbursement of Medicaid providers.--Subject

28  to specific appropriations, the agency shall reimburse

29  Medicaid providers, in accordance with state and federal law,

30  according to methodologies set forth in the rules of the

31  agency and in policy manuals and handbooks incorporated by

                                  3

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2000                                   SB 954
    25-341B-00




  1  reference therein.  These methodologies may include fee

  2  schedules, reimbursement methods based on cost reporting,

  3  negotiated fees, competitive bidding pursuant to s. 287.057,

  4  and other mechanisms the agency considers efficient and

  5  effective for purchasing services or goods on behalf of

  6  recipients.  Payment for Medicaid compensable services made on

  7  behalf of Medicaid eligible persons is subject to the

  8  availability of moneys and any limitations or directions

  9  provided for in the General Appropriations Act or chapter 216.

10  Further, nothing in this section shall be construed to prevent

11  or limit the agency from adjusting fees, reimbursement rates,

12  lengths of stay, number of visits, or number of services, or

13  making any other adjustments necessary to comply with the

14  availability of moneys and any limitations or directions

15  provided for in the General Appropriations Act, provided the

16  adjustment is consistent with legislative intent.

17         (1)  Reimbursement to hospitals licensed under part I

18  of chapter 395 must be made prospectively or on the basis of

19  negotiation.

20         (a)  Reimbursement for inpatient care is limited as

21  provided for in s. 409.905(5). Reimbursement for hospital

22  outpatient care is limited to $2,000 $1,000 per state fiscal

23  year per recipient, except for:

24         1.  Such care provided to a Medicaid recipient under

25  age 21, in which case the only limitation is medical

26  necessity;

27         2.  Renal dialysis services; and

28         3.  Other exceptions made by the agency.

29         Section 5.  (1)  The sum of        is appropriated from

30  the General Revenue Fund to the Public Medical Assistance

31  Trust Fund to replace the revenues lost due to the repeal of

                                  4

CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2000                                   SB 954
    25-341B-00




  1  section 395.7015, Florida Statutes, and to maintain federal

  2  financial participation.

  3         (2)  The sum of        is appropriated from the General

  4  Revenue Fund to the Public Medical Assistance Trust Fund to

  5  provide for the increased reimbursement to hospitals for

  6  hospital outpatient care.

  7         Section 6.  Section 395.7015, Florida Statutes, is

  8  repealed.

  9         Section 7.  This act shall take effect July 1, 2000,

10  except that the amendment to section 395.701, Florida

11  Statutes, by this act shall take effect only upon the receipt

12  by the Agency for Health Care Administration of written

13  confirmation from the federal Health Care Financing

14  Administration that the changes contained in such amendment

15  will not adversely affect the use of the remaining assessments

16  as state match for the state's Medicaid program.

17

18            *****************************************

19                          SENATE SUMMARY

20    Provides for an assessment of 1.5 percent of the annual
      net operating revenues for inpatient services of
21    hospitals to fund public medical assistance. Increases to
      $2,000 the limit on benefits for hospital outpatient
22    services for persons enrolled in the MedAccess program.
      Increases to $2,000 the benefits furnished by Medicaid
23    providers to recipients of hospital outpatient services.
      Increases to $2,000 the amount of reimbursement to
24    hospitals for outpatient care. Repeals s. 395.7015, F.S.,
      relating to assessments on defined health care entities.
25    Provides appropriations.

26

27

28

29

30

31

                                  5