995147
GENERAL APPROPRIATIONS BILL Committee Amendment
SB2500 HHS 36
Senator(s): Silver
moved the following amendment:
Section: 03 EXPLANATION:
On Page: 052 This amendment provides Special Medicaid Payments for
the implementation of a revised Upper Payment Limit
Spec App: 222 proposal which incorporates a 17.5% rate of return,
modifications of reimbursements for trauma centers,
rural hospitals, Graduate Medical Education, Primary
Care and the hold harmless reimbursements. The Regular
Disproportionate Share Program has been revised to be a
public hospital Disproportionate Share Program only.
These changes are necessitated because of federal
regulations which reduced UPL limits from 150% to 100%
for public hospitals.
NET IMPACT ON: Total Funds General Revenue Trust Funds
Recurring - 38,422,195 6,400,000 32,022,195
Non-Recurring - 0 0 0
_________________________________________________________________________________
Positions & Amount Positions & Amount
DELETE INSERT
AGENCY FOR HEALTH CARE ADMINISTRATION
Program: Health Care Services
Medicaid Services To Individuals 68501400
In Section 03 On Page 052
222 Special Categories 101582
Hospital Inpatient Services IOEE
1000 From General Revenue Fund 169,607,035 176,007,035
CA 6,400,000 FSI2 6,400,000
2339 From Grants And Donations Trust 205,254,157 214,749,419
Fund
CA 9,495,262 FSI2 9,495,262
2474 From Medical Care Trust Fund 1,083,309,577 1,105,836,510
CA 22,526,933 FSI3 22,526,933
DELETE the second through the eight paragraphs of proviso language
following Specific Appropriation 222,
995147 Log:0156 EDP/LFB 03/13/02 09:21:39 PM Senate Page: 1
and INSERT the following:
From the funds in Specific Appropriation 222, $14,400,741 from the
Grants and Donations Trust Fund and $20,408,881 from the Medical Care
Trust Fund are provided for special Medicaid payments to statutory
teaching hospitals, hospitals providing primary care to low-income
individuals, hospitals which operate designated or provisional trauma
centers, and rural hospitals. Statutory teaching hospitals that qualify
for the Graduate Medical Education disproportionate share (DSH) hospital
program shall be paid $10,183,190 distributed in the same proportion as
Graduate Medical Education DSH payments. Hospitals providing primary
care to low-income individuals and participating in the Primary Care DSH
program shall be paid $10,183,190 distributed in the same proportion as
the Primary Care DSH payments. Hospitals, which are designated as
provisional trauma centers, shall be paid $8,976,621. Of this amount,
$3,497,000 shall be distributed equally between hospitals which are a
Level I trauma center; $3,789,000 shall be distributed equally between
hospitals which are either a Level II or Pediatric trauma center; and
$1,690,621 shall be distributed equally between hospitals which are both
a Level II and Pediatric trauma center. Rural hospitals participating in
the Rural Hospital DSH program shall be paid $5,466,621 distributed in
the same proportion as the DSH payments.
From the funds in Specific Appropriation 222, $3,744,991 from the
Grants and Donations Trust Fund and $5,307,443 from the Medical Care
Trust Fund are provided to eliminate the inpatient reimbursement
ceilings for hospitals whose charity care and Medicaid days, as a
percentage of total hospital days, equals or exceeds 15 percent.
Hospitals that exceed 15 percent and are a trauma center shall be paid
$2,000,000 if their variable cost rate is less than their variable cost
target or county ceiling target. The agency shall use the 1997 audited
DSH data available as of March 1, 2001.
From the funds in Specific Appropriation 222, $2,199,090 from the
Grants and Donations Trust Fund and $3,116,575 from the Medical Care
Trust Fund are provided to eliminate the inpatient reimbursement
ceilings for hospitals whose Medicaid days, as a percentage of total
hospital days, exceeds 9.6 percent and are a trauma center. The Agency
shall use the 1997 audited DSH data available as of March 1, 2001.
From the funds in Specific Appropriations 222, $9,400,000 from the
General Revenue Fund, $26,771,369 from the Grants and Donations
Trust Fund, and $51,262,446 from the Medical Care Trust Fund are
provided to make special Medicaid payments to hospitals which serve as
a safety net in providing emergency and inpatient care to low-income
and indigent individuals. These amounts shall be paid to the following:
University Medical Center - Shands $53,529,603
All Children's Hospital 6,604,745
St. Mary's Hospital 51,222
995147 Log:0156 EDP/LFB 03/13/02 09:21:39 PM Senate Page: 2
Miami Chldren's Hospital 5,750,230
Tampa General Hospital 10,711,480
Glades General Hospital 4,111
Orlando Regional Medical Center 3,641,219
Tallahassee Memorial Healthcare 54,402
St. Joseph's Hospital 52,835
Florida Hospital 55,072
Wellington Regional Medical Center 1,910
Bethesda Memorial Hospital 23,395
Mt. Sinai Medical Center 6,884,094
Boca Raton Community Hospital 1,711
Columbia JFK Medical Center 20,170
Good Samaritan Hospital 16,259
Palm Beach Garden Medical Center 3,515
Delray Medical Center 19,712
West Boca Medical Center 1,300
Palms West Hospital 3,820
Jupiter Medical Center 3,010
Of the amount provided to University Medical Center - Shands,
$12,086,053 is contingent upon University Medical Center - Shands
submitting a financially balanced break-even operating budget for
University Medical Center - Shands. These funds are also contingent
upon additional financial commitments from the City of Jacksonville and
the parent corporation of University Medical Center - Shands. Prior to
the release of these funds the break-even operating budgets and
statements of additional financial commitments must be submitted to the
Legislative Budget Commission for review and approval. In the event
that University Medical Center - Shands is unable to match with federal
funds all or some portion of the state funds provided, the unmatched
state revenue may be provided directly to University Medical Center -
Shands upon approval of the Legislative Budget Commission.
From the funds in Specific Appropriation 222, $90,192,230 from the
Grants and Donation Trust Fund, and $127,821,379 from the Medical Care
Trust Fund are provided for special Medicaid payments to hospitals
providing enhanced services to low-income individuals.
From the funds in Specific Appropriation 222, $6,157,515 from the
Grants and Donations Trust Fund and $8,726,496 from the Medical Care
Trust Fund are provided to make special Medicaid payments to the
statutory teaching hospitals. These payments shall be used by the
teaching hospitals in collaboration with the Department of Health and
the Area Health Education Centers to enhance medical education programs.
From the funds in Specific Appropriation 222, $39,969,638 from the
Grants and Donations Trust Fund and $56,645,393 from the Medical Care
Trust Fund are provided to eliminate the inpatient reimbursement
ceilings for teaching, specialty and Community Hospital Education
Program hospitals.
995147 Log:0156 EDP/LFB 03/13/02 09:21:39 PM Senate Page: 3
In Section 03 On Page 054
225 Special Categories 101596
Hospital Outpatient Services IOEE
DELETE the first three paragraphs of proviso language immediately
following Specific Appropriation 225.
and INSERT the following proviso in its place.
From the funds in Specific Appropriation 225, $18,216,011 from the
Grants and Donations Trust Fund and $25,815,924 from the Medical Care
Trust Fund are provided to increase the hospital outpatient cap for
adults from $1,000 to $1,500 per year and to eliminate the outpatient
reimbursement ceilings for teaching, specialty and Community Health
Education Program hospitals.
From the funds in Specific Appropriation 225, $833,061 from the
Grants and Donations Trust Fund and $1,180,625 from the Medical Care
Trust Fund are provided to eliminate the outpatient reimbursement
ceilings for hospitals whose charity care and Medicaid days, as a
percentage of total hospital days, equals or exceeds 15 percent. The
Agency shall use the 1997 audited DSH data available as of March 1,
2001.
From the funds in Specific Appropriation 225, $148,702 from the
Grants and Donations Trust Fund and $210,741 from the Medical Care Trust
Fund are provided to eliminate the outpatient reimbursement ceilings for
hospitals whose Medicaid days, as a percentage of total hospital days,
exceeds 9.6 percent, and are a trauma center. The agency shall use the
1997 audited DSH data available as of March 1, 2001.
Line item amendments are accepted as part of the amendatory process. However, due to the necessity of using computerized systems this may entail a different placement
within a budget entity or the renumbering of the specific appropriation items. |
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