Senate Bill sb0696
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Florida Senate - 2003 SB 696
By Senator Saunders
37-425-03
1 A bill to be entitled
2 An act relating to indigent health care;
3 amending s. 154.306, F.S.; increasing the cap
4 on the financial responsibility limits of
5 counties for the cost of indigent county
6 residents who receive treatment at
7 participating hospitals in other counties;
8 creating s. 154.317, F.S.; establishing
9 reimbursement procedures and guidelines for the
10 reimbursement of trauma centers by counties;
11 providing an effective date.
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13 Be It Enacted by the Legislature of the State of Florida:
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15 Section 1. Subsection (1) of section 154.306, Florida
16 Statutes, is amended to read:
17 154.306 Financial responsibility for certified
18 residents who are qualified indigent patients treated at an
19 out-of-county participating hospital or regional referral
20 hospital.--Ultimate financial responsibility for treatment
21 received at a participating hospital or a regional referral
22 hospital by a qualified indigent patient who is a certified
23 resident of a county in the State of Florida, but is not a
24 resident of the county in which the participating hospital or
25 regional referral hospital is located, is the obligation of
26 the county of which the qualified indigent patient is a
27 resident. Each county shall reimburse participating hospitals
28 or regional referral hospitals as provided for in this part,
29 and shall provide or arrange for indigent eligibility
30 determination procedures and resident certification
31 determination procedures as provided for in rules developed to
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Florida Senate - 2003 SB 696
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1 implement this part. The agency, or any county determining
2 eligibility of a qualified indigent, shall provide to the
3 county of residence, upon request, a copy of any documents,
4 forms, or other information, as determined by rule, which may
5 be used in making an eligibility determination.
6 (1) A county's financial obligation for each certified
7 resident who qualifies as an indigent patient under this part,
8 and who has received treatment at an out-of-county hospital,
9 shall not exceed 45 days per county fiscal year at a rate of
10 payment equivalent to 100 percent of the per diem
11 reimbursement rate currently in effect for the out-of-county
12 hospital under the medical assistance program for the needy
13 under Title XIX of the Social Security Act, as amended, except
14 that those counties that are at their 10-mill cap on October
15 1, 1991, shall reimburse hospitals for such services at not
16 less than 80 percent of the hospital Medicaid per diem.
17 However, nothing in this section does not shall preclude a
18 hospital that has a formal signed agreement with a county to
19 treat such county's indigents from negotiating a higher or
20 lower per diem rate with the county. A No county may not
21 shall be required to pay more than the equivalent of $6 $4 per
22 capita in the county's fiscal year. The agency shall
23 calculate and certify to each county by March 1 of each year,
24 the maximum amount the county may be required to pay by
25 multiplying the most recent official state population estimate
26 for the total population of the county by $6 $4 per capita.
27 Each county shall certify to the agency within 60 days after
28 the end of the county's fiscal year, or upon reaching the $6
29 $4 per capita threshold, should that occur before the end of
30 the fiscal year, the amount of reimbursement it paid to all
31 out-of-county hospitals under this part. The maximum amount a
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Florida Senate - 2003 SB 696
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1 county may be required to pay to out-of-county hospitals for
2 care provided to qualified indigent residents may be reduced
3 by up to one-half if, provided that the amount not paid has or
4 is being spent for in-county hospital care provided to
5 qualified indigent residents.
6 Section 2. Section 154.317, Florida Statutes, is
7 created to read:
8 154.317 County financial responsibility for trauma
9 care.--
10 (1) Notwithstanding ss. 154.301-154.316, each county
11 shall participate in supporting a regionalized system of
12 trauma care which provides reimbursement to hospitals that are
13 trauma centers, designated in accordance with s. 395.4025.
14 Financial responsibility shall be limited to uninsured or
15 underinsured inpatients with primary or secondary diagnoses of
16 DRG 483-487.
17 (2) Payment levels may not exceed the statewide
18 average cost per trauma patient in each level of designated
19 trauma center. Initial payment rates, subject to annual
20 updates by the Agency for Healthcare Administration are:
21 (a) Level I: $14,000 per trauma patient;
22 (b) Level II: $9,000 per trauma patient; and
23 (c) Pediatric: $6,000 per trauma patient.
24 (3) Counties shall be designated as responsible for
25 payment if:
26 (a) The county of residence has unspent funds received
27 under this part at the end of the fiscal year in which the
28 hospitalization occurs.
29 (b) The responsible county is not currently
30 contributing to the financial support of a regional trauma
31 system through direct funding of trauma care, tax district
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1 support for hospitals in the county designated as trauma
2 centers, or under the terms of an intergovernmental agreement
3 with other counties in the trauma region or a written
4 agreement with the nearest trauma center.
5 (c) The responsible county is not exempt based on the
6 following criteria:
7 1. The county population in the most recent United
8 States Census totals fewer than 30,000 residents and the
9 proportion of county residents with incomes below the poverty
10 level exceeds 20 percent; or
11 2. The property tax rate, including special districts
12 and municipal service taxes, of the county equals or exceeds
13 10 mills.
14 (d) Residence in the county at the time of the
15 hospitalization is verified by:
16 1. Current active driver's license;
17 2. Mortgage, lease, or rental receipt or letter from a
18 landlord;
19 3. Water, electric, or other public utility bill in
20 the name of the patient or a family member at a residential
21 address within the county;
22 4. A state, county, or federal document mailed to the
23 patient at a residential address within the county;
24 5. Vehicle registration in the name of the patient or
25 a family member at a residential address within the county;
26 6. Voter registration; or
27 7. Proof of children enrolled in public schools within
28 the county.
29 Section 3. This act shall take effect July 1, 2003.
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2 SENATE SUMMARY
3 Increases a cap on the reimbursement responsibility of
counties for indigent patients who are treated in certain
4 hospitals outside of the indigent patient's county of
residence. Establishes guidelines and procedures for
5 counties to reimburse certain trauma centers for patient
treatment.
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