Senate Bill sb0696c1
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Florida Senate - 2003 CS for SB 696
By the Committee on Health, Aging, and Long-Term Care; and
Senator Saunders
317-1908-03
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 CS for SB 696
317-1908-03
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 CS for SB 696
317-1908-03
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, approved 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 484-487. For purposes of this section, the term,
17 "underinsured" means insurance coverage for a person who is an
18 inpatient which is inadequate to cover the cost of that
19 patient's care.
20 (2) Payment levels may not exceed the statewide
21 average cost per trauma patient in each level of designated
22 trauma center. Initial payment rates, subject to annual
23 updates by the Agency for Health Care Administration are:
24 (a) Level I: $14,000 per trauma patient;
25 (b) Level II: $9,000 per trauma patient; and
26 (c) Pediatric: $6,000 per trauma patient.
27 (3) Counties shall be designated as responsible for
28 payment if:
29 (a) The county of residence has unspent funds received
30 under this part at the end of the fiscal year in which the
31 hospitalization occurs.
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Florida Senate - 2003 CS for SB 696
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1 (b) The responsible county is currently contributing
2 to the financial support of a regional trauma system through
3 direct funding of trauma care, tax district support for
4 hospitals in the county designated as trauma centers, or under
5 the terms of an intergovernmental agreement with other
6 counties in the trauma region or a written agreement with the
7 nearest trauma center.
8 (c) The responsible county is exempt based on the
9 following criteria:
10 1. The county population in the most recent United
11 States Census totals fewer than 30,000 residents and the
12 proportion of county residents with incomes below the poverty
13 level exceeds 20 percent; or
14 2. The property tax rate, including special districts
15 and municipal service taxes, of the county equals or exceeds
16 10 mills.
17 (d) Residence in the county at the time of the
18 hospitalization is verified by:
19 1. Current active driver's license;
20 2. Mortgage, lease, or rental receipt or letter from a
21 landlord;
22 3. Water, electric, or other public utility bill in
23 the name of the patient or a family member at a residential
24 address within the county;
25 4. A state, county, or federal document mailed to the
26 patient at a residential address within the county;
27 5. Vehicle registration in the name of the patient or
28 a family member at a residential address within the county;
29 6. Voter registration; or
30 7. Proof of children enrolled in public schools within
31 the county.
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Florida Senate - 2003 CS for SB 696
317-1908-03
1 Section 3. This act shall take effect July 1, 2003.
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3 STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
COMMITTEE SUBSTITUTE FOR
4 Senate Bill 696
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6 The Committee Substitute provides a definition for the term
"underinsured" for the purpose of extending financial
7 responsibility on counties to fund trauma care. An exemption
from the trauma care funding requirement is provided for
8 certain rural counties or counties in which the property tax
rate equals or exceeds 10 mils.
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