Florida Senate - 2016                                    SB 1370
       
       
        
       By Senator Grimsley
       
       21-00633-16                                           20161370__
    1                        A bill to be entitled                      
    2         An act relating to Medicaid provider overpayments;
    3         amending s. 409.908, F.S.; authorizing the Agency for
    4         Health Care Administration to certify that a Medicaid
    5         provider is out of business and that overpayments made
    6         to a provider cannot be collected under state law;
    7         reenacting s. 409.8132(4), F.S., to incorporate the
    8         amendment made to s. 409.908, F.S., in a reference
    9         thereto; providing an effective date.
   10          
   11  Be It Enacted by the Legislature of the State of Florida:
   12  
   13         Section 1. Subsection (25) is added to section 409.908,
   14  Florida Statutes, to read:
   15         409.908 Reimbursement of Medicaid providers.—Subject to
   16  specific appropriations, the agency shall reimburse Medicaid
   17  providers, in accordance with state and federal law, according
   18  to methodologies set forth in the rules of the agency and in
   19  policy manuals and handbooks incorporated by reference therein.
   20  These methodologies may include fee schedules, reimbursement
   21  methods based on cost reporting, negotiated fees, competitive
   22  bidding pursuant to s. 287.057, and other mechanisms the agency
   23  considers efficient and effective for purchasing services or
   24  goods on behalf of recipients. If a provider is reimbursed based
   25  on cost reporting and submits a cost report late and that cost
   26  report would have been used to set a lower reimbursement rate
   27  for a rate semester, then the provider’s rate for that semester
   28  shall be retroactively calculated using the new cost report, and
   29  full payment at the recalculated rate shall be effected
   30  retroactively. Medicare-granted extensions for filing cost
   31  reports, if applicable, shall also apply to Medicaid cost
   32  reports. Payment for Medicaid compensable services made on
   33  behalf of Medicaid eligible persons is subject to the
   34  availability of moneys and any limitations or directions
   35  provided for in the General Appropriations Act or chapter 216.
   36  Further, nothing in this section shall be construed to prevent
   37  or limit the agency from adjusting fees, reimbursement rates,
   38  lengths of stay, number of visits, or number of services, or
   39  making any other adjustments necessary to comply with the
   40  availability of moneys and any limitations or directions
   41  provided for in the General Appropriations Act, provided the
   42  adjustment is consistent with legislative intent.
   43         (25) In accordance with 42 C.F.R. s. 433.318(d), the agency
   44  may certify that a Medicaid provider is out of business and that
   45  any overpayments made to the provider cannot be collected under
   46  state law and procedures.
   47         Section 2. Subsection (4) of s. 409.8132, Florida Statutes,
   48  is reenacted for the purpose of incorporating the amendment made
   49  by this act to s. 409.908, Florida Statutes, in a reference
   50  thereto.
   51         Section 3. This act shall take effect July 1, 2016.