Florida Senate - 2021                                     SB 348
       
       
        
       By Senator Rodriguez
       
       
       
       
       
       39-00678-21                                            2021348__
    1                        A bill to be entitled                      
    2         An act relating to Medicaid; amending s. 409.908,
    3         F.S.; revising the types of emergency transportation
    4         vehicle services provided to Medicare-eligible persons
    5         for which Medicaid shall pay deductibles and
    6         coinsurance; providing an effective date.
    7          
    8  Be It Enacted by the Legislature of the State of Florida:
    9  
   10         Section 1. Paragraph (c) of subsection (13) of section
   11  409.908, Florida Statutes, is amended to read:
   12         409.908 Reimbursement of Medicaid providers.—Subject to
   13  specific appropriations, the agency shall reimburse Medicaid
   14  providers, in accordance with state and federal law, according
   15  to methodologies set forth in the rules of the agency and in
   16  policy manuals and handbooks incorporated by reference therein.
   17  These methodologies may include fee schedules, reimbursement
   18  methods based on cost reporting, negotiated fees, competitive
   19  bidding pursuant to s. 287.057, and other mechanisms the agency
   20  considers efficient and effective for purchasing services or
   21  goods on behalf of recipients. If a provider is reimbursed based
   22  on cost reporting and submits a cost report late and that cost
   23  report would have been used to set a lower reimbursement rate
   24  for a rate semester, then the provider’s rate for that semester
   25  shall be retroactively calculated using the new cost report, and
   26  full payment at the recalculated rate shall be effected
   27  retroactively. Medicare-granted extensions for filing cost
   28  reports, if applicable, shall also apply to Medicaid cost
   29  reports. Payment for Medicaid compensable services made on
   30  behalf of Medicaid eligible persons is subject to the
   31  availability of moneys and any limitations or directions
   32  provided for in the General Appropriations Act or chapter 216.
   33  Further, nothing in this section shall be construed to prevent
   34  or limit the agency from adjusting fees, reimbursement rates,
   35  lengths of stay, number of visits, or number of services, or
   36  making any other adjustments necessary to comply with the
   37  availability of moneys and any limitations or directions
   38  provided for in the General Appropriations Act, provided the
   39  adjustment is consistent with legislative intent.
   40         (13) Medicare premiums for persons eligible for both
   41  Medicare and Medicaid coverage shall be paid at the rates
   42  established by Title XVIII of the Social Security Act. For
   43  Medicare services rendered to Medicaid-eligible persons,
   44  Medicaid shall pay Medicare deductibles and coinsurance as
   45  follows:
   46         (c) Notwithstanding paragraphs (a) and (b):
   47         1. Medicaid payments for Nursing Home Medicare part A
   48  coinsurance are limited to the Medicaid nursing home per diem
   49  rate less any amounts paid by Medicare, but only up to the
   50  amount of Medicare coinsurance. The Medicaid per diem rate shall
   51  be the rate in effect for the dates of service of the crossover
   52  claims and may not be subsequently adjusted due to subsequent
   53  per diem rate adjustments.
   54         2. Medicaid shall pay all deductibles and coinsurance for
   55  Medicare-eligible recipients receiving freestanding end stage
   56  renal dialysis center services.
   57         3. Medicaid payments for general and specialty hospital
   58  inpatient services are limited to the Medicare deductible and
   59  coinsurance per spell of illness. Medicaid payments for hospital
   60  Medicare Part A coinsurance shall be limited to the Medicaid
   61  hospital per diem rate less any amounts paid by Medicare, but
   62  only up to the amount of Medicare coinsurance. Medicaid payments
   63  for coinsurance shall be limited to the Medicaid per diem rate
   64  in effect for the dates of service of the crossover claims and
   65  may not be subsequently adjusted due to subsequent per diem
   66  adjustments.
   67         4. Medicaid shall pay all deductibles and coinsurance for
   68  Medicare-eligible recipients receiving Medicare emergency
   69  transportation services provided by ambulances or emergency
   70  medical services vehicles as defined by s. 401.23(5) licensed
   71  pursuant to chapter 401.
   72         5. Medicaid shall pay all deductibles and coinsurance for
   73  portable X-ray Medicare Part B services provided in a nursing
   74  home, in an assisted living facility, or in the patient’s home.
   75         Section 2. This act shall take effect July 1, 2021.