FL – Proposed Governor’s Budget for Fiscal Year 2017
February 2017 ~
Florida Governor Rick Scott, on January 31st, announced a near $83.5 billion budget for 2017-18.
The recommended budget would incorporate the following changes:
Proposed Additions to the State Budget
- Medicaid Enrollment
- $626.4 million allocated to fully fund Medicaid price level and estimated enrollment of 4.2 million.
- KidCare Enrollment
- $85.1 million towards fully fund KidCare estimated enrollment of 211,656.
- Low Income Pool
- $607.8 million towards continuation of LIP funding but with new measures for charitable purpose and profitmaking purposes, and new tier thresholds benchmarked to the for-profit sector. The program pays hospitals based on their charity care only, as measured by their Medicare rate. Hospitals are ranked from high to low based on their percentage of charity care to total margin. Hospitals are then divided into four tiers based on the level of charity care to total margin and all hospitals are paid a prescribed percentage of their charity care.
- Disproportionate Share Hospital
- $311.9 million allotted for the Medicaid DSH program. No changes were made to rural DSH, Mental Health DSH, and Tuberculosis DSH programs. A total of $1 million is to be paid to hospitals that meet federal minimum requirements under Section 1923(b) of the Social Security Act. The remaining regular DSH is reserved for hospitals that have Medicaid inpatient utilization rates of more than 18 percent and have residents in the Statewide Medicaid Residency Program. Following are the DSH payments by program: Minimum – $1 million; Regular – $226.0 million; Rural – $10.3 million; Mental Health – $72.2 million; and Tuberculosis – $2.4 million.
- Redistribution of DSH
- $85.2 million reserved to redistribute federal DSH allotments and the associated state share to eligible providers with additional uncompensated care costs identified through an audit for Fiscal Year 2010-2011 and Fiscal Year 2011-2012.
- Florida Medicaid Management Information System (FMMIS)
- $5.8 million allotted for the Medicaid Enterprise Systems procurement project.
- Preadmission Screening and Resident Review (PASRR)
- $750,000 allotted to contract with a vendor to implement and operate the federally required PASRR program.
- Transfer Waivers to SMMC Managed Care
- transfers funds and beneficiaries from the Adult Cystic Fibrosis Waiver ($474,206); Traumatic Brain Injury/Spinal Cord Medicaid Waiver ($1,976,544); and the Project AIDS Care Waiver ($4,346,859) to MMA and LTC managed care programs.
- APD Medicaid Waiver Waiting List
- $7.5 million reserved to enroll onto the Home and Community-Based Services Waiver an additional 682 developmentally disabled individuals from the waiver waitlist.
- APD Medicaid Waiver LPN Rate Increase
- $3.4 million designated to support a rate increase for nursing services provided by licensed practical nurses under the Home and Community-Based Services Waiver to match the current Medicaid State Plan nursing rates.
Proposed State Budget Reductions
- Hospital Rate Reduction
- A $297.7 million reduction by eliminating the add-on payment amounts to individual hospital rates for hospitals whose un-reimbursed Medicaid and charity care in 2015 represented less than 67.06% of its overall profit, before applying a 10% disregard, measured according to the hospital’s level of Medicare payments relative to charges.
- Offset Hospital Rate Inflation
- A $50.5 million reduction that eliminates the automatic 2% annual inflation rate for hospital inpatient and hospital outpatient services.
Source(s): Health News Florida, January 26, 2017; FPI January 2017; FLgov January 2017