ALERT!! Possible cost shifts in Medicaid inpatient servic...

ALERT!! Possible cost shifts in Medicaid inpatient services

FAC learned late Thursday that the Revenue Estimating Conference would review the financial impact of a proposed change to county Medicaid contributions for inpatient hospital services.

While this proposal is not currently part of a proposed bill, the mere fact that the REC is considering it is concerning. The proposed changes would result in significant cost increases for counties.

FAC encourages counties to start looking at those numbers outlined below so that FAC can move quickly should this become a budget conforming bill. When building the numbers, please remember that it’s NOT only an increase in the number of inpatient days. Under the provisions of this proposal, each county will have to pay the total they are billed by AHCA. Have your staff compare what your county has been billed in the last three years with what your county ultimately paid to the state.  Please send all data to FAC’s Health & Human Services Advocate Heather Wildermuth.

FAC will carefully track the outcome of the REC and will update members next week during our legislative day activities.

Below is a detailed outline of the changes under consideration:

Changes to Section 409.915, F.S. include

• An increases in the number of inpatient hospital days from 11 - 45 to 8 - 45 (3 additional days)
• Elimination of the requirement that the Agency for Health Care Administration work in consultation with the counties to determine residency. From our interpretation, it looks like counties will no longer be able to deny individual billings.
• The language stipulates that each county's eligible recipients will be determined solely by recipient address information contained in the Medicaid eligibility system within the Department of Children and Families, except in those cases when the system does not contain a recipient's address, the recipient shall be considered an eligible recipient of the county in which the costs were incurred.
• Recapture language that is completely new and works to collect all outstanding Medicaid billings that have been denied or r-ebilled.
• Requiring that counties pay for services provided outside the state of Florida for their eligible recipients (North Florida Counties were specifically mentioned)

 For more information or questions please contact FAC’s Health and Human Services Advocate, Heather Wildermuth.