Bill Amendment: FL S1884 | 2013 | Regular Session
NOTE: For additional amemendments please see the Bill Drafting List
Bill Title: County Medicaid Contributions
Status: 2013-05-03 - Died in Messages, companion bill(s) passed, see SB 1520 (Ch. 2013-48) [S1884 Detail]
Download: Florida-2013-S1884-Senate_Floor_Amendment_148516.html
Bill Title: County Medicaid Contributions
Status: 2013-05-03 - Died in Messages, companion bill(s) passed, see SB 1520 (Ch. 2013-48) [S1884 Detail]
Download: Florida-2013-S1884-Senate_Floor_Amendment_148516.html
Florida Senate - 2013 SENATOR AMENDMENT Bill No. CS for SB 1884 Barcode 148516 LEGISLATIVE ACTION Senate . House . . . Floor: 1/AD/2R . 04/29/2013 02:26 PM . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— Senator Grimsley moved the following: 1 Senate Amendment (with title amendment) 2 3 Delete lines 34 - 366 4 and insert: 5 (2)(a) For the 2013-2014 state fiscal year through the 6 2019-2020 state fiscal year, the total amount of the counties’ 7 annual contribution is $269.6 million. For each fiscal year 8 thereafter, the annual amount shall be adjusted by the 9 percentage change in the state Medicaid expenditures as 10 determined by the Social Services Estimating Conference. 11 (b) By March 15, 2020, and each year thereafter, the Social 12 Services Estimating Conference shall determine the percentage 13 change in state Medicaid expenditures by comparing expenditures 14 for the 2 most recent completed state fiscal years. 15 (3)(a)1. The amount of each county’s annual contribution is 16 equal to the product of the amount determined under subsection 17 (2) multiplied by the sum of the percentages calculated in sub 18 subparagraphs a. and b.: 19 a. The enrollment weight provided in subparagraph 2. is 20 multiplied by a fraction, the numerator of which is the number 21 of the county’s Medicaid enrollees as of March 1 of each year, 22 and the denominator of which is the number of all counties’ 23 Medicaid enrollees as of March 1 of each year. The agency shall 24 calculate this amount for each county and provide the 25 information to the Department of Revenue by May 15 of each year. 26 b. The payment weight provided in subparagraph 2. is 27 multiplied by the percentage share of payments provided in 28 subparagraph 3. for each county. 29 2. The weights for each fiscal year are equal to: 30 31 WEIGHTS 32 33 34 FISCAL YEAR ENROLLMENT PAYMENT 35 36 37 38 39 40 41 42 43 3. The percentage share of payments for each county is: 44 45 46 COUNTY SHARE OF PAYMENTS 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 (b)1. The Legislature intends to replace the county 117 percentage share provided in subparagraph (a)3. with percentage 118 shares based upon each county’s proportion of the total 119 statewide amount of county billings made under this section from 120 April 1, 2012, through March 31, 2013, for which the state 121 ultimately receives payment. 122 2. By February 1 of each year and continuing until a 123 certification is made under sub-subparagraph b., the agency 124 shall report to the President of the Senate and the Speaker of 125 the House of Representatives the status of the county billings 126 made under this section from April 1, 2012, through March 31, 127 2013, by county, including: 128 a. The amounts billed to each county which remain unpaid, 129 if any; and 130 b. A certification from the agency of a final accounting of 131 the amount of funds received by the state from such billings, by 132 county, upon the expiration of all appeal rights that counties 133 may have to contest such billings. 134 3. By March 15 of the state fiscal year in which the state 135 receives the certification provided for in sub-subparagraph 136 (b)2.b., the Social Services Estimating Conference shall 137 calculate each county’s percentage share of the total statewide 138 amount of county billings made under this section from April 1, 139 2012, through March 31, 2013, for which the state ultimately 140 receives payment. 141 4. Beginning in the state fiscal year following the receipt 142 by the state of the certification provided in sub-subparagraph 143 (b)2.b., each county’s percentage share under subparagraph (a)3. 144 shall be replaced by the percentage calculated under 145 subparagraph (b)3. 146 5. If the court invalidates the replacement of each 147 county’s share as provided in this paragraph, the county share 148 set forth in subparagraph (a)3. shall continue to apply. 149 (4) By June 1 of each year, the Department of Revenue shall 150 notify each county of its required annual contribution. Each 151 county shall pay its contribution, by check or electronic 152 transfer, in equal monthly installments to the department by the 153 5th day of each month. If a county fails to remit the payment by 154 the 5th day of the month, the department shall reduce the 155 monthly distribution of that county pursuant to s. 218.61 and, 156 if necessary, by the amount of the monthly installment pursuant 157 to s. 218.26. The payments and the amounts by which the 158 distributions are reduced shall be transferred to the General 159 Revenue Fund. 160(1) Each county shall participate in the following items of161care and service:162(a) For both health maintenance members and fee-for-service163beneficiaries, payments for inpatient hospitalization in excess164of 10 days, but not in excess of 45 days, with the exception of165pregnant women and children whose income is in excess of the166federal poverty level and who do not participate in the Medicaid167medically needy program, and for adult lung transplant services.168(b) For both health maintenance members and fee-for-service169beneficiaries, payments for nursing home or intermediate170facilities care in excess of $170 per month, with the exception171of skilled nursing care for children under age 21.172(2) A county’s participation must be 35 percent of the173total cost, or the applicable discounted cost paid by the state174for Medicaid recipients enrolled in health maintenance175organizations or prepaid health plans, of providing the items176listed in subsection (1), except that the payments for items177listed in paragraph (1)(b) may not exceed $55 per month per178person.179(3) Each county shall set aside sufficient funds to pay for180items of care and service provided to the county’s eligible181recipients for which county contributions are required,182regardless of where in the state the care or service is183rendered.184(4) Each county shall contribute its pro rata share of the185total county participation based upon statements rendered by the186agency. The agency shall render such statements monthly based on187each county’s eligible recipients. For purposes of this section,188each county’s eligible recipients shall be determined by the189recipient’s address information contained in the federally190approved Medicaid eligibility system within the Department of191Children and Family Services. A county may use the process192developed under subsection (10) to request a refund if it193determines that the statement rendered by the agency contains194errors.195 (5) In any county in which a special taxing district or 196 authority is located which benefitswill benefitfrom the 197 Medicaid programmedical assistance programs covered by this198section, the board of county commissioners may divide the 199 county’s financial responsibility for this purpose 200 proportionately, and each such district or authority must 201 furnish its share to the board of county commissioners in time 202 for the board to comply with subsection (4)(3). Any appeal of 203 the proration made by the board of county commissioners must be 204 made to the Department of Financial Services, which shallthen205 set the proportionate share forofeach party. 206(6) Counties are exempt from contributing toward the cost207of new exemptions on inpatient ceilings for statutory teaching208hospitals, specialty hospitals, and community hospital education209program hospitals that came into effect July 1, 2000, and for210special Medicaid payments that came into effect on or after July2111, 2000.212 (6)(7)(a) By August 1, 2012, the agency shall certify to 213 each county the amount of such county’s billings from November 214 1, 2001, through April 30, 2012, which remain unpaid. A county 215 may contest the amount certified by filing a petition under the 216 applicable provisions of chapter 120 on or before September 1, 217 2012. This procedure is the exclusive method to challenge the 218 amount certified. In order to successfully challenge the amount 219 certified, a county must show, by a preponderance of the 220 evidence, that a recipient was not an eligible recipient of that 221 county or that the amount certified was otherwise in error. 222 (b) By September 15, 2012, the agency shall certify to the 223 Department of Revenue: 224 1. For each county that files a petition on or before 225 September 1, 2012, the amount certified under paragraph (a); and 226 2. For each county that does not file a petition on or 227 before September 1, 2012, an amount equal to 85 percent of the 228 amount certified under paragraph (a). 229 (c) The filing of a petition under paragraph (a) doesshall230 not stay or stop the Department of Revenue from reducing 231 distributions in accordance with paragraph (b) and subsection 232 (7)(8). If a county that files a petition under paragraph (a) 233 is able to demonstrate that the amount certified should be 234 reduced, the agency shall notify the Department of Revenue of 235 the amount of the reduction. The Department of Revenue shall 236 adjust all future monthly distribution reductions under 237 subsection (7)(8)in a manner that results in the remaining 238 total distribution reduction being applied in equal monthly 239 amounts. 240 (7)(8)(a) Beginning with the October 2012 distribution, the 241 Department of Revenue shall reduce each county’s distributions 242 pursuant to s. 218.26 by one thirty-sixth of the amount 243 certified by the agency under subsection (6)(7)for that 244 county, minus any amount required under paragraph (b). Beginning 245 with the October 2013 distribution, the Department of Revenue 246 shall reduce each county’s distributions pursuant to s. 218.26 247 by one forty-eighth of two-thirds of the amount certified by the 248 agency under subsection (6)(7)for that county, minus any 249 amount required under paragraph (b). However, the amount of the 250 reduction may not exceed 50 percent of each county’s 251 distribution. If, after 60 months, the reductions for any county 252 do not equal the total amount initially certified by the agency, 253 the Department of Revenue shall continue to reduce such county’s 254 distribution by up to 50 percent until the total amount 255 certified is reached. The amounts by which the distributions are 256 reduced shall be transferred to the General Revenue Fund. 257 (b) As an assurance to holders of bonds issued before the 258 effective date of this act to which distributions made pursuant 259 to s. 218.26 are pledged, or bonds issued to refund such bonds 260 which mature no later than the bonds they refunded and which 261 result in a reduction of debt service payable in each fiscal 262 year, the amount available for distribution to a county shall 263 remain as provided by law and continue to be subject to any lien 264 or claim on behalf of the bondholders. The Department of Revenue 265 must ensure, based on information provided by an affected 266 county, that any reduction in amounts distributed pursuant to 267 paragraph (a) does not reduce the amount of distribution to a 268 county below the amount necessary for the timely payment of 269 principal and interest when due on the bonds and the amount 270 necessary to comply with any covenant under the bond resolution 271 or other documents relating to the issuance of the bonds. If a 272 reduction to a county’s monthly distribution must be decreased 273 in order to comply with this paragraph, the Department of 274 Revenue must notify the agency of the amount of the decrease and 275 the agency must send a bill for payment of such amount to the 276 affected county. 277(9)(a) Beginning May 1, 2012, and each month thereafter,278the agency shall certify to the Department of Revenue by the 7th279day of each month the amount of the monthly statement rendered280to each county pursuant to subsection (4). Beginning with the281May 2012 distribution, the Department of Revenue shall reduce282each county’s monthly distribution pursuant to s.218.61by the283amount certified by the agency minus any amount required under284paragraph (b). The amounts by which the distributions are285reduced shall be transferred to the General Revenue Fund.286(b) As an assurance to holders of bonds issued before the287effective date of this act to which distributions made pursuant288to s.218.61are pledged, or bonds issued to refund such bonds289which mature no later than the bonds they refunded and which290result in a reduction of debt service payable in each fiscal291year, the amount available for distribution to a county shall292remain as provided by law and continue to be subject to any lien293or claim on behalf of the bondholders. The Department of Revenue294must ensure, based on information provided by an affected295county, that any reduction in amounts distributed pursuant to296paragraph (a) does not reduce the amount of distribution to a297county below the amount necessary for the timely payment of298principal and interest when due on the bonds and the amount299necessary to comply with any covenant under the bond resolution300or other documents relating to the issuance of the bonds. If a301reduction to a county’s monthly distribution must be decreased302in order to comply with this paragraph, the Department of303Revenue must notify the agency of the amount of the decrease and304the agency must send a bill for payment of such amount to the305affected county.306(10) The agency, in consultation with the Department of307Revenue and the Florida Association of Counties, shall develop a308process for refund requests which:309(a) Allows counties to submit to the agency written310requests for refunds of any amounts by which the distributions311were reduced as provided in subsection (9) and which set forth312the reasons for the refund requests.313(b) Requires the agency to make a determination as to314whether a refund request is appropriate and should be approved,315in which case the agency shall certify the amount of the refund316to the department.317(c) Requires the department to issue the refund for the318certified amount to the county from the General Revenue Fund.319The Department of Revenue may issue the refund in the form of a320credit against reductions to be applied to subsequent monthly321distributions.322 (8)(11)Beginning in the 2013-2014 fiscal year and each 323 year thereafter through the 2020-2021 fiscal year, the Chief 324 Financial Officer shall transfer from the General Revenue Fund 325 to the Lawton Chiles Endowment Fund an amount equal to the 326 amounts transferred to the General Revenue Fund in the previous 327 fiscal year pursuant to subsections (4) and (7)subsections (8)328and (9), reduced by the amount of refunds paid pursuant to329subsection (10),which are in excess of the official estimate 330 for medical hospital fees for such previous fiscal year adopted 331 by the Revenue Estimating Conference on January 12, 2012, as 332 reflected in the conference’s workpapers. By July 20 of each 333 year, the Office of Economic and Demographic Research shall 334 certify the amount to be transferred to the Chief Financial 335 Officer. Such transfers must be made before July 31 of each year 336 until the total transfers for all years equal $350 million. If 337In the event thatsuch transfers do not total $350 million by 338 July 1, 2021, the Legislature shall provide for the transfer of 339 amounts necessary to total $350 million. The Office of Economic 340 and Demographic Research shall publish the official estimates 341 reflected in the conference’s workpapers on its website. 342 (9)(12)The agency may adopt rules to administer this 343 section. 344 Section 2. The Agency for Health Care Administration shall 345 provide a data report to the Florida Association of Counties 346 which includes such information as may be necessary for a 347 comprehensive evaluation of the cost and utilization of health 348 services by Medicaid enrollees in each county by service type. 349 The data report shall be provided at least annually at the 350 request of the association. Copies of the data report shall also 351 be provided to the Governor, the President of the Senate, and 352 the Speaker of the House of Representatives. The agency shall 353 provide other information and assistance requested by the 354 association in order to assess the impact on counties of the 355 changes to the methodology for determining county contributions 356 to Medicaid made by this act and to evaluate the impact of 357 various Medicaid policies, including the use of diagnosis 358 related groups on the reimbursement of hospital inpatient 359 services and the implementation of statewide managed care, 360 including managed long-term care. This section is repealed 361 December 31, 2015. 362 363 ================= T I T L E A M E N D M E N T ================ 364 And the title is amended as follows: 365 Delete lines 4 - 15 366 and insert: 367 contribution for certain years and specifying the 368 method for determining the amount in the following 369 years; revising the method for calculating each 370 county’s contribution; providing tables for 371 calculating county contributions; requiring the Agency 372 for Health Care Administration to annually report the 373 status of county billings to the Legislature; 374 authorizing the Department of Revenue to withhold 375 county distributions for failure to remit Medicaid 376 contributions; deleting provisions specifying the care 377 and services that counties must participate in, 378 obsolete bond provisions, and a process for refund 379 requests; requiring the agency to provide a report to 380 the Florida Association of Counties and the 381 Legislature on the impact on counties of the changes 382 to the methodology for determining county Medicaid 383 contributions and other factors;