The Florida Agency for Health Care Administration (the Agency), Bureau of Medicaid
Program Analysis provides the following public notice regarding reimbursement for
nursing home facilities participating in the Florida Medicaid Program.
PURPOSE: To comply with federal public notice requirements in Section 1902(a)(13)(A) of the Social Security Act in changing reimbursement for nursing home facilities, the Agency is publishing the final rates, the methodologies underlying the establishment of such rates, and justifications for the final rates. The Agency has amended its Title XIX Long-Term Care Reimbursement Plan (The Plan) to incorporate changes to the reimbursement methodology.
FINAL RATES: The final rates for the Florida Title XIX Long-Term Care Reimbursement Plan payment methodology effective July 1, 2005 are as follows:
1. Effective July 1, 2005, a proportional reimbursement rate reduction was established until an annual aggregate total estimated savings of $132,096,857 was achieved for the period ending June 30, 2006. The weighted average per diem rates as of July 1, 2005 and January 1, 2006 are the bases for the determination of these savings, and were compared to the weighted average per diem as of June 30, 2005 with a .5% increase. The full savings will be assumed realized if the weighted average rate for the period July 1, 2005 through June 30, 2006 does not exceed the weighted average rate as of June 30, 2005 with a .5% increase.
2. Effective July 1, 2006, the annual aggregate amount the rates were reduced during the period July 1, 2005 through June 30, 2006 shall become a recurring annual reduction. This recurring reduction, called the Medicaid Trend Adjustment, shall be applied proportionally to all rates on an annual basis. Effective July 1, 2005, in accordance with House Bill 1267, Section 2, and 633.022 F.S.:
4. (a) Notwithstanding any provision of law to the contrary, each nursing home licensed under part II of chapter 400 shall be protected by an approved, supervised automatic sprinkler system in accordance with section 9 of the National Fire Protection Association, Inc., Life Safety Code, in accordance with the following schedule: Each hazardous area of each nursing home shall be protected by an approved, supervised automatic sprinkler system by no later than December 31, 2008. Each entire nursing home shall be protected by an approved, supervised automatic sprinkler system by no later than December 31, 2010.
(b) The division may grant up to two 1-year extensions of the time limits for compliance in subparagraph (a)2. if the division determines that the nursing home has been prevented from complying for reasons beyond its control.
(c) The division is authorized to adopt any rule necessary for the implementation and enforcement of this subsection. The division shall enforce this subsection in accordance with the provisions of this chapter, and any nursing home licensed under part II of chapter 400 that is in violation of this subsection may be subject to administrative sanctions by the division pursuant to this chapter.
(d) Adjustments shall be made to the provider Medicaid rate to allow reimbursement over a 5-year period for Medicaid's portion of the costs incurred to meet the requirements of this subsection. Funding for this adjustment shall come from existing nursing home appropriations.
METHODOLOGIES: The methodology underlying the establishment of the final rates for Medicaid nursing facilities will be rates resulting from the revised methodology used to calculate per diems in the Long-Term Care Reimbursement Plan in accordance with the 2005-06 General Appropriations Act, Senate Bill 2600, Specific Appropriation 219 and House Bill 1267, Section 2.
JUSTIFICATION: The justification for the final rate change is the 2005-06 General Appropriations Act, Senate Bill 2600, Specific Appropriation 219 and House Bill 1267, Section 2, 633.022 F.S.