Notice of Proposed Rule

AGENCY FOR HEALTH CARE ADMINISTRATION
Medicaid
RULE NO: RULE TITLE
59G-6.020: Payment Methodology for Inpatient Hospital Services
PURPOSE AND EFFECT: The purpose and effect of the proposed rule is to incorporate changes to the Florida Title XIX Inpatient Hospital Reimbursement Plan effective January 1, 2010.
The 2009-10 General Appropriations Act, Senate Bill 2600, Specific Appropriation 188, authorized a $35,478,571 inpatient hospital rate reduction, based upon the calculation of the unit cost. If the unit cost was equal to or less than the unit cost used in establishing the budget, no rate reduction would be necessary. After calculating the unit cost for the July 1, 2009 inpatient hospital rates, it was determined that no rate reduction was necessary for the July 1, 2009 rate semester.
For the January 1, 2010, rate semester, the unit cost was recalculated and it was determined that a rate reduction would be necessary. Effective January 1, 2010, the Agency shall implement a recurring methodology in the Title XIX Inpatient Hospital Reimbursement Plan to achieve a $9,635,295 rate reduction. In establishing rates through the normal process, prior to including this reduction, if the unit cost is equal to or less than the unit cost used in establishing the budget, then no additional reduction in rates is necessary. In establishing rates through the normal process, prior to including this reduction, if the unit cost is greater than the unit cost used in establishing the budget, then rates shall be reduced by an amount required to achieve this reduction, but shall not be reduced below the unit cost used in establishing the budget.
SUMMARY: Effective January 1, 2010, the Agency shall implement a recurring methodology in the Title XIX Inpatient Hospital Reimbursement Plan to achieve a $9,635,295 rate reduction.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
SPECIFIC AUTHORITY: 409.919 FS.
LAW IMPLEMENTED: 409.908, 409.911, 409.9112, 409.9113, 409.9115, 409.9116, 409.9117 409.9118, 409.9119 FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE,TIME AND PLACE SHOWN BELOW(IF NOT REQUESTED, THIS HEARING WILL NOT BE HELD):
DATE AND TIME: June 3, 2010, 9:00 a.m. – 10:00 a.m.
PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room C, Tallahassee, Florida 32308
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Edwin Stephens, Medicaid Program Analysis, 2727 Mahan Drive, Mail Stop 21, Tallahassee, Florida 32308, (850)412-4077 or edwin.stephens@ahca.myflorida.com

THE FULL TEXT OF THE PROPOSED RULE IS:

59G-6.020 Payment Methodology for Inpatient Hospital Services.

Reimbursement to participating inpatient hospitals for services provided shall be in accord with the Florida Title XIX Inpatient Hospital Reimbursement Plan, Version XXVI, Effective Date January March 1, 201009 March 1, 2008 and incorporated herein by reference. A copy of the Plan as revised may be obtained by writing to the Office of the Deputy Secretary for Medicaid, Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Mail Stop 8, Tallahassee, Florida 32308.

Rulemaking Authority 409.919 FS. Law Implemented 409.908, 409.9117 FS. History–New 10-31-85, Formerly 10C-7.391, Amended 10-1-86, 1-10-89, 11-19-89, 3-26-90, 8-14-90, 9-30-90, 9-16-91, 4-6-92, 11-30-92, 6-30-93, Formerly 10C-7.0391, Amended 4-10-94, 8-15-94, 1-11-95, 5-13-96, 7-1-96, 12-2-96, 11-30-97, 9-16-98, 11-10-99, 9-20-00, 3-31-02, 1-8-03, 7-3-03, 2-1-04, 2-16-04, 2-17-04, 8-10-04, 10-12-04, 4-19-06, 12-11-06, 3-4-08, 6-10-08, 1-11-09, 3-24-10,_______.


NAME OF PERSON ORIGINATING PROPOSED RULE: Edwin Stephens
NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Roberta K. Bradford
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: April 20, 2010
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: March 12, 2010