Medicaid Reform/Health Care Budget
- HB 5001 PASSED
            The state's health and human services budget is 9.35 percent more than last year's budget due to increased Medicaid caseloads. The Legislature did not anticipate an extension of federal assistance for Medicaid and crafted the budget accordingly.

            Specifically, Medicaid spending was increased by $2.56 billion over the current year ($20.5 billion or 29 percent of the total state budget), which is a 14.05 percent increase due to the addition of approximately 301,482 new Medicaid recipients. With a total projected budget shortfall of $3.2 billion, the Legislature focused on funding the following priorities:

Restored the Medically Needy and MEDS AD Programs to approximately 39,684 beneficiaries monthly.
Funded the anticipated Kidcare enrollment growth of an additional 22,374 children.
Restored funding for services for pregnant women who qualify at between 150-185 percent of the federal poverty level.


          Programs within the Agency for Health Care Administration received numerous reductions. Following are some of the key funding decisions:

Reduced nursing home reimbursement rates by 7 percent, effective July 1, 2010 ($199.4 million). However, the Legislature provided an option for nursing homes to partially restore this reduction through its quality assessment program. This option is contingent upon the extension of the federal stimulus funds through July 2011.
Reduced hospice reimbursement rates by 7 percent, effective July 1, 2009 ($17.5 million). Legislators also offered these providers a partial buy back of rate reductions through the quality assessment program.
Reduced county health department reimbursement rates to the level paid to Federally Qualified Health Centers (FQHC) ($40.4 million). The county health departments are permitted to buy back rate reductions through county intergovernmental transfers.
Reduced hospital inpatient and outpatient rates by ($287 million) effective July 1, 2010. The plan exempts children's specialty and rural hospitals. Some hospitals have the ability to buy back rate reductions through the use of intergovernmental transfers, if available.
Reduced prepaid health plan payments by $63.3 million based on the projected Medicaid Prepaid Health Plan rates effective September 1, 2009. Prepaid health plan reimbursement rates are calculated as a percentage of the hospital inpatient, hospital outpatient and County Health Department Clinic rates, and receive a corresponding reduction when hospital inpatient rates are reduced.

Eliminated the MediPass $2/member/month case management fee.

         DOH also faced severe budget reductions this year. DOH's budget is $2.9 billion, a decrease of $32.7 million in general revenue over the current year's spending, which represents a 1.1 percent decrease. DOH's administration was reduced by $6.3 million in general revenue funds. Some notable spending areas include the following:

DOH's budget for next year provides $26.1 million in targeted stimulus funds:

o $9.7 million for Early Learning Intervention Services;

o   $4.4 million for Immunizations Services, $1.4 million for Community Health Centers;
o   $2.9 million for Behavioral Risk Factor Surveillance and Diabetes Prevention programs; and
o   $9 million for Communities Putting Prevention to Work.

DOH's budget allocates $1.5 million for the Rural Diversity Minority Healthcare Program and $19.9 million for maintenance repair and capital improvement projects to county health departments.
Other DOH reductions include:

o   Special projects ($624,000);
o   Area Health Education Center Networks ($4.9 million);
o   Children's Medical Services ($3.4 million);
o   Healthy Start Coalitions ($2.6 million);
o   Florida Center for Nursing ($450,000); and
o   Contributions to county health departments ($30.1 million) in general revenue funds.