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12!6!2019 Statutes & Constitution :View Statutes : Online Sunshine supplemented except as authorized under uniform rules adopted pursuant to s. 120.54(5). The failure to timely file a petition in compliance with this subparagraph is deemed conclusive acceptance of the audited hospital cost - based per diem reimbursement rate for inpatient and outpatient care established by the agency. 2. Any challenge to the methodologies set forth in the rules of the agency and in reimbursement plans incorporated by reference therein used to calculate the reimbursement rate for inpatient and outpatient care may not result in a correction or an adjustment of a reimbursement rate for a rate period that occurred more than 5 years before the date the petition initiating the proceeding was filed. 3. This paragraph applies to any challenge to final agency action which seeks the correction or adjustment of a provider's audited hospital cost -based per diem reimbursement rate for inpatient and outpatient care and to any challenge to the methodologies set forth in the rules of the agency and in reimbursement plans incorporated by reference therein used to calculate the reimbursement rate for inpatient and outpatient care, including any right to challenge which arose before July 1, 2015. A correction or adjustment of an audited hospital cost -based per diem reimbursement rate for inpatient and outpatient care which is required by an administrative order or appellate decision: a. Must be reconciled in the first rate period after the order or decision becomes final. b. May not be the basis for any challenge to correct or adjust hospital rates required to be paid by any Medicaid managed care provider pursuant to part IV of this chapter. 4. The agency may not be compelled by an administrative body or a court to pay additional compensation to a hospital relating to the establishment of audited hospital cost -based per diem reimbursement rates by the agency or for remedies relating to such rates, unless an appropriation has been made by law for the exclusive, specific purpose of paying such additional compensation. As used in this subparagraph, the term "appropriation made by Law" has the same meaning as provided in s. 11.066. 5. Any period of time specified in this paragraph is not totted by the pendency of any administrative or appellate proceeding. 6. The exclusive means to chattenge a written notice of an audited hospital cost -based per diem reimbursement rate for inpatient and outpatient care for the purpose of correcting or adjusting such rate before, on, or after July 1, 2015, or to challenge the methodologies set forth in the rules of the agency and in reimbursement plans incorporated by reference therein used to calculate the reimbursement rate for inpatient and outpatient care is through an administrative proceeding pursuant to chapter 120. 1(2)(a)l . Reimbursement to nursing homes licensed under part II of chapter 400 and state -owned -and -operated intermediate care facilities for the developmentally disabled licensed under part Vill of chapter 400 must be made prospectively. 2. Unless otherwise limited or directed in the General Appropriations Act, reimbursement to hospitals licensed under part i of chapter 395 for the provision of swing -bed nursing home services must be made on the basis of the average statewide nursing home payment, and reimbursement to a hospital licensed under part I of chapter 395 for the provision of skilled nursing services must be made on the basis of the average nursing home payment for those services in the county in which the hospital is located. When a hospital is located in a county that does not have any community nursing homes, reimbursement shall be determined by averaging the nursing home payments in counties that surround the county in which the hospital is located. Reimbursement to hospitals, including Medicaid payment of Medicare copayments, for skitted nursing services shalt be limited to 30 days, unless a prior authorization has been obtained from the agency. Medicaid reimbursement may be extended by the agency beyond 30 days, and approval must be based upon verification by the patient's physician that the patient requires short- term rehabilitative and recuperative services only, in which case an extension of no more than 15 days may be approved. Reimbursement to a hospital licensed under part I of chapter 395 for the temporary provision of skilled nursing services to nursing home residents who have been displaced as the result of a natural disaster or other emergency may not exceed the average county nursing home payment for those services in the county in which the hospital is located and is limited to the period of time which the agency considers necessary for continued placement of the nursing home residents in the hospital. 218 www.leg.state.fl.us/statutesAndex.cfm?App_mode=Display_Statute&URL=0400-0499!0409/Sections/0409.908.html 3/12