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12/6/2019
<br />Statutes & Constitution :View Statutes : Online Sunshine
<br />provided in the General Appropriations Act.
<br />(b}1. Base rate reimbursement for inpatient services under a diagnosis-related group payment methodology
<br />shall be provided in the General Appropriations Act.
<br />2. Base rate reimbursement for outpatient services under an enhanced ambulatory payment group
<br />methodology shalt be provided in the General Appropriations Act.
<br />3. Prospective payment system reimbursement for nursing home services shall be as provided in subsection (2)
<br />and in the General Appropriations Act.
<br />(24) If a provider faits to notify the agency within 5 business days after suspension or disenrotlment from
<br />Medicare, sanctions may be imposed pursuant to this chapter, and the provider may be required to return funds
<br />paid to the provider during the period of time that the provider was suspended or disenrolled as a Medicare
<br />provider.
<br />(25) In accordance with 42 C.F.R. s. 433.318(d), the agency may certify that a Medicaid provider is out of
<br />business and that any overpayments made to the provider cannot be collected under state law and procedures.
<br />3(26) The agency may receive funds from state entities, including, but not limited to, the Department of
<br />Health, local governments, and other local political subdivisions, for the purpose of making speciat exception
<br />payments and Low Income Pool Program payments, including federal matching funds. Funds received for this
<br />purpose shall be separately accounted for and may not be commingled with other state or local funds in any
<br />manner. The agency may certify alt local governmental funds used as state match under Title XIX of the Social
<br />Security Act to the extent and in the manner authorized under the General Appropriations Act and pursuant to an
<br />agreement between the agency and the local governmental entity. In order for the agency to certify such local
<br />governmental funds, a local governmental entity must submit a final, executed letter of agreement to the agency,
<br />which must be received by October 1 of each fiscal year and provide the total amount of local governmental funds
<br />authorized by the entity for that fiscal year under the General Appropriations Act. The local governmental entity
<br />shalt use a certification form prescribed by the agency. At a minimum, the certification form must identify the
<br />amount being certified and describe the relationship between the certifying local governmental entity and the
<br />local health care provider. Local governmental funds outlined in the letters of agreement must be received by the
<br />agency no later than October 31 of each fiscal year in which such funds are pledged, unless an alternative plan is
<br />specifically approved by the agency.
<br />History. -s. 37, ch. 91.282; s. 17, ch. 92-179; s. 1, ch. 92-311; s. 47, ch. 93-129; s. 28, ch. 93-211; s. 2, ch. 94-299; s. 4, ch. 94-317; s.
<br />2, ch. 95.291; s. 3, ch. 95-336; s. 5, ch. 95-393; s. 6, ch. 96-417; s. 3, ch. 97.168; s. 65, ch. 97-237; s. 1, ch. 97-243; s. 11, ch. 97-260; ss.
<br />14, 19, ch. 97.263; s. 4, ch. 97-309; ss. 13, 38, ch. 98-46; s. 236, ch. 98-166; s. 28, ch. 98-191; ss. 17, 30, ch. 2000-163; s. 19, ch. 2000-
<br />209; s. 54, ch. 2000-256; s. 110, ch. 2000-318; s. 49, ch. 2001-45; s. 51, ch. 2001-62; s. 5, ch. 2001-104; s. 4, ch. 2001-222; s. 7, ch. 2001-
<br />377; s. 16, ch. 2002-223; s. 996, ch. 2002-387; s. 22, ch. 2002-400; s. 11, ch. 2003-405; s. 53, ch. 2004-5; s. 12, ch. 2004-270; s. 21, ch.
<br />2004-344; s. 68, ch. 2005-2; s. 9, ch. 2005-60; s. 17, ch. 2005-133; s. 13, ch. 2006-28; s. 53, ch. 2006-227; s. 96, ch. 2007-5; s. 50, ch.
<br />2007-217; s. 3, ch. 2007-331; s. 5, ch. 2008-143; s. 1, ch. 2008-203; s. 93, ch. 2010-5; s. 7, ch. 2010-156; s. 5, ch. 2011-61; s. 12, ch. 2011-
<br />135; s. 6, ch. 2012-33; s. 4, ch. 2013-48; s. 14, ch. 2013-162; ss. 2, 6, ch. 2015.225; s. 19, ch. 2016-65; s. 1, ch. 2016.103; ss. 8, 9, ch.
<br />2017-129; ss. 17, 18, 19, ch. 2018-10; s. 39, ch. 2018-106; ss. 16, 17, 18, 19, 20, 21, ch. 2019-116.
<br />1 Note. -
<br />A. Section 16, ch. 2019-116, amended subsection (2) "[i]n order to implement Specific Appropriations 221 and 222 of the 2019-2020
<br />General Appropriations Act."
<br />B. Section 17, ch. 2019-116, provides that "[t]he amendment made by this act to s. 409.908(2), Florida Statutes, by this act expires
<br />July 1, 2020, and the text of that subsection shall revert to that in existence on July 1, 2019, except that any amendments to such text
<br />enacted other than by this act shall be preserved and continue to operate to the extent that such amendments are not dependent upon
<br />the portions of text which expire pursuant to this section." Effective July 1, 2020, subsection (2), as amended by s. 17, ch. 2019-116, will
<br />read:
<br />(2)(a)1. Reimbursement to nursing homes licensed under part 11 of chapter 400 and state -owned -and -operated intermediate care
<br />facilities for the developmentally disabled licensed under part Vill of chapter 400 must be made prospectively.
<br />2. Unless otherwise limited or directed in the General Appropriations Act, reimbursement to hospitals licensed under part I of chapter
<br />395 for the provision of swing -bed nursing home services must be made on the basis of the average statewide nursing home payment, and
<br />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
<br />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
<br />that does not have any community nursing homes, reimbursement shall be determined by averaging the nursing home payments in counties
<br />that surround the county in which the hospital is located. Reimbursement to hospitals, including Medicaid payment jf5dicare
<br />copayments, for skilled nursing services shall be limited to 30 days, unless a prior authorization has been obtained from {fie agency.
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