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Senate Eyes Hospital Medicaid Payments

stethoscope resting on cash stock photo.
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

A Senate health-care panel unveiled an early budget proposal Wednesday that would revamp how Florida pays hospitals, direct $85.6 million to address the opioid crisis and change rules regarding medical marijuana. 

Unlike the House, which has floated about $111 million in Medicaid cuts to hospitals, the Senate is not proposing such reductions.

But Senate Health and Human Services Appropriations Chairman Aaron Bean, R-Fernandina Beach, said his chamber wants Medicaid payments to “follow the patient” and not just be directed to so-called “safety net” facilities, which include teaching hospitals in urban areas and other hospitals that provide large amounts of Medicaid care.

Justin Senior, chief executive officer of the Safety Net Hospital Alliance of Florida, told reporters his industry group is analyzing the House and Senate spending proposals to understand the impacts on its member hospitals.

A similar proposal floated by the Senate last year would have resulted in a $58 million reduction to Jackson Memorial Hospital in Miami.  Ultimately, the Senate proposal did not pass.

Bean also said the Senate wants to waive a requirement that the Legislature ratify medical marijuana rules.

The state’s Office of Medical Marijuana Use has issued a series of proposed regulations for Florida’s fast-growing cannabis industry, but many of the rules have not been finalized.

State health officials blame the delays on legal and administrative challenges.

Since 2010, Florida law has required legislative ratification of any rule that would increase the costs of doing business by more than $1 million over a five-year period. But when rules go to the Legislature, they often are not ratified.

Bean said the Senate doesn’t want to take any more chances on delays in getting medical marijuana into the hands of people who need the product. He said lawmakers have been “exasperated” about the length of time it has taken to bring cannabis to the market.

House and Senate subcommittees have released budget proposals this week as an initial step in drawing up a budget for the 2019-2020 fiscal year, which starts July 1. The full House and Senate will approve budgets in the coming weeks before leaders negotiate a final spending plan.

The Senate health and human-services proposal released Wednesday would allocate an overall $37.7 billion in funding through five state agencies. A House proposal released earlier in the week proposed spending nearly $37.2 billion in those same agencies.

Included in the Senate budget is a $16.2 million proposal to help lower premiums for children in the Florida KidCare program by almost 30 percent. KidCare provides subsidized health insurance to children from low-income and working-class families.

The budget also would include a $4 million hike for addressing the opioid crisis, bringing the total funding to $85.6 million.

Hospital funding is always a high-profile part of budget negotiations and appears likely to be an issue again this year. But the House and Senate also differ in their initial proposals on other issues.

The House budget, for example, would require the state Agency for Persons with Disabilities to revamp its Medicaid “waiver” program for people with disabilities if it runs a deficit at the end of June.

The program operates through a system known as the iBudget. It serves about 34,000 people with intellectual and developmental disabilities. There are about 21,000 more people on the waiting list for the program.

The Senate’s proposed budget doesn’t address reconfiguring the iBudget program but would appropriate $74.5 million to address the deficit and future growth.  Moreover, the budget would direct $41.7 million in funding to provide a rate increase for direct care workers who work with people with intellectual and developmental disabilities.