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Health News Florida

AHCA Backs More Medicaid Money For 28 Hospitals

Jackson Memorial Hospital from the street
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Twenty-eight Florida hospitals will see bumps in their Medicaid reimbursement rates under a plan the Agency for Health Care Administration has announced.

Twenty-eight Florida hospitals will see bumps in their Medicaid reimbursement rates under a plan the Agency for Health Care Administration has announced.

The state is updating a hospital inpatient reimbursement methodology for the 2019-2020 fiscal year, a move that will have a $19 million impact on federal Medicaid funding, according to the announcement published Friday.

The agency did not answer questions about the changes, which apply to care rendered beginning June 2. But former AHCA Secretary Justin Senior told The News Service of Florida on Tuesday that the changes are being made to ensure that the full $319 million in supplemental funds lawmakers agreed to spend last year on 28 hospitals that treat the most Medicaid patients is appropriated.

Senior, who now heads the Safety Net Hospital Alliance of Florida, has described the supplemental Medicaid dollars as “critical care” funds.

The dollars are used to pad the Medicaid reimbursement rates of those facilities to care for poor, elderly and disabled patients.

The funds are disbursed to the facilities as an add-on and are provided after patients receive care and are discharged.

The numbers of patients that those 28 hospitals have treated during the COVID-19 pandemic --- especially between March 23 and May 4, when there was a ban on elective procedures --- have decreased.

That means “critical care” funds are at risk of not being fully spent.

Senior said the goal behind the announcement is to ensure that the 28 hospitals that were scheduled to receive the funds in the current fiscal year actually receive them.

According to AHCA’s announcement, the changes to the hospital reimbursement formula will have a $19 million “federal fiscal impact” in the fiscal year that ends June 30.

There is no impact on federal funds for the 2020-2021 fiscal year, according to the announcement. 

“This is helpful,” Senior said. “This is a recognition that discharges have dropped significantly.”

Although all hospitals have lost revenue as a result of the pandemic, the changes would only impact the 28 facilities that qualify for the add-on funding.