January 26, 2018

2018 Legislative Session Highlights - week 4

The House chamber passed House Bill 27 related to certificate of need deregulation. The Senate companion bill Senate Bill 1492 has not been heard in a committee.

House Bill 1099 related to advanced birth centers by Rep. MaryLynn Magar passed favorably in the Health Care Appropriations Subcommittee and will now be referred to the Health & Human Services Committee for consideration. The bill would create a new category of licensed facilities that would be authorized to provide child birth services including cesarean section deliveries and vaginal birth after cesarean (VBAC) deliveries. In the Senate - Senate Bill 1564 by Sen. Denise Grimsley has been referred to the Health Policy Committee for consideration.

House Bill 1876 related to trauma center licensure by Sen. Dana Young passed favorably in the Health Policy Committee and will now be referred to the Appropriations Subcommittee on Health and Human Services for consideration. The bill includes grandfathering language for currently verified and specified provisionally approved trauma centers.  The bill would also revise the both the current statute and trauma data reporting requirements; and require the Florida Department of Health to establish the Florida Trauma System Advisory Council to recommend increases in the number of trauma centers. House Bill 1165 has been referred to the Health Quality Subcommittee for consideration. The House Bill differs from the Senate Bill and would determine the need for minimum number of level I or Level II adult trauma centers in trauma service areas with certain population.

Budget

This week, the House and Senate released their fiscal year (FY) 2018-19 health and human services budget proposals. The House Health Care Appropriations Subcommittee released its fiscal year (FY) 2018-19 budget totals $36.9 billion, a 2.6 percent increase over FY2017-18. General revenue totals $9.8 million, a 3.75 percent increase over FY 2017-18. Below are additional highlights from the proposal.

- Fully funds Medicaid - $691.6 million; 4.1 million beneficiaries
- Fully funds the Children's Health Insurance Program  - $47.7 million; 238,000 children
- Low Income Pool (LIP) Supplemental Payments - $1.5 billion
- Medicaid School Faculty Physician Payments - $277.3 million
- Graduate Medical Education (GME) Shortage Primary Care - $5.0 million
- GME Shortage Physician Specialties - $10.0 million
- Cancer Center Medicaid Prospective Payment Exemption (HB 3275, HB 3277) - $81.5 million
- Actuarial Consulting Services -$850,000
- Long Term Care (LTC) Wait List Reduction - $4.7m for 113 additional slots
- Preadmission Screening and Resident Review (PASRR) - $1.5 million
- Florida Medicaid Management Information System (FMMIS) - $24.5 million
- Claims Data Analytics Solution - $925,000
- Health Facility Inspection Scheduling system - $500,000

The Senate Appropriations Subcommittee on Health and Human Services released its budget proposal, proviso and implementing language, which includes the EAPG reconciliation. The Senate proposal:

- Fully funds the Medicaid and KidCare programs.
- Authorizes $1.5 billion from the federal government for the Low Income Pool and $277 million for faculty physician supplemental payments.
- Repurposes $318 million of automatic rate payments:

o $265 million to inpatient DRG base rate
o $52 million to increase cap on adult outpatient reimbursement from $500 to $1,500 per recipient
o $130 million increase in hospital inpatient DRG base rate.

- Includes $53 million to address the opioid issue (Note: this is not included in the HHS Budget documents as it is part of Senate Bill 8)
- $81 million for the cancer center Medicaid perspective payment exemption.
- $130 million as an increase for nursing home payments.