Agency for Health Care Administration, Medicaid

AGENCY FOR HEALTH CARE ADMINISTRATION
Medicaid

AGENCY FOR HEALTH CARE ADMINISTRATION

The Florida Agency for Health Care Administration (the Agency), Bureau of Medicaid

Program Analysis provides the following public notice regarding reimbursement for

nursing home facilities participating in the Florida Medicaid Program.

PURPOSE:  To comply with federal public notice requirements in Section 1902(a)(13)(A) of the Social Security Act in changing reimbursement for nursing home facilities, the Agency is publishing the proposed rates, the methodologies underlying the establishment of such rates, and justifications for the proposed rates.  The Agency is in the process of amending its Title XIX Long-Term Care Reimbursement Plan (The Plan) to incorporate changes to the reimbursement methodology.

PROPOSED RATES: The purpose of the proposed amendment is to incorporate changes to the Florida Title XIX Long-Term Care Reimbursement Plan payment methodology effective April 1, 2006.

1.        The Agency is deleting the low occupancy adjustment for the direct care component of the nursing home reimbursement rate.

METHODOLOGIES: The methodology underlying the establishment of the proposed rates for Medicaid nursing facilities will be rates resulting from the revised methodology used to calculate the nursing home per diem reimbursement rate.

JUSTIFICATION:  The justification for the proposed rate change is to remove occupancy related rate reductions for direct care nursing staff, as the Agency requires minimum staffing requirements on a daily basis.  This component of Medicaid reimbursement is computed separately from other components of the rate, which is different than when the low occupancy adjustment was first included in the Long-term Care Reimbursement Plan.  The direct correlation between minimum staffing requirements and the rate calculation justify the removal of this provision.

The Agency is proposing the above changes effective April 1, 2006.  Providers, beneficiaries and their representatives, and other concerned state residents may provide written comment on the proposed rates, methodologies and justification underlying the establishment of such changes.  Written comments may be submitted to:  Edwin Stephens, Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Mail Stop 21, Tallahassee, Florida 32308.  Written comments should be submitted no later than March 17, 2006.

 Please contact the person listed above to request a copy when they are available.