Payment Methodology for Services in Facilities Not Publicly Owned and Publicly Operated (Facilities Formerly Known as ICF/DD Facilities)

AGENCY FOR HEALTH CARE ADMINISTRATION
Medicaid

RULE NO.: RULE TITLE:
59G-6.045: Payment Methodology for Services in Facilities Not Publicly Owned and Publicly Operated (Facilities Formerly Known as ICF/DD Facilities)

NOTICE OF CHANGE

Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 38 No. 3, January 20, 2012 issue of the Florida Administrative Weekly.

Based upon comments received at the public hearing held on February 14, 2012, the Title XIX Reimbursement Plan for Facilities Not Publically Owned and Publicly Operated (Facilities Formerly Known as ICF/DD Facilities) will be amended as follows:

Section V.B.7

Effective July 1, 2011, pursuant to Section 409.908(23)(a), F.S., the agency shall establish rates at a level that ensures no increase in statewide expenditures resulting from a change in unit costs. subsequent to all rate reductions, if the rate setting unit cost is equal to or less than the April 2011 unit cost, no additional reduction in rates is necessary. Subsequent to all rate reductions, if the rate setting unit cost is greater than the April 2011 unit cost, then rates shall be reduced by an amount until the rate setting unit cost is equal to the April 2011 unit cost, but shall not be reduced below the April 2011 unit cost. The methodology is designed to reduce individual Medicaid Intermediate Care Facility rates proportionally until the required reduction is achieved. The unit cost comparison ensures no increase in statewide expenditures as mandated by 409.908(23)(a), F.S., as the April 2011 unit cost and the rate setting unit cost are derived from statewide expenditures divided by total Medicaid Days.