The purpose and effect of the proposed rule are to incorporate changes to the Florida Title XIX Outpatient Hospital Reimbursement plan (the Plan) payment methodology effective January 1, 2008 in accordance with the Senate Bill 2-C 2007-08 Special Appropriations Act, Specific Appropriation 107 and Section 13. 1. An additional Medicaid Trend Adjustment shall be applied to achieve a recurring annual reduction of $17,211,796. 2. Effective January 1, 2008, and ending June 30, 2008, the Medicaid Trend Adjustment shall be removed for all certified trauma centers and hospitals defined in section 408.07(45), Florida Statutes. The aggregate Medicaid Trend Adjustment found in item 2 above shall be reduced by up to $2,034,032. 3. In reducing hospital outpatient rates, rural hospitals and hospitals with twenty thousand (20,000) or more combined Medicaid managed care and fee-for-service inpatient days shall not have their outpatient rates reduced below the final rates that are effective on the prior June 30 of each year. The 2002 Financial Hospital Uniform Reporting System (FHURS) data shall be used to determine the combined inpatient Medicaid days. 4. Grammatical corrections throughout the Title XIX Outpatient Hospital Reimbursement Plan.