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A $30 million hospital issue could get tucked into Medicaid conforming bill

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During the contentious debate over Medicaid expansion top Republicans in the Florida House railed against hospitals as special interests and part of the “healthcare industrial complex.”

Now the House is taking its battle against hospitals on multiple fronts, including trying to revive a little-noticed bill from the 2015 Regular Session that cracks down on the ability of hospitals to challenge Medicaid reimbursement rates set by the state.

A staff analysis of SB 322 noted there were a number of hospitals that were challenging their rates and, if successful, the state could be on the hook for upward of $30 million.

Though the issue was heard only in the Senate during the Regular Session, it was offered up by the House during the Special Session budget conference process. The Senate deferred acceptance, which means the issue will be hammered out by the House and Senate’s chief budget writers.

The House proposal makes clear that if hospitals prevail in their challenges to the rates they must secure an appropriation from the Legislature in order to collect the money.

“The agency may not be compelled by an administrative body or a court or pay additional compensation to a hospital,” the language offered by the House in the Medicaid conforming bill, SB 2508 A, reads.

The offer also would change the rules with regards to rate challenges to make clear that written notification of the audited rates is a “final agency action” and that the hospitals may request an administrative hearing to challenge the rates by filing a petition with the agency within 180 days. Hospitals could challenge the methodologies set forth in the rules used to calculate the rates for a retroactive period of three years from the date of the challenge.

State Sen. Kelli Stargel filed the bill during the 2015 Regular Session and it was heard by the Health Policy and Fiscal Policy committees and was passed unanimously.

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