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Chambers agree to $400 million in general revenue to hospitals, zero for doctor training (for now)

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Budget conferees have agreed to target $400 million in recurring general revenue to hospitals — and, as of Saturday morning, to not fund graduate medical education.

Eliminating the funding is a “work in progress” Sen. Rene Garcia said. And Rep. Matt Hudson quickly agreed. “It’s certainly not off the table and both chambers recognize the importance of GME. I think it’s also important to both chambers we address some of the physician shortfall across the state.”

The agreement on LIP has both men acknowledging that the conferees are making quick progress bridging the differences between the chambers’ initial health care funding proposals.

The $400 million in recurring general revenue will help “backfill,” or replace with general revenue, the loss of $1 billion in supplemental funding. The money will be complemented by contributions made by the counties and then ultimately matched by federal Medicaid dollars.

Pumping general revenue into the hospital funding is not something that Gov. Rick Scott initially supported and Deputy Medicaid Director Justin Senior is trying to get approval of Scott’s alternative formula this weekend in Chicago at a conference of state Medicaid directors. The alternate approach, Senior said, could help keep hospitals whole but would not require general revenue. The hospitals disagree.

Hudson said the general revenue was put into the hospitals because both House Speaker Steve Crisafulli and Senate President Andy Gardiner supported the approach.

How the Low Income Pool money will be distributed among hospitals will be decided later in the conference process and after the chambers are able to resolve other issues, Garcia and Hudson both agreed.

Hudson said he was going to “take a deep dive and look at that later today or maybe tomorrow and we’re certainly going to get there,” he said.

The House and Senate have each made one offer to each other in hopes of bridging the spending differences between the health budgets. Already lawmakers have agreed on certifying $15 million in trust funds for emergency medical services care and the chambers also have agreed to $3.9 million in rate increases for intermediate care facilities for the developmentally disabled.

Some Medicaid issues that are outstanding include:

  • pay increases for private duty nurses– Senate has $1.2 million House has $1.7 million;
  • pediatric physician increase– Senate has $3 million, House has zero;
  • Meridian home health care “pilot”– Senate has $443,150, House has zero;
  • pay increase for prescribed pediatric extended care increases–Senate has $1.48 million, House has zero; and
  • additional money for the Agency for Health Care Administration to spend on Medicaid financial consulting–the House has targeted $500,000 and the Senate is earmarking $750,000.

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