4767082, 59G-6.010 - Florida Administrative Rules, Law, Code, Register

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Florida Department of State and Division of Library and Information Services

Notice: 4767082

Notice of Proposed Rule

Department:

AGENCY FOR HEALTH CARE ADMINISTRATION

Division:

Medicaid

Chapter:

REIMBURSEMENT TO PROVIDERS

Overview

RULE:

59G-6.010

Payment Methodology for Nursing Home Services

PURPOSE:

The purpose of the proposed rule is to incorporate changes to the Florida Title XIX Long-Term Care Reimbursement Plan (the Plan) payment methodology, effective July 1, 2007.
1. The operating and indirect patient care component targets and target rate class ceilings of the Medicaid nursing home per diem rate shall be rebased. The operating and indirect patient care components of the per diem rate shall continue to be limited by the lower of the cost-based class ceiling, the target rate class ceiling, or the individual provider-specific target.
2. Establish a target rate class ceiling floor equal to 90 percent of the cost-based class ceiling.
3. Establish an individual provider-specific target floor equal to 75 percent of the cost-based class ceiling.
4. Modify the inflation multiplier to equal 2.0 times inflation for the individual provider-specific target. (The inflation multiplier for the target rate class ceiling shall remain at 1.4 times inflation.)
5. Modify the calculation of the change of ownership target to equal the previous providers’ operating and indirect patient care cost per diem (excluding incentives), plus 50 percent of the difference between the previous providers’ per diem (excluding incentives) and the effective class ceiling and use an inflation multiplier of 2.0 times inflation. 
6. The methodology for nursing home special Medicaid payments is being revised.

SUMMARY:

The proposed changes to Rule 59G-6.010, F.A.C., incorporate revisions to the Florida Title XIX Long-Term Care Reimbursement Plan. The rule modifies July 1, 2007 nursing home rates and changes the term Upper Payment Limit to special Medicaid payments.

RULEMAKING AUTHORITY:

409.919, FS.

LAW:

409.908, FS.

PRINT PUBLISH DATE:

10/26/2007 Vol. 33/43

COMMENTS:

From 10/26/2007 To 11/16/2007 (21 Days)
The public comment period for this notice has already expired.

REFERENCE MATERIALS:

No reference(s).

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