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 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

1. Section V.B. is being inserted after section V.A.12 to read: B. “Medicaid Trend Adjustment (MTA)” which adds the following language:

A Medicaid Trend Adjustment is a percentage reduction that is uniformly applied to all Medicaid Intermediate Care Facility providers each rate semester which equals all recurring and nonrecurring budget reductions on an annualized basis. The MTA is applied to all components after targets and ceilings are applied. Below are all the recurring reductions that are included in the Medicaid Trend Adjustment. In addition, please reference Appendix C for each MTA percentage by rate semester.

2. Section V.A.13. has been renumbered as Section V.B.1. A fourth sentence has been added: The recurring methodology is designed to reduce individual Medicaid Intermediate Care Facility rates proportionally until the required reduction is achieved.

3. Section V.A.14 has been renumbered as Section V.B.2:

4. Section V.A.15 has been renumbered as Section V.B.3. A second sentence has been added: Subsequent to B.1, the recurring methodology is designed to reduce individual Medicaid Intermediate Care Facility rates proportionally until the required reduction is achieved.

5. Section V. A.16 has been renumbered as Section V.B.4.

6. Section V. A.17 has been stricken.

7. Section V.B.5. has been added: Effective October 1, 2011, budget authority up to $6,297,463 is provided for implementing a recurring rate reduction for intermediate care facilities for the developmentally disabled. Subsequent to B.3, the recurring methodology is designed to reduce individual Medicaid Intermediate Care Facility rates proportionally until the required reduction is achieved.

8. Section V. A.18 has been renumbered as Section V.B.6. A second sentence has been added which states: The methodology is designed to increase individual Medicaid Intermediate Care Facility rates proportionally until the required buyback is achieved.

9. Section V.A. 19 has been stricken.

10. Section V.B.7. has been added: Pursuant to Section 409.908(23)(a), F.S., subsequent to all rate reductions and buy back of 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 and buy back of 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.

Appendix C –

       Effective Date            Percentages         Reduction Amount

1.    October 1, 2008         .8200%               1,524,597 $6,160,256

2.    April 1, 2009             .8200%                $6,160,256