Nursing Home Prospective Payment System
During the 2016 Legislative Session, Legislation passed requiring the Agency to contract with an independent consultant to develop a plan to convert Medicaid payments for nursing home services from a cost based reimbursement methodology to a prospective payment system. The Agency has engaged Navigant Consulting, Inc. to perform the study and develop the plan.
The plan is required to identify steps necessary complete the transition in a budget neutral manner. Additionally, the plan is required to address the impact of a prospective payment system on Medicaid reimbursement rates for hospice providers. As required by Specific Appropriation 186 of the 2016 General Appropriations Act, the plan will be submitted to the Governor, the President of the Senate, and the Speaker of the House of Representatives no later than January 1, 2017.
Effective October 1, 2018 Florida Medicaid Nursing Home providers will be reimbursed through a prospective payment system. Please see Section 409.908, Florida Statutes for the prospective payment parameters adopted by the legislature. If the statutes and the reimbursement plan do not specifically describe certain criteria for the prospective payment system, the Agency intends to default to the Nursing Facility Payment Method Recommendations Report.
Florida Statutes - Nursing Home Payments
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Nursing Facility Payment Method Recommendations Report
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