Florida § 409.9119 - Disproportionate share program for specialty hospitals for children.

§ 409.9119. Disproportionate share program for specialty hospitals for children.

In addition to the payments made under s. 409.911, the Agency for Health Care Administration shall develop and implement a system under which disproportionate share payments are made to those hospitals that are separately licensed by the state as specialty hospitals for children, have a federal Centers for Medicare and Medicaid Services certification number in the 3300-3399 range, have Medicaid days that exceed 55 percent of their total days and Medicare days that are less than 5 percent of their total days, and were licensed on January 1, 2013, as specialty hospitals for children. This system of payments must conform to federal requirements and must distribute funds in each fiscal year for which an appropriation is made by making quarterly Medicaid payments. Notwithstanding s. 409.915, counties are exempt from contributing toward the cost of this special reimbursement for hospitals that serve a disproportionate share of low-income patients. The agency may make disproportionate share payments to specialty hospitals for children as provided for in the General Appropriations Act. (1) Unless specified in the General Appropriations Act, the agency shall use the following formula to calculate the total amount earned for hospitals that participate in the specialty hospital for children disproportionate share program: TAE = DSR x BMPD x MD Where: TAE = total amount earned by a specialty hospital for children. DSR = disproportionate share rate. BMPD = base Medicaid per diem. MD = Medicaid days. (2) The agency shall calculate the total additional payment for hospitals that participate in the specialty hospital for children disproportionate share program as follows: TAP = (TAE x TA) ÷ STAE Where: TAP = total additional payment for a specialty hospital for children. TAE = total amount earned by a specialty hospital for children. TA = total appropriation for the specialty hospital for children disproportionate share program. STAE = sum of total amount earned by each hospital that participates in the specialty hospital for children disproportionate share program. (3) A hospital may not receive any payments under this section until it achieves full compliance with the applicable rules of the agency. A hospital that is not in compliance for two or more consecutive quarters may not receive its share of the funds. Any forfeited funds must be distributed to the remaining participating specialty hospitals for children that are in compliance. (4) Notwithstanding any provision of this section to the contrary, for each state fiscal year, for hospitals achieving full compliance under subsection (3), the agency shall make disproportionate share payments to specialty hospitals for children as provided in the General Appropriations Act.