State Politics

Jackson Memorial breathes $58 million sigh of relief. Medicaid formula doesn’t change.

The emergency room at Miami’s Jackson Memorial hospital is a busy place. The Florida Legislature decided to keep its current Medicaid funding formula on Wednesday, and that was worth $58 million to Jackson.
The emergency room at Miami’s Jackson Memorial hospital is a busy place. The Florida Legislature decided to keep its current Medicaid funding formula on Wednesday, and that was worth $58 million to Jackson. Miami Herald file photo

Medicaid reimbursements for Florida hospitals will remain the same for another year after lawmakers reached a belated compromise on the healthcare budget, House and Senate leaders announce.

The agreement, which keeps additional payments for largely “safety net” hospitals with a higher Medicaid caseload and increases state money for nursing homes by $50 million, resolved the final points of contention that had kept the legislative session from ending on time.

Sen. Rob Bradley, R-Fleming Island, the chamber’s budget chief, said Wednesday House and Senate leaders had compromised by taking up the House’s plan for hospitals and the Senate’s plan to increase state funds for nursing homes. The Senate had proposed changing the current Medicaid funding model for hospitals by redistributing $318 million that currently goes to additional payments for 28 hospitals to all hospitals in the state.

$58 million How much was at stake in the Medicaid decision for Jackson Memorial

“If the policy for hospitals is what’s important to somebody, then they got that. If getting more money for nursing homes is what’s important, we got that,” he said Wednesday afternoon. “That’s how we worked out healthcare.”

Rep. Carlos Trujillo, R-Miami, the House’s budget chair, said Wednesday the chamber’s priority was protecting the hospitals that currently receive the additional payments.

“We’re not going to cut the safety nets,” he said. “We’re going to protect the most vulnerable institutions in our state that we feel we have a fiscal, fiduciary and moral duty towards.”

Bradley said Wednesday that the chambers had agreed to up state funding to nursing homes by $40 million, but a final agreement accepted Thursday between the two chairs added another $10 million in state funds. The additional money draws down enough federal funds to meet the Senate’s original $130 million proposal, Bradley said Thursday.

The change in funding also coincides with an expected change in nursing homes’ Medicaid payment system this October.

But the Senate ceded to the House on its hospital funding plan, which would have funneled the enhanced payments into the base reimbursement rates for all hospitals. Under the Senate plan, Miami’s Jackson Memorial Hospital stood to lose about $58 million and Broward Health could have lost about $17 million, according to an analysis by the Safety Net Hospital Alliance of Florida. Other hospitals, including HCA, a for-profit chain, could have seen its reimbursements rise by more than $40 million.

$17 million How much Broward Health had on the line in the Medicaid decision

Proponents of the Senate plan had said changing the reimbursement model would have more fairly compensated hospitals for the care they provide, and that many of the hospitals that currently receive the additional funds are also capable of drawing down federal funding that other hospitals cannot. But the Safety Net Alliance, which represents many of the hospitals that currently receive the additional payments, said any cuts were unsustainable.

This year’s budget preserved current funding levels for several programs and agencies, including Healthy Start, a risk screening program for pregnant women and infants that feared substantial cuts and restructuring. But the delayed compromise means legislators will have to go into overtime to complete the session: Rules require that the budget go through a 72-hour “cooling-of period” after it is completed before lawmakers can vote to pass it.

This story has been updated.

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