Christine Jordan Sexton
For years, providers worried about legislators slashing Medicaid reimbursements they received for rendering health care and mental health services to the poor, elderly, disabled and others in need.
With a $15 billion general revenue appropriation and the state flush in money, those days appear to be a thing of the past — at least for the Fiscal Year 2023-24 budget.
The 2023-24 health and human services budget being hammered out by conferees this week has more than $323 million in proposed rate increases for 12 different types of health care providers, including those that deliver durable medical equipment, Medicaid beneficiaries, pediatricians, community mental health providers and nursing homes.
Of the 12 provider groups targeted for rate increases in the 2023-24 budget, four of them are included only in the Senate’s proposed budget: a $76 million proposed increase for children’s hospitals; a $1.7 million increase for organ transplant providers; a $29.7 million increase for community mental health providers; and an $11.9 million for Medicaid iBudget waiver support coordinators.
One of them, a $76.1 million increase for pediatricians, appears only in the House’s proposed budget.
The $323 million figure reflects all the proposed rate increases in both budgets. In instances when the funding amounts didn’t align, Florida Politics used the lower of the two figures when computing the overall dollar amount tied to rate increases.
While the chambers are both proposing to spend about $76 million for pediatric care, the Senate has directed its money toward hospitals while the House has directed it toward increasing physician payments.
In the past, that could have pitted pediatricians against the hospitals.
But as the budget conference began, legislative leaders agreed to give the chambers a $15 billion general revenue allocation, which was hundreds of millions higher than what the chambers thought they’d have to build their budgets.
The increase prompted House Appropriations Chairman Sam Garrison to note that “Shakespeare said it best, ‘If money go before, all ways do lie open. “We’ll see how it plays out, but it’s certainly a good problem to have.”
“We are hopeful there’s enough money in the system and the allocations to do both of those things,” Safety Net Hospital Association of Florida CEO Justin Senior told Florida Politics.
Meanwhile, seven of the 12 proposed rate increases appear in both budgets, with three of them seemingly finalized because the spending amounts are the same in both budgets. Both chambers have agreed to give a $4.3 million cost of living adjustment to contracted agencies that provide mental health services, a $2.46 million bump for maternal fetal rates and a $9.58 million increase for Healthy Start Coalitions.
Nursing homes, institutional centers for people with developmental disabilities (ICFDDs), pediatric behavioral health providers and durable medical equipment providers have rate increases in both budgets. But the chambers haven’t agreed on final dollar amounts.
The House is recommending that nursing homes receive a $95.5 million rate increase, while the Senate has recommended a $93.18 increase. The House is recommending a $9 million bump in rates for ICFDDs, while the Senate is recommending a near $5 million hike.
Also, the House wants a $5.4 million bump in Medicaid rates for pediatric behavioral health services. The Senate has floated a $15 million hike. The House is proposing a $9.6 million increase for DME providers and while the Senate has pushed for a $19.3 million hike.
Budget conference subcommittees will meet throughout the week to resolve differences in each area. When remaining issues reach an impasse, they will be “bumped” to the full budget conference committee.
Lawmakers must reach an agreement on a final spending plan by May 2 to meet the 72-hour “cooling off” period required by the state constitution before they can vote on the budget to avoid pushing the Regular Session past its scheduled May 5 end date.
