Low Income Pool
Background

What is the Low Income Pool?

On October 19, 2005, the Centers for Medicare and Medicaid Services (CMS), approved the 1115 Research and Demonstration Waiver Application for the State of Florida, relating to Medicaid reform. The Florida Legislature passed House Bill (HB) 3B [119KB PDF] on December 8, 2005 authorizing implementation of the waiver effective July 1, 2006. In the Waiver Special Terms and Conditions (STC) [58KB PDF], # 91, the Low Income Pool (LIP) is "established to ensure continued government support for the provision of health care services to Medicaid, underinsured and uninsured populations. The low-income pool consists of a capped annual allotment of $1 billion total computable for each year of the 5 year demonstration period." The parameters of LIP are defined in STCs 91 through 106.

Who receives the Low Income Pool funds?

STC # 94 states that "LIP funds may be used for health care expenditures (medical care costs or premiums) that would be within the definition of medical assistance in Section 1905(a) of the Act. These health care expenditures may be incurred by the State, by hospitals, clinics, or by other provider types for uncompensated medical care costs of medical services for the uninsured, Medicaid shortfall (after all other Title XIX payments are made) may include premium payments for provider access systems (PAS) and insurance products for such services provided to otherwise uninsured individuals, as agreed upon by the State and CMS."

In accordance with STCs # 93 and # 100, the State submitted to CMS on June 26, 2006, the first Reimbursement and Funding Methodology [429KB PDF] document for LIP expenditures, which includes the definition of expenditures eligible for Federal Matching funds under the LIP and entities eligible to receive reimbursement.

Who funds the Low Income Pool?

Local governments, such as counties, hospital taxing districts and other state agencies (e.g. Florida Department of Health) provide funding for the non-federal share of the $1 billion LIP distributions.

In accordance with STC # 100(d), the Source of Funds [11KB PDF] for LIP was submitted to CMS. On June 30, 2006, the Florida Agency for Health Care Administration (the Agency) received CMS's approval [20KB PDF] of the Source of Funds.

If you have questions regarding LIP, please contact:

T. K. Feehrer - Tanisha.Feehrer@ahca.myflorida.com 850-412-4131

Low Income Pool Council

In accordance with HB 3 B and codified in s. 409.911(10), Florida Statutes [26KB PDF], “The Agency for Health Care Administration shall create a Medicaid Low-Income Pool Council by July 1, 2006.”

LIP Council was in place from July 2006 through October 2014.  Florida Statute sunset the LIP Council in the 2014 Session under F.S. 409.911.  More historical documents and meeting minutes can be found on the LIP Council website.

Please mail your comments or suggestions to:
Bureau of Medicaid Program Finance
Agency for Health Care Administration
2727 Mahan Drive, MS #23
Tallahassee, Florida 32308
Email your comments and suggestions on Medicaid reform to
LIPProvidersReports@ahca.myflorida.com