Low Income Pool (LIP)

Florida Statute 409.909 Statewide Medicaid Residency Program [207KB PDF]

Executed Rate LOAs for SFY 2013-14 [176KB PDF]

The deadline for Self-funded IGT Rate LOAs was October 1, 2013.  No more LOAs can be created for this category (that includes Outpatient Self-funded Buybacks, Outpatient Self-funded Exemptions, and Inpatient Self-funded DRG Add-ons) for SFY 2013-14.


arrows Florida Medicaid Reform (2011-2014)
Approved 3-Year Extension of the 1115 Research and Demonstration Waiver arrows

On December 15, 2011, the Centers for Medicare and Medicaid Services (CMS) approved the 3-year waiver extension request the Agency submitted on June 30, 2010. The waiver extension period for Florida’s Section 1115 Research and Demonstration Waiver is December 16, 2011 through June 30, 2014. For more information, please visit the Medicaid Reform Pilot program website.


arrows LIP Council Meetings Past and Present arrows

All meeting are located at the Agency for Health Care Administration, 2727 Mahan Dr., Tallahassee, FL 32308

Next Meeting

There are no meetings scheduled at this time.

Nicole.Maldonado@ahca.myflorida.com or 850-412-4287.

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Meetings Archive

2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013


arrows Low Income Pool Reporting Deadlines arrows

STC 62 Top 15 Milestone Requirement

Please submit ALL of the following reports to Lip_Providers_Rpts@ahca.myflorida.com:

Reporting for all Providers

The Milestone Report and Cost Limit Report are required to be submitted by all LIP Provider Access Systems for the corresponding years of funding. If your facility received LIP funds in the corresponding State Fiscal Year (SFY) then your facility is required to report.

Due Date Report Provider Access Systems Corresponding State Fiscal Year

September 15, 2013

SFY 2012-13 Milestones

All Providers

SFY 2012-13

March 1, 2014

SFY 2011-12 Cost Limit

All Providers

SFY 2011-12

Milestones and Cost Limit Report must be filed online, links can be found below:

Cost Limit Report Link:
https://apps.ahca.myflorida.com/SingleSignOnPortal/Login.aspx

Milestone Report Link:
http://apps.ahca.myflorida.com/LIPS/

Failure to file reports timely will result in LIP and DSH payments being withheld until Provider is in compliance.

Other LIP Reporting

The following reporting is only due to the listed corresponding LIP Provider Access Systems the corresponding years of receiving LIP funding:

$35 Million Primary Care Recipients’ Reporting

Due Date

Report

Provider Access Systems

Corresponding State Fiscal Year

July 22, 2013

Primary Care
($35 Million) for Fourth Quarter

Only recipients of the $35 million Primary Care award

Fourth Quarter    SFY 2012-13
(April 1, 2013 through June 30, 2013)

August 30, 2013

$35 Million Primary Care
Annual
Report

$35 Million Primary Care Awardees & $15 Million Quality Add-On Recipients

SFY 2012-13

October 15, 2013

Primary Care 
($35 Million) for Fourth Quarter

Only recipients of the $35 million Primary Care award

First Quarter SFY 2013-14
(July 1, 2013 through September 30, 2013)

January 15, 2014

Primary Care
($35 Million) for Fourth Quarter

Only recipients of the $35 million Primary Care award

Second Quarter SFY 2013-14
(October 1, 2013 through December 31, 2013)

April 15, 2014

Primary Care 
($35 Million) for Fourth Quarter

Only recipients of the $35 million Primary Care award

Third Quarter SFY 2013-14
(January 1, 2014 through March 31, 2014)

July 15, 2014

Primary Care
($35 Million) for Fourth Quarter

Only recipients of the $35 million Primary Care award

Fourth Quarter SFY 2013-14
(April 1, 2014 through June 30, 2014)


STC 62 Top 15 LIP Hospital Reporting

Due Date

Report

Provider Access Systems

Corresponding State Fiscal Year

July 22, 2013

Fourth Quarter STC 62 Top 15 Reporting

Top 15 LIP Hospitals

Fourth Quarter SFY 2012-13
(April 1, 2013 through June 30, 2013)

October 15, 2013

First Quarter STC 62 Top 15 Reporting

Top 15 LIP Hospitals

First Quarter SFY 2013-14
(July 1, 2013 through September 30, 2013)

January 15, 2014

Second Quarter STC 62 Top 15 Reporting

Top 15 LIP Hospitals

Second Quarter SFY 2013-14           
(October 1, 2013 through December 31, 2013)

April 15, 2014

Third Quarter STC 62 Top 15 Reporting

Top 15 LIP Hospitals

Third Quarter SFY 2013-14          
(January 1, 2014 through March 31, 2014)

July 15, 2014

Fourth Quarter STC 62 Top 15 Reporting

Top 15 LIP Hospitals

Fourth Quarter SFY 2013-14
(April 1, 2014 through June 30, 2014)


34 Million Primary Care Recipientsí Reporting

Due Date

Report

Provider Access Systems

Corresponding State Fiscal Year

March 31, 2014

SFY 2012-13 Primary Care Report
($34 million)

Only recipients of the $34 million award

SFY 2012-13

For the Primary Care funding Recipients, STC 62 and STC 61 reporting should be emailed to Lip_Providers_Rpts@ahca.myflorida.com

Failure to file reports timely will result in LIP and DSH payments being withheld until Provider is in compliance.

If you need assistance or have questions, please contact us at:

Forms

Hospital Cost Limit [102KB MS Excel] Updated 1/22/2014

FQHC Cost Limit [69KB MS Excel ]

CHD Cost Limit [28KB MS Excel ]

Reference Documents


arrows Online Reporting Tool arrows

The LIP Online Reporting Tool will allow Provider Access Systems (PAS) to submit the required LIP Milestone Reporting document and LIP Cost Limit reports through the website. The LIP Online Reporting Tool will enable the PAS to submit and view previously submitted reports online, for their PAS. This system is now available. Only one User ID will be assigned per PAS. The provider passwords will be sent to the email address provided on the LIP Provider User Account Agreement.

Information regarding the SFY 2008-09 Cost Limits will be forthcoming.


arrows $35 Million LIP Primary Care Award arrows

Medicaid Supplemental Hospital Funding Programs Fiscal Year 2013-2014 Final Conference Report for House Bill 1500



arrows LIP Council Recommendations to Governor and Legislature for SFY 2013-14 arrows


arrows Low Income Pool Background arrows

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 Reimbursement and Funding Methodology [429KB PDF] for LIP expenditures, which includes the definition of expenditures eligible for Federal Matching funds under the LIP and entities eligible to receive reimbursement. Attachment A [35KB PDF] provides the detail of the anticipated distributions by provider, as submitted to CMS, with the Reimbursement and Funding Methodology document as of May 26, 2006.

In accordance to STC #101 a Updated Final Reimbursement and Funding Methodology [238KB PDF] document, including a reporting methodology for the number of individuals and types of services provided through the LIP, was submitted to CMS on November 22, 2006.   In response to CMS' comments on April 27, 2007, the revised document (provided in the link above) was submitted on May 29, 2007.

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. Effective October 1, 2006, through September 30, 2007, the Federal Matching Assistance Percentage is 58.76%; and the state non-federal, share is 41.24%.

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 question regarding LIP, please email or call:

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. The Low-Income Pool Council [151KB PDF] shall consist of 24 members, including 2 members appointed by the President of the Senate, 2 members appointed by the Speaker of the House of Representatives, 3 representatives of statutory teaching hospitals, 3 representatives of public hospitals, 3 representatives of nonprofit hospitals, 3 representatives of for-profit hospitals, 2 representatives of rural hospitals, 2 representatives of units of local government which contribute funding, 1 representative of family practice teaching hospitals, 1 representative of federally qualified health centers, 1 representative from the Department of Health, and 1 nonvoting representative of the Agency for Health Care Administration who shall serve as chair of the council. Except for a full-time employee of a public entity, an individual who qualifies as a lobbyist under s. 11.045 or s. 112.3215 may not serve as a member of the council. Of the members appointed by the Senate President, only one shall be a physician. Of the members appointed by the Speaker of the House of Representatives, only one shall be a physician. The physician member appointed by the Senate President and the physician member appointed by the Speaker of the House of Representatives must be physicians who routinely take calls in a trauma center, as defined in s. 395.4001, or a hospital emergency department. The council shall:

  1. Make recommendations on the financing of the low-income pool and the disproportionate share hospital program and the distribution of their funds.
  2. Advise the Agency for Health Care Administration on the development of the low-income pool plan required by the federal Centers for Medicare and Medicaid Services pursuant to the Medicaid reform waiver.
  3. Advise the Agency for Health Care Administration on the distribution of hospital funds used to adjust inpatient hospital rates, rebase rates, or otherwise exempt hospitals from reimbursement limits as financed by intergovernmental transfers.
  4. Submit its findings and recommendations to the Governor and the Legislature no later than February 1 of each year.

Intergovernmental Transfer (IGT) Workgroup

On May 28, 2010, Governor Crist signed into law Senate Bill 1484 (Chapter 2010-144, Laws of Florida) which directed the Agency to appoint members and convene a technical advisory workgroup to advise the Agency in the study and development of intergovernmental transfer distribution methodologies and the best methods for ensuring the continued availability of intergovernmental transfers in any expansion of prepaid managed care in the Medicaid program.

Pursuant to SB 1484, the Agency is required to submit a report on the intergovernmental transfer methodologies developed to the Speaker of the House of Representatives, the President of the Senate, and the Governor by January 1, 2011.

Appointments to the workgroup were made by Agency for Health Care Administration Secretary Tom Arnold on June 18, 2010.

Intergovernmental Transfer (IGT) Workgroup

 

Related Documents

Please mail your comments or suggestions to:

Medicaid Reform
Office of the Deputy Secretary for Medicaid
Agency for Health Care Administration
2727 Mahan Drive, MS #8
Tallahassee, Florida 32308

Email your comments and suggestions on Medicaid reform to
medicaidreform@ahca.myflorida.com

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Reporting Medicaid Fraud