Medicaid Program Finance

Tom Wallace
Bureau Chief

2727 Mahan Drive
Mail Stop #23
Tallahassee, FL 32308

Phone: (850) 412-4102
Fax: (850) 922-5172 

The Bureau of Medicaid Program Finance (MPF) is responsible for the fiscal planning of the $23.6 billion Florida Medicaid Services budget. The Bureau administers the Low Income Pool and Disproportionate Share programs and sets reimbursement rates for inpatient/outpatient hospitals, County Health Departments, Federally Qualified Health Centers, Intermediate Care Facilities, and nursing homes. MPF also monitors the financial performance and health of Medicaid managed care health plans. 

Budget and Fiscal Planning

The Budget and Fiscal Planning unit is responsible for estimating, implementing and tracking the Florida Medicaid budget.

Financial Monitoring

The Financial Monitoring unit oversees the financial reporting of contracted Medicaid Health Maintenance Organizations (HMOs) and Provider Service Networks (PSNs) as well as reviewing the reporting of the Medical Loss Ratio and the Achieved Savings Rebate.

Institutional Reimbursements

This Hospitals/CHD/ICF Rates unit calculates the Medicaid reimbursement rates for institutional providers. These providers include inpatient and outpatient hospitals, Federally Qualified Health Centers (FQHCs), County Health Departments (CHDs), and Intermediate Care Facilities (ICFs).

LIP/DSH/GME Operations

The LIP/DSH/GME Operations unit ensures continued government support for the provision of health care services to Medicaid, underinsured and uninsured populations through the Low Income Pool (LIP) program. The Disproportionate Share Hospital (DSH) program distributes moneys to hospitals providing a disproportionate share of Medicaid or charity care services. The Graduate Medical Education (GME) Statewide Residency program is made up of $80 million used to provide funding to qualified participating hospitals involved in graduate medical education.

Nursing Homes and Audit Services

The Nursing Home unit calculates reimbursement rates for nursing home Medicaid providers. Audit Services is responsible for the collection and review of nursing home cost reports based on Medicaid and cost reporting requirements.