Nursing Home Prospective Payment System

During the 2016 Legislative Session, Legislation passed requiring the Agency to contract with an independent consultant to develop a plan to convert Medicaid payments for nursing home services from a cost based reimbursement methodology to a prospective payment system. The Agency has engaged Navigant Consulting, Inc. to perform the study and develop the plan.

The plan is required to identify steps necessary complete the transition in a budget neutral manner. Additionally, the plan is required to address the impact of a prospective payment system on Medicaid reimbursement rates for hospice providers. As required by Specific Appropriation 186 of the 2016 General Appropriations Act, the plan will be submitted to the Governor, the President of the Senate, and the Speaker of the House of Representatives no later than January 1, 2017.

Florida Nursing Home Ventilator Recipient Data Request

The Agency for Health Care Administration (the Agency) is seeking a data submission from Medicaid nursing home providers related to Medicaid recipients receiving ventilator care.  Section 409.908, Florida Statutes requires a ventilator supplemental payment of $200 per Medicaid day within the prospective payment system effective October 1, 2018.  In order to calculate the supplemental payments for the October 1, 2018 rate setting, the Agency is requesting the attached data submission for ventilator dependent Medicaid recipients with dates of service from January 1, 2017 through December 31, 2017.  Please list the information for each ventilator dependent Medicaid recipient on a separate line.

To submit this data to the Agency, either:
  1. Send the file in an encrypted email to NH.Reimbursement@AHCA.MyFlorida.com.  Please use your encryption program to ensure this information remains secure.
  2. Send the file via a secure file share site.  Please send your file sharing instructions to NH.Reimbursement@AHCA.MyFlorida.com.
This data is due no later than May 15, 2018 for the October 1, 2018 rate setting.

Florida Nursing Home Ventilator Recipient Data Request [11KB MS Excel]

Nursing Facility Payment Method Recommendations Report [3.77MB]

Public Comments

LeadingAge Florida Comments, June 30, 2016 [502KB]

LeadingAge Florida Presentation, submitted August 12, 2016 [237KB]

LeadingAge Florida Meeting Comments, August 18, 2016 [443KB]

Florida Health Care Association Comments [73KB]

Florida Health Care Association Testimony, August 18, 2016 [76KB]

1199SEIU UHWE Florida Prospective Payment Recommendations, September 20, 2016 [334KB]

LeadingAge Florida Comments for the September 22, 2016 PPS Public Meeting [542KB]

Florida Health Care Association Recommendations, October 21, 2016 [62KB]

1199SEIU UHWE Comments on Navigant’s Draft Model at AHCA Public Meeting, September 22, 2016 [319KB]

LeadingAge Florida Comments Regarding the PPS Plan Presented at the September 22, 2016 Public Meeting [489KB]

LeadingAge Florida Comments for November 17, 2016 PPS Public Meeting [493KB]

1199SEIU UHWE Comments on Navigant’s Draft Model at AHCA Public Meeting November 17, 2016 [136KB]

LeadingAge Florida Comments for the December 8, 2016 PPS Public Meeting [504KB]

Public Meetings

The Agency for Health Care Administration (Agency) is hosting a public meeting regarding Nursing Home Prospective Payment System.

Location Date Time Meeting Materials

Agency for Health Care Administration
2727 Mahan Drive
Bldg. 3, Conference Room D
Tallahassee, FL 32308

A conference number will also be available for those unable to attend in person.

Operated assisted Conference number:
Dial-in Number: 1 (888) 419-5570, code 469-258-83

December 8, 2016

1:00 p.m. - 4:00 p.m.

FAR

Webinar Link

Agenda [191KB]

Presentation [316KB]

Audio of Meeting [8.49MB]

Simulation Results [1.25MB]

Simulation Results with 5% limit [899KB]

Agency for Health Care Administration
2727 Mahan Drive
Bldg. 3, Conference Room A
Tallahassee, FL 32308

A conference number will also be available for those unable to attend in person.

Operated assisted Conference number:
Dial-in Number: 1 (888) 419-5570, code 957-500-30

November 17, 2016

1:00 p.m. - 4:00 p.m.

FAR Notice

Webinar Link

Agenda [192KB]

Presentation [445KB]

Audio of Meeting [18.92MB MP3]

Simulation Results [2.35MB]

Agency for Health Care Administration
2727 Mahan Drive
Bldg. 3, Conference Room A
Tallahassee, FL 32308

A conference number will also be available for those unable to attend in person.

Operator assisted conference call:
Dial-in Number: 1 (888) 419-5570, Conference Code 940-776-14

October 26, 2016 2:30 pm - 5:00 pm

FAR Notice

Webinar Link

Agenda [192KB]

Presentation [697KB]

Audio of Meeting
[20.77MB MP3]

Simulation Parameters
[23KB]

Simulation Results
[1.99MB]

Agency for Health Care Administration
2727 Mahan Drive
Bldg. 3, Conference Room A
Tallahassee, FL 32308

A conference number will also be available for those unable to attend in person.

Operator assisted conference call:
Dial-in Number: 1 (888) 419-5570, Conference Code 728-241-52

September 22, 2016 1:00 pm – 4:00 pm

FAR Notice

Webinar Link

Agenda [192KB]

Presentation [582KB]

Audio of Meeting
[17.12MB MP3]

Agency for Health Care Administration
2727 Mahan Drive
Bldg. 3, Conference Room A
Tallahassee, FL 32308

A conference number will also be available for those unable to attend in person.

Dial-in Number: 1 (866) 515-2908, Conference Code 937-258-66

August 18, 2016 1:00 pm – 4:00 pm

FAR Notice

Governance Meeting Summary
[368KB]

Agenda [85KB]

Presentation [637KB]

Webinar Link

Audio of Meeting
[27.53MB MP3]

Agency for Health Care Administration
2727 Mahan Drive
Bldg. 3, Conference Room A
Tallahassee, FL 32308

A conference number will be available for those unable to attend in person.

Dial-in Number: 1 (888) 670-3525, Conference Code 906-716-2866.

June 30, 2016 1:00 pm - 4:00 pm

FAR Notice

Governance Meeting Summary
[370KB]

Agenda [81KB]

Presentation [499KB]

Webinar Link

Audio of Meeting
[29.56MB MP3]