Medicaid Program Finance

Lisa Smith
Bureau Chief

2727 Mahan Drive
Mail Stop #23
Tallahassee, FL 32308

Phone: (850) 412-4114
Fax: (850) 922-5172 

The Bureau of Medicaid Program Finance (MPF) is responsible for the fiscal planning of the $28.3 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.

Finance and Banking Operations

This bureau section is responsible for overseeing the management and monitoring of the financial and banking functions of the Fiscal Agent to ensure appropriate payment of Medicaid claims, including coordinating all federal IRS tax reporting efforts for payments made to providers.

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

The Cost Reimbursement unit calculates the Medicaid reimbursement rates for institutional providers. These providers include inpatient and outpatient hospitals, ambulatory surgical centers (ASCs), Skilled Nursing Units (SNUs), Swing Beds, Hospices, Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), County Health Departments (CHDs), Intermediate Care Facilities (ICFs), and Statewide Inpatient Psychiatric Program (SIPP) providers.

LIP/DSH/GME Operations

The LIP/DSH/GME Operation Unit manages supplemental payment funding distributions and monitors state and federal compliance for the Low Income Pool (LIP) program, Disproportionate Share Hospital (DSH) program, Graduate Medical Education (GME) program, Medicaid School Faculty Physicians payments, Public Emergency Medical Transportation (PEMT) program, and the Florida Cancer Hospital (FCHP) program.

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.