409.9112 Disproportionate share program for regional perinatal intensive care centers.
409.9112 Disproportionate share program for regional perinatal intensive care centers.
In addition to the payments made under s. 409.911, the agency shall design and implement a system for making disproportionate share payments to those hospitals that participate in the regional perinatal intensive care center program established pursuant to chapter 383. The system of payments must conform to federal requirements and distribute funds in each fiscal year for which an appropriation is made by making quarterly Medicaid payments. Notwithstanding s. 409.915, counties are exempt from contributing toward the cost of this special reimbursement for hospitals serving a disproportionate share of low-income patients. For the 2010-2011 state fiscal year, the agency may not distribute moneys under the regional perinatal intensive care centers disproportionate share program.
(1) The following formula shall be used by the agency to calculate the total amount earned for hospitals that participate in the regional perinatal intensive care center program:
TAE = HDSP/THDSP
Where:
TAE = total amount earned by a regional perinatal intensive care center.
HDSP = the prior state fiscal year regional perinatal intensive care center disproportionate share payment to the individual hospital.
THDSP = the prior state fiscal year total regional perinatal intensive care center disproportionate share payments to all hospitals.
(2) The total additional payment for hospitals that participate in the regional perinatal intensive care center program shall be calculated by the agency as follows:
TAP = TAE x TA
Where:
TAP = total additional payment for a regional perinatal intensive care center.
TAE = total amount earned by a regional perinatal intensive care center.
TA = total appropriation for the regional perinatal intensive care center disproportionate share program.
(3) In order to receive payments under this section, a hospital must be participating in the regional perinatal intensive care center program pursuant to chapter 383 and must meet the following additional requirements:
(a) Agree to conform to all departmental and agency requirements to ensure high quality in the provision of services, including criteria adopted by departmental and agency rule concerning staffing ratios, medical records, standards of care, equipment, space, and such other standards and criteria as the department and agency deem appropriate as specified by rule.
(b) Agree to provide information to the department and agency, in a form and manner to be prescribed by rule of the department and agency, concerning the care provided to all patients in neonatal intensive care centers and high-risk maternity care.
(c) Agree to accept all patients for neonatal intensive care and high-risk maternity care, regardless of ability to pay, on a functional space-available basis.
(d) Agree to develop arrangements with other maternity and neonatal care providers in the hospital’s region for the appropriate receipt and transfer of patients in need of specialized maternity and neonatal intensive care services.
(e) Agree to establish and provide a developmental evaluation and services program for certain high-risk neonates, as prescribed and defined by rule of the department.
(f) Agree to sponsor a program of continuing education in perinatal care for health care professionals within the region of the hospital, as specified by rule.
(g) Agree to provide backup and referral services to the county health departments and other low-income perinatal providers within the hospital’s region, including the development of written agreements between these organizations and the hospital.
(h) Agree to arrange for transportation for high-risk obstetrical patients and neonates in need of transfer from the community to the hospital or from the hospital to another more appropriate facility.
(4) Hospitals which fail to comply with any of the conditions in subsection (3) or the applicable rules of the department and agency may not receive any payments under this section until full compliance is achieved. A hospital which is not in compliance in two or more consecutive quarters may not receive its share of the funds. Any forfeited funds shall be distributed by the remaining participating regional perinatal intensive care center program hospitals.
History. s. 40, ch. 91-282; s. 123, ch. 97-101; s. 186, ch. 99-8; s. 14, ch. 2003-405; s. 14, ch. 2004-270; s. 12, ch. 2005-60; s. 7, ch. 2008-143; s. 10, ch. 2009-55; s. 11, ch. 2010-156.