Florida 2022 Regular Session

Florida House Bill H1237 Compare Versions

Only one version of the bill is available at this time.

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3	3	HB 1237 2022
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7	7	CODING: Words stricken are deletions; words underlined are additions.
8	8	hb1237-00
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10	10	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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14	14	A bill to be entitled 1
15	15	An act relating to nursing home accountability; 2
16	16	amending s. 400.141, F.S.; requiring licensed nursing 3
17	17	home facilities to comply with certain rules adopted 4
18	18	by the Agency for Health Care Administration; 5
19	19	requiring the agency to adopt rules establishing a 6
20	20	medical loss ratio for the disposition of Medicaid 7
21	21	revenue in excess of expenses for nursing home 8
22	22	facilities; providing the method of calculating the 9
23	23	medical loss ratio; requiring that a nursing home 10
24	24	facility pay any excess Medicaid revenue to the agency 11
25	25	by a specified date under certain circumstances; 12
26	26	requiring the agency to collect such payments; 13
27	27	authorizing the use of refunds of excess Medicaid 14
28	28	revenue to fund initiatives that improve the quality 15
29	29	of care or quality of life for nursing home facility 16
30	30	residents; requiring a nursing home facility to limit 17
31	31	the use of excess Medicaid revenues for management 18
32	32	salaries and for contracted staff or contracted 19
33	33	services; prohibiting a nursing home facility from 20
34	34	using more than a specified percentage of its total 21
35	35	expenses funded through the Medicaid program for 22
36	36	certain salaries; prohibiting a nursing home facility 23
37	37	from contracting with certain management companies for 24
38	38	staffing or services; providing an exception; 25
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40	40	HB 1237 2022
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44	44	CODING: Words stricken are deletions; words underlined are additions.
45	45	hb1237-00
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47	47	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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51	51	requiring a nursing home facility to post specified 26
52	52	information on its Internet website and update such 27
53	53	information annually; requiring a nursing home 28
54	54	facility to post a certain list on its Internet 29
55	55	website and submit such list to the agency; requiring 30
56	56	that such list be updated within a specified 31
57	57	timeframe; requiring a nursing home facility to post 32
58	58	summaries of certain contracts or agreements on its 33
59	59	Internet website within a specified timeframe; 34
60	60	requiring the agency t o adopt rules; amending s. 35
61	61	408.061, F.S.; requiring nursing homes and their home 36
62	62	offices to annually file with the agency their audited 37
63	63	actual experience for purposes of financial reporting; 38
64	64	providing an effective date. 39
65	65	40
66	66	Be It Enacted by the Legislatur e of the State of Florida: 41
67	67	42
68	68	Section 1. Paragraphs (x), (y), and (z) are added to 43
69	69	subsection (1) of section 400.141, Florida Statutes, to read: 44
70	70	400.141 Administration and management of nursing home 45
71	71	facilities.— 46
72	72	(1) Every licensed facility shall comp ly with all 47
73	73	applicable standards and rules of the agency and shall: 48
74	74	(x) Comply with rules adopted by the agency which 49
75	75	establish a medical loss ratio for the disposition of revenue in 50
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77	77	HB 1237 2022
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81	81	CODING: Words stricken are deletions; words underlined are additions.
82	82	hb1237-00
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84	84	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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86	86
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88	88	excess of expenses for nursing home facilities. 51
89	89	1. The agency shall a dopt rules requiring that a minimum 52
90	90	of 75 percent of the total Medicaid revenue of a nursing home 53
91	91	facility be spent on costs related to patient care, of which 55 54
92	92	percent must be spent on direct care, as defined by agency rule. 55
93	93	Patient care costs are calcul ated by combining direct care and 56
94	94	indirect care costs pursuant to agency rule. 57
95	95	2. If any nursing home facility fails to spend at least 75 58
96	96	percent of its total Medicaid revenue on patient care costs as 59
97	97	defined by agency rule, the nursing home facility mus t pay such 60
98	98	excess revenue to the agency by January 1 of the following 61
99	99	fiscal year. The agency shall collect such payments by any 62
100	100	method it deems necessary, including, but not limited to, 63
101	101	deductions or offsets from payments made under the Medicaid 64
102	102	program. Refunds of excess Medicaid revenue collected by the 65
103	103	agency shall be used to fund initiatives that improve the 66
104	104	quality of care or quality of life for residents of nursing home 67
105	105	facilities. Such initiatives may include, but need not be 68
106	106	limited to, surveillanc e and inspection activities; activities 69
107	107	designed to improve the quality, performance, and compliance of 70
108	108	poorly performing nursing home facilities; training and 71
109	109	education for facility staff; and activities to encourage 72
110	110	resident and consumer involvement in i nitiatives to improve the 73
111	111	quality of care or quality of life for residents of facilities. 74
112	112	(y) Limit the use of excess Medicaid revenues for 75
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121	121	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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125	125	management salaries and for contracted staff or contracted 76
126	126	services that are provided at a cost that exceeds the c urrent 77
127	127	market rates for such services. 78
128	128	1. A nursing home facility may not use more than 15 79
129	129	percent of its total expenses funded through the Medicaid 80
130	130	program for executive or managerial salaries. 81
131	131	2. A nursing home facility may not contract for staffing 82
132	132	or services with any management company that has an ownership 83
133	133	interest in the facility at a rate exceeding 10 percent of the 84
134	134	facility's in-house staffing or service costs, unless an 85
135	135	emergency has been declared as determined by the agency or as 86
136	136	defined by agency rule. 87
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138	138	The agency shall adopt rules to implement this paragraph. 89
139	139	(z) Post on its Internet website, and update annually, the 90
140	140	maximum rates to be charged for the use of facilities and the 91
141	141	provision of services, including the rates for services paid 92
142	142	through public and private payer sources. 93
143	143	1. A nursing home facility shall post on its Internet 94
144	144	website a list of all facility owners and submit such list to 95
145	145	the agency for posting on the agency's Internet website. Such 96
146	146	list must be updated within 30 days after any changes are made 97
147	147	to the list. 98
148	148	2. A nursing home facility shall also post on its Internet 99
149	149	website a summary of any contract or agreement entered into by 100
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151	151	HB 1237 2022
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155	155	CODING: Words stricken are deletions; words underlined are additions.
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158	158	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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162	162	the facility for the provision of goods or services in w hich the 101
163	163	facility has an ownership interest and pays for such goods or 102
164	164	services using any portion of Medicaid funds within 30 days 103
165	165	after such contract or agreement is executed. 104
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167	167	The agency shall adopt rules to implement this paragraph. 106
168	168	Section 2. Subsections (5) and (6) of section 408.061, 107
169	169	Florida Statutes, are amended to read: 108
170	170	408.061 Data collection; uniform systems of financial 109
171	171	reporting; information relating to physician charges; 110
172	172	confidential information; immunity. — 111
173	173	(5) Within 120 days after the end of its fiscal year, each 112
174	174	nursing home as defined in s. 408.07 shall file with the agency, 113
175	175	on forms adopted by the agency and based on the uniform system 114
176	176	of financial reporting, its actual financial experience for that 115
177	177	fiscal year, including expenditur es, revenues, and statistical 116
178	178	measures. Such data may be based on internal financial reports 117
179	179	that are certified to be complete and accurate by the chief 118
180	180	financial officer of the nursing home. A nursing home's actual 119
181	181	financial experience shall be its audite d actual experience. 120
182	182	This audited actual experience must include the fiscal year -end 121
183	183	balance sheet, income statement, statement of cash flow, and 122
184	184	statement of retained earnings and must be submitted to the 123
185	185	agency in addition to the information filed in the uniform 124
186	186	system of financial reporting. The financial statements must tie 125
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188	188	HB 1237 2022
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192	192	CODING: Words stricken are deletions; words underlined are additions.
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195	195	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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199	199	to the information submitted in the uniform system of financial 126
200	200	reporting, and a crosswalk must be submitted along with the 127
201	201	financial statements. 128
202	202	(6) Within 120 days after the end of its fiscal year, the 129
203	203	home office of each nursing home as defined in s. 408.07 shall 130
204	204	file with the agency, on forms adopted by the agency and based 131
205	205	on the uniform system of financial reporting, its actual 132
206	206	financial experience for that fiscal year, includ ing 133
207	207	expenditures, revenues, and statistical measures. Such data may 134
208	208	be based on internal financial reports that are certified to be 135
209	209	complete and accurate by the chief financial officer of the 136
210	210	nursing home. The actual financial experience of the home office 137
211	211	of a nursing home shall be its audited actual experience. This 138
212	212	audited actual experience must include the fiscal year -end 139
213	213	balance sheet, income statement, statement of cash flow, and 140
214	214	statement of retained earnings and must be submitted to the 141
215	215	agency in addition to the information filed in the uniform 142
216	216	system of financial reporting. The financial statements must tie 143
217	217	to the information submitted in the uniform system of financial 144
218	218	reporting, and a crosswalk must be submitted along with the 145
219	219	audited financial st atements. 146
220	220	Section 3. This act shall take effect October 1, 2022. 147