Subject:
Title
Certification of Low-Income Pool Charity Costs with the State of Florida Agency for Health Care Administration.
label
Recommended Action:
Recommended Action
Approval and execution by the County Administrator of the Certification of Low-Income Pool Charity Costs with the State of Florida Agency for Health Care Administration (AHCA).
• This attestation is required per the Laws of Florida Chapter 2024-228 Section 14, Page 11, which reads “In addition, for each entity included in the distribution model, a signed attestation must be provided that includes the charity care cost upon which the Low Income Pool payment is based and an acknowledgment that should the distribution result in an overpayment based on the Low Income Pool cost limit audit, the entity is responsible for returning that overpayment to the agency for return to the federal Centers for Medicare and Medicaid Services. This section expires July 1, 2025.”
• The LIP funds Pinellas County is forecasted to receive totals $332,374.00, which is substantially below the charity care amount of $1,866,104.00 Consequently, it is highly unlikely that we will need to repay anything back to AHCA.
• This is the second year the State has requested this form, and it must be returned to the Agency before they will move forward with the Low-Income Pool.
• The form follows the requirements in the LIP Reimbursement and Funding Methodology Document (attached). It confirms an eligible provider's (CHCs, for example) agreement to repay any amount above the charity care number resulting from the Myers and Stauffer audit.
• This attestation by itself does not have a fiscal impact. The funding referenced in the attestation is included in the Fiscal Year 2025 Proposed Budget.Body
Strategic Plan:
Ensure Public Health, Safety, and Welfare
2.1 Provide planning, coordination, prevention, and protective services to ensure a safe and secure community
2.2 Be a facilitator, convener, and purchaser of services for those in need
Deliver First Class Services to the Public and Our Customers
5.1 Maximize partner relationships and public outreach
5.2 Be responsible stewards of the public’s resources
5.3 Ensure effective and efficient delivery of county services and support
Summary:
The Certification of Low-Income Pool Charity Costs with the State of Florida Agency for Health Care Administration (AHCA) is required per the Laws of Florida Chapter 2024-228 Section 14, Page 11, which attests to the charity care cost upon which the Low Income Pool payment is based and acknowledges that should the distribution result in an overpayment based on the Low Income Pool cost limit audit, the entity is responsible for returning that overpayment to the agency for return to the federal Centers for Medicare and Medicaid Services (CMS). This form was also requested in SFY23-24 and must be returned to the Agency before they will move forward with the Low Income Pool.
The form follows the requirements in the LIP Reimbursement and Funding Methodology Document (attached). It confirms an eligible provider's (CHCs, for example) agreement to repay any amount above the charity care number resulting from the Myers and Stauffer audit.
Background/Explanation:
Pinellas County continues to seek opportunities to assist local hospital and healthcare partners in maximizing revenues while serving our most needy citizens. State funding known as Medicaid LIP allows local governments to increase certain Medicaid hospital and other healthcare provider payments by providing the required State Medicaid Assistance Percentage (SMAP) through Intergovernmental Transfers (IGTs).
Fiscal Impact:
This attestation by itself does not have a fiscal impact. The funding referenced in the attestation is included in the FY25 Proposed Budget.
The current information from the State of Florida Agency for Health Care Administration (AHCA) indicates an expected IGT of $249,004.00 from Pinellas County for the Healthcare for the Homeless Program. Funding has been designated within the Human Services Fiscal Year (FY) 2025 Proposed Budget in the amount of $250,000.00 for the IGT related to the County’s Healthcare for the Homeless Program. The County is expected to receive an additional $83,370.00 back from AHCA for a total of $332,374.00, which is substantially below the charity care amount of $1,866,104.00. Consequently, it is highly unlikely that the County will need to repay anything back to AHCA.
Delegated Authority:
Authority for the County Administrator to sign this Certification is granted under Code Section 2-62 (a)(1).
Staff Member Responsible:
Karen Yatchum, Director, Human Services
Partners:
N/A
Attachments:
AHCA Certification Form
LIP Reimbursement and Funding Methodology Document