by Steven Carr



This morning, the House Health Care Appropriations Committee released its proposed budget for Fiscal Year 2023-2024. Read below for FHA’s summary and analysis.

For far too many years, legislative budget proposals have routinely included a variety of Medicaid reimbursement cuts to hospitals. FHA has been focused on building and strengthening relationships with state legislators and providing critical information about the role of hospitals and the current financial challenges affecting Florida’s hospitals. I am happy to share that the proposed budget released by the state House today DOES NOT INCLUDE ANY CUTS TO HOSPITAL MEDICAID REIMBURSEMENT and lawmakers have capitalized on several opportunities to enhance Medicaid funding for providers who treat Florida’s most vulnerable patients; including rate increases for pediatric physicians and pediatric behavioral health providers, as well as investments in our physician workforce through Medicaid GME.

As previously reported, two important FHA priorities remain intact through the first phase of budget releases: $125 million for the LINE & PIPELINE Programs to expand the capacity of nurses, and $126 million to expand community-based behavioral health services.

The latest General Revenue Conference held in March projects that the current year budget will have a surplus of $15.7B in General Revenue to be carried forward into the next fiscal year. The carry-forward balance reflects approximately 1/3 of the General Revenue need for the State. This forecast is driven by consumer spending dramatically increasing sales tax collections far beyond those originally projected. Additionally, there is $3.14B in the Budget Stabilization fund.
After several years of contending with proposed cuts to Medicaid reimbursement for care provided to Medicaid patients, we are pleased to see a budget that prioritizes critical health care services for Florida’s most vulnerable individuals. Thank you for your advocacy and we look forward to continuing to work together for a final state budget that supports a bright future for Florida’s healthcare delivery system.

FHA President & CEO Mary Mayhew issued the following statement:

“Florida hospitals deliver the high-quality care that Florida residents and visitors expect and deserve. But with hundreds of people moving to Florida daily, the demand for health care services is skyrocketing. As we think about the future of Florida, we must have strong and financially stable hospitals with a robust health care workforce. FHA is grateful to the Florida Legislature and legislative leaders including Senate President Passidomo, House Speaker Renner, and Health Care Appropriations Chairs Senator Harrell and Representative Garrison for championing important investments in the state health care system. We are proud to see an increased commitment to mental health and substance use disorder treatment, strengthening our pipeline of health care workers and making it more adorable for them to live and work in the Sunshine State. These meaningful investments are critical to Florida’s future economic vitality and to supporting a modern, sophisticated health care delivery system ready to provide worldclass care.”

Please review below for a summary and highlights of the budget proposals that have been released so far. I encourage you to contact us if you have any questions or comments.

House Health & Human Services

The House’s proposed Health and Human Services budget totals $46.8B, of which $14.7B is General Revenue, representing a decrease of 4.5 percent in total funds for the HHS budget. This initial Senate proposal maintains the Medicaid Budget and considers the reduction in caseload due to the end of the Public Health Emergency (PHE) and the start of Medicaid redeterminations. Additionally, this budget factors in the step-down of the enhanced FMAP with the unwinding of the PHE.

Highlights of Additional funding within the AHCA budget include:

  • $30M Graduate Medicaid Education for the Slots for Doctors Program
  • $76.1M Rate Increase for Medicaid Pediatric Physician Services
  • $34.7M for Modification to the KidCare income threshold
  • $9M Rate Increase for ICF/IID level three individuals
  • $9.7M Rate Increase for Durable Medical Equipment
  • $95.5M Nursing Home Quality Component Rate Increase
  • $2.5M Maternal Fetal Medicine Provider Rate Increase
  • $5.4M Medicaid Behavioral Health Services Rate Increase

Highlights of the Department of Children and Families budget

  • Continues the $126M recurring investment to expand community-based behavioral health through CAT, FIT, FACT teams and mobile response models
  • $7.7M Electronic Health Records – Mental Health Treatment Facilities
  • $1.4M Recurring Funding for Florida Assertive Community Treatment (FACT) Team – Putnam and St. Johns Counties
  • $19M Homelessness Housing Opportunities
  • $42.9M Mental Health Treatment Bed Capacity Maintenance
  • $110.6M for State Opioid Response Grant Budget Authority Request for grants
  • $156.3M for Substance Abuse and Mental Health (SAMH) Block Grant
  • $110M Opioid Settlement Funding
  • 22 positions and $4.3M of Opioid Settlement – Office of Opioid Recovery
  • $26.8M Opioid Settlement – Coordinated Opioid Recovery (CORE)
  • $6M Opioid Settlement – On-Demand Mobile Medication-Assisted Treatment
  • $4M Opioid Settlement – Hospital Bridge Programs
  • $10M Opioid Settlement – Naloxone
  • $6.5M Opioid Settlement – Recovery Housing

Highlights of the Agency for Persons with Disabilities budget

  • 35 additional positions to assist with placement on individuals in group homes/intermediate care facilities
  • $79.6M Serve Additional Clients on the Home and Community-Based Services Waiver Waitlist

Highlights of the Department of Health budget

  • $27.5M to expand the Casey DeSantis Cancer Research Program
  • $12.7M for the expansion of Maternal Health Improvement through coordinated telehealth
  • $682K Children’s Medical Services Child Protection Team’s Statewide Forensic Interview System Improvement
  • $20M to establish the Florida Cancer Innovation Fund within the Biomedical Research TF to promote emerging cancer research grants

Having released both chambers’ budgets, here is an overview of some of the major differences between the House & Senate’s budgets.

Item Florida Senate Florida House
Medicaid Budget No Cuts to Hospital Medicaid Reimbursement No Cuts to Hospital Medicaid Reimbursement
No Cuts to Hospital Medicaid Reimbursement $76.5M Included Not Included
Pediatric Physician rate Increase $76.2M total
GME Adjustments $143M for Graduate Medical Education (GME). Of which, the Senate allocated $50.2M in General Revenue
• $93.8M to the Statewide Medicaid Residency Program
• $30M for the Slots for Doctors Program
• $15.5M in Additional funds for the GME Program
• $4M for the Certified Addition Medicine Physician Program
$30M increase for Slots for Doctors
KidCare Expansion to 300% of FPL $0 $34.7M total
Medicaid Pediatric Behavioral Health Services Provider Rate Increase $15M total $5.4M total
Medicaid Reimbursement for Community Mental Health and Substance Abuse Services $29.7M total $0
Supplemental Payment Programs LIP – modifies authority for LIP requiring an AHCA Budget Amendment LIP – modifies authority for LIP requiring an AHCA Budget Amendment

Makes similar changes in the Physician Supplemental Payment Program & Emergency Medical Transportation Program

Thank you,

Mary C. Mayhew
President & CEO

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