George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid...
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Transcript of George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid...
George A. Ralls M.D.Health Services Department
February 7, 2012
Legislative Update 2012
•Medicaid•DOH Reorganization
F.S. 409.915: County contributions to Medicaid
Medicaid
60 Days to pay State can withhold revenue sharing
funds if not paid
Medicaid Billed/Paid FY07-11
Medicaid
Orange County
Medicaid: Proposed Changes
• Balance between what we’ve paid and 75% of total billed– Approximately $20 Million Dollars
• 36 monthly installments directly out of revenue sharing dollars– $556,000 per month
Collection of Unpaid Bills for last 4 Years
Medicaid: Proposed Changes
• County’s eligible recipients will be determined solely on the address listed in the DCF system
• If no address, eligibility is based on the county where services were rendered– Tertiary referral centers– High risk obstetrics– Neonatal intensive care centers
Attributing Costs to Counties
Medicaid: Proposed Changes
• Beginning Dec. 2012:
–Future unpaid billings will be taken from revenue sharing after 6 months
–Counties will be paying the entire bill
–No reconciliation process or “re-billing”
Payment Method
Medicaid: Proposed Changes
• $20 Million in past denied bills
• Loss of our ability to determine County residence
• Services rendered at any of our tertiary referral centers may contribute to costs
• Mandate to pay entire bill submitted to us– 2011 billed amount was $29.5 M, versus
$17.4 M paid
Summary of local impact:
Medicaid: Proposed Changes
HB 1263 - Department of Health (DOH)
DOH Reorganization
• All CHDs have responsibilities in three functional areas:– Infectious disease prevention & control
• Surveillance, diagnosis, treatment, risk reduction
– Basic family health care services• Primary care, pre-natal care, school based
health care
– Environmental health services• Sanitary nuisances, on-site sewage disposal
systems, water well monitoring
DOH Reorganization
• Orange County Health Department:– Neighborhood Centers for Families– HUG-Me Program– Office of Community Health
• Health Disparities• Chronic Disease and Tobacco Prevention• Risk Communication• Prevention Research, Informatics, and
Health Education Center (PRIHEC)• “All In”
– PCAN Partner
DOH Reorganization
OCHD FY10 Annual Report
Orange County Health Dept
Revenues
$45 M $45.6 M
Expenditures
DOH Reorganization
FY10
OCHD Revenue Sources
DOH Reorganization
FY10
OCHD Expenditures
DOH Reorganization
• Summary of HB 1263:– Counties to take over local health depts
• Health dept employees become county employees
– DOH contracts with counties to maintain primary health department functions• Environmental Health • Communicable Disease• Primary Care
– State block grants will offset county costs
DOH Reorganization
• A significant shift of responsibilities.
• A significant increase in the County workforce.
• Will services be compromised?
• Will State block grants offset the added County costs?
• Amount based on population• No mention of funding formula yet
Concerns:
DOH Reorganization
George A. Ralls M.D.Health Services Department
February 7, 2012
Legislative Update 2012
•Medicaid•DOH Reorganization