George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid...
-
Upload
candace-taylor -
Category
Documents
-
view
212 -
download
0
Transcript of George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid...
![Page 1: George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid DOH Reorganization.](https://reader030.fdocuments.in/reader030/viewer/2022032722/56649f425503460f94c61dcb/html5/thumbnails/1.jpg)
George A. Ralls M.D.Health Services Department
February 7, 2012
Legislative Update 2012
•Medicaid•DOH Reorganization
![Page 2: George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid DOH Reorganization.](https://reader030.fdocuments.in/reader030/viewer/2022032722/56649f425503460f94c61dcb/html5/thumbnails/2.jpg)
F.S. 409.915: County contributions to Medicaid
Medicaid
60 Days to pay State can withhold revenue sharing
funds if not paid
![Page 3: George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid DOH Reorganization.](https://reader030.fdocuments.in/reader030/viewer/2022032722/56649f425503460f94c61dcb/html5/thumbnails/3.jpg)
Medicaid Billed/Paid FY07-11
Medicaid
Orange County
![Page 4: George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid DOH Reorganization.](https://reader030.fdocuments.in/reader030/viewer/2022032722/56649f425503460f94c61dcb/html5/thumbnails/4.jpg)
Medicaid: Proposed Changes
![Page 5: George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid DOH Reorganization.](https://reader030.fdocuments.in/reader030/viewer/2022032722/56649f425503460f94c61dcb/html5/thumbnails/5.jpg)
• 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
![Page 6: George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid DOH Reorganization.](https://reader030.fdocuments.in/reader030/viewer/2022032722/56649f425503460f94c61dcb/html5/thumbnails/6.jpg)
• 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
![Page 7: George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid DOH Reorganization.](https://reader030.fdocuments.in/reader030/viewer/2022032722/56649f425503460f94c61dcb/html5/thumbnails/7.jpg)
• 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
![Page 8: George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid DOH Reorganization.](https://reader030.fdocuments.in/reader030/viewer/2022032722/56649f425503460f94c61dcb/html5/thumbnails/8.jpg)
• $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
![Page 10: George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid DOH Reorganization.](https://reader030.fdocuments.in/reader030/viewer/2022032722/56649f425503460f94c61dcb/html5/thumbnails/10.jpg)
HB 1263 - Department of Health (DOH)
DOH Reorganization
![Page 11: George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid DOH Reorganization.](https://reader030.fdocuments.in/reader030/viewer/2022032722/56649f425503460f94c61dcb/html5/thumbnails/11.jpg)
• 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
![Page 12: George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid DOH Reorganization.](https://reader030.fdocuments.in/reader030/viewer/2022032722/56649f425503460f94c61dcb/html5/thumbnails/12.jpg)
• 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
![Page 13: George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid DOH Reorganization.](https://reader030.fdocuments.in/reader030/viewer/2022032722/56649f425503460f94c61dcb/html5/thumbnails/13.jpg)
OCHD FY10 Annual Report
Orange County Health Dept
Revenues
$45 M $45.6 M
Expenditures
DOH Reorganization
![Page 14: George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid DOH Reorganization.](https://reader030.fdocuments.in/reader030/viewer/2022032722/56649f425503460f94c61dcb/html5/thumbnails/14.jpg)
FY10
OCHD Revenue Sources
DOH Reorganization
![Page 15: George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid DOH Reorganization.](https://reader030.fdocuments.in/reader030/viewer/2022032722/56649f425503460f94c61dcb/html5/thumbnails/15.jpg)
FY10
OCHD Expenditures
DOH Reorganization
![Page 16: George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid DOH Reorganization.](https://reader030.fdocuments.in/reader030/viewer/2022032722/56649f425503460f94c61dcb/html5/thumbnails/16.jpg)
• 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
![Page 17: George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid DOH Reorganization.](https://reader030.fdocuments.in/reader030/viewer/2022032722/56649f425503460f94c61dcb/html5/thumbnails/17.jpg)
• 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
![Page 18: George A. Ralls M.D. Health Services Department February 7, 2012 Legislative Update 2012 Medicaid DOH Reorganization.](https://reader030.fdocuments.in/reader030/viewer/2022032722/56649f425503460f94c61dcb/html5/thumbnails/18.jpg)
George A. Ralls M.D.Health Services Department
February 7, 2012
Legislative Update 2012
•Medicaid•DOH Reorganization