SUBJECT:
Title
PUBLIC HEARING to Consider an Ordinance Amending the Marion County Code, Chapter 17, Special Assessments, Article VI, The Marion County Local Provider Participation Fund Non-Ad Valorem Special Assessment
Body
|
INITIATOR: |
DEPARTMENT: |
|
Matthew G. Minter, County Attorney |
County Attorney |
DESCRIPTION/BACKGROUND:
On July 6, 2021, the Board of County Commissioners (BCC) adopted Ordinance No. 21-18, establishing the Marion County Local Provider Participation Fund. The ordinance requires the hospitals to pay a uniform, non-ad valorem special assessment, set annually by resolution by the BCC, on hospitals that have an ownership or leasehold interest in real property in Marion County. Hospitals in Marion County annually provide millions of dollars of uncompensated care to persons who qualify for Medicaid. The hospitals report that on average, Medicaid typically only covers 60% of the costs of the healthcare services provided by hospitals to Medicaid-eligible persons, leaving hospitals with significant uncompensated costs. The Centers for Medicare & Medicaid Services (CMS) Medicaid managed care regulations at 42 C.F.R Part 438 govern how states may direct plan expenditures in connection with implementing delivery system and provider payment initiatives under Medicaid managed care contracts. In November 2017, CMS published guidance for states to obtain approval of state-directed payments under 42 C.F.R. § 438.6(c). The State of Florida received CMS approval of its proposal for its directed payment program arrangement on April 26, 2021. The non-federal share of the program will be obtained through the proposed non-ad valorem assessments to be levied on each participating private hospital.
In 2025, Congress passed the One Big Beautiful Bill Act (OBBBA), a transformational piece of legislation for the Medicaid landscape, which affected how states can finance Medicaid programs and what opportunities remain available for the future. Florida is now seeking waivers to exempt certain facilities from the provider taxes in 19 local jurisdictions across the state. If CMS grants the waivers, the exempt facilities will no longer be subject to the assessment. While the state and CMS continue to negotiate these waivers, Marion County should alter the current ordinance language to prepare for the possible exemptions. The amended language addresses the new quality incentive program, the exemption of waiver facilities, and clearly identifies the authorized purposes and programs qualifying under the DPP, as an outcome of the federal changes implemented through the OBBBA.
BUDGET/IMPACT:
None
RECOMMENDED ACTION:
Recommended action
Motion to approve the Ordinance.
end