Bryan Ávila wants to know why retirement homes and hospitals are always looking for more money

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The state may be strapped for cash, but the chairman of the House Health Care Spending Committee says accountability is still important.

representing Bryan Avila pressed the Secretary of the Agency for Health Care Administration on Tuesday Simone Martiller on the spending recommendations included in the legislative budget proposal presented by his boss, the governor. Ron DeSantis.

Among other things, DeSantis proposed health care budget for the financial year 2022-2023 The budget recommended the state continue to provide rate improvements to hospitals that provide the most Medicaid in the state. The governor also recommended the Legislature spend an additional $185 million to increase reimbursement rates for Florida’s 690 skilled nursing facilities.

The decision to keep the rate improvements intact reverses a decision by the Florida Legislature last year to eliminate the money. the Safety Net Hospital Alliance of Florida dubbed the enhanced payments the “Critical Care Fund.”

Ávila noted that hospitals received $3 billion in federal grants CARE funding and are set to benefit from a new $1.8 billion supplemental Medicaid program the Legislature created last year called “direct provider payments.”

Given this, Ávila asked Marstiller, “What is the rationale for restoring these automatic rate improvements?”

Marstiller told Ávila that federal funding for CARES is non-recurring and said hospitals continue to see rising costs of care. Additionally, she noted that hospitals are facing staffing shortages.

Therefore, she said the governor “didn’t recommend any rate cuts to them.”

Marstiller also explained that the new supplemental payment program helps hospitals make up the difference between care delivery costs and Medicaid reimbursements. She said the funding also helps hospitals train their staff.

Ávila noted that targeted funding for the critical care fund could be used, however, to help alleviate a labor shortage instead.

“Wouldn’t those funds from hospital rate improvements be better spent on issues like staffing?” Ávila asked Marstiller. “Which is most needed?”

Marstiller tried to avoid answering the question directly, but when Ávila pressed again, she said, “I would hate to say we should or must choose one over the other. These are all critical issues for your hospitals.

Ávila also lobbied Marstiller over the governor’s recommended increases for nursing homes, noting that the Legislative Budget Committee has approved a $104 million increase over three months in nursing home tariffs.

Marstiller said the temporary bump expired in January. Additionally, she said nursing homes — where residents’ care is primarily paid for by Medicaid — are facing critical staffing issues. Nursing staff, she said, are “falling in droves.”

“We need to make sure these nursing homes can continue to operate,” Marstiller said, adding that when skilled nursing facilities fall below staffing requirements, they are required to impose a moratorium on nursing. acceptance of new residents.

Ávila, however, did not seem sympathetic and said the legislature is asked to raise rates every year.

“It almost seems like the agency should have candid conversations with the industry and either say you need to diversify your business model or it’s just not a working business model anymore,” Ávila said. “Did these conversations take place? Because it almost feels like the nursing home industry – as well as the hospitals – always comes back and that’s always a problem. It’s always a need for more money.

Marstiller said she speaks with the nursing home industry regularly, but would be happy to “start” the conversations.

Ávila noted that it is important to ensure that the state is accountable for its spending.

“At the end of the day, a dollar that goes somewhere, probably where it shouldn’t go, keeps it from going to someone who really needs it, especially in health care,” Ávila said. .


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