HB 5305 Summary

• Amends Florida Statutes Section 409.908 to revise the prospective payment methodology for Medicaid reimbursement rates for nursing home care, effective October 1, 2023.

• Divides the patient care component of per diem rates into direct care and indirect care subcomponents, with separate pricing calculations based on September 2016 cost reports and subsequently on most recently audited cost reports during rebasing years.

• Establishes specific payment parameters including direct care costs at 100% of median costs, indirect care costs at 92%, operating costs at 86%, floors of 95% for direct care and 92.5% for indirect care, and pass-through payments for real estate taxes and property insurance.

• Requires rate rebasing every four years using the most recently audited cost report for each participating provider, and mandates the agency report direct and indirect care costs to the Legislature annually on July 1.

• Exempts pediatric, Florida Department of Veterans Affairs, and government-owned facilities from the pricing model and maintains them on a cost-based prospective payment system without retroactive settlements.