LIP Offer from Feds on Florida's Table

May 21, 2015

Credit sacred-heart.org

Uncle Sam is offering a one billion dollar compromise to Florida, regarding the Low Income Pool – which is provided to hospitals to help pay for uninsured and under-insured patients and is scheduled to expire on June 30 if not renewed.

State Senator Don Gaetz made the announcement on Thursday, adding that there are a number of conditions. One is that the LIP money must follow the patient. That’s a catch he says the state has known about for some time.

“That the money needs to follow the patient, wherever the patient who is uninsured goes, that’s where the Low Income Pool money should be applied,” Gaetz said. “And the federal government has required that we do that for a year. The state of Florida chose not to make a proposal.”

Such a proposal in the Florida Senate became the state’s proposal, in trying to secure the $2.2 billion LIP allocated to Florida. But he adds even if the one billion dollar offer is accepted, the state would still be on the hook for the remainder.

“Anything less than $2.2 billion, we’ll have to make up by diluting other forms of revenue, and other critical needs,” said Gaetz. And that’s the budget stress where health care affects how we balance the budget.

Gaetz says northwest Florida would benefit from the “Follow the Patient” provision, because a lop-sided amount of LIP funding currently is being sent downstate.

The offer comes one day after the new Commission on Healthcare and Hospital Funding met for the first time. Created by Gov. Rick Scott, the panel sought data from hospitals and related facilities. Many – including Sacred Heart Health System CEO Susan Davis -- referred the Governor to data already on file with the Florida Agency for Health Care Administration

While most of the requests were fairly straightforward regarding profits, services, diagnoses and patient outcomes -- Davis says requests were also made for proprietary material.

“There was one section of the data request that we did not fill out,” said Davis. “This information’s available on the ACHA website. But he was asking about rates that we were getting from payers; and that is not something we can share.”

The Commission was formed after the Legislature failed to agree on a budget for the fiscal year that begins July 1st. Lawmakers return to Tallahassee June 1st to work on the spending plan, and a way to resolve health care funding. Davis says if LIP is allowed to expire, the impact to not-for-profit Sacred Heart would be enormous.

“We will lose in excess of $22 million after June 30 when this expires,” Davis said. “The dollar value that comes to Sacred Heart because we have such a high number of uninsured or Medicaid patients – many of which are children.”

Another impasse is whether to expand Medicaid. Gov. Scott wants the federal government to extend LIP, but the Obama administration and the hospitals want Medicaid provided to the more than 800 thousand low-income Floridians.

Scott’s also drawing fire over who sits on the nine-member commission. There are no hospital executives, and only one medical doctor. Chairman Carlos Beruff is a home builder from south Florida, and reportedly a six-figure donor to Scott’s two gubernatorial campaigns.

The panel’s membership is also a concern of Sacred Heart CEO Susan Davis.

“If the purpose of this commission is to explore various ways of hospitals operating or their expense structure,” said Davis. “It would surely help answer those questions better, by having somebody that lives in that world, day in and day out.”

For now, it’s unclear how much impact the Commission on Health Care and Hospital Funding will have. Its next scheduled meeting is Tuesday in Orlando.