Scott to sign budget Monday posted on 5/20/13

by Bill Rufty | Ledger

Gov. Rick Scott is expected to sign the 2013-2014 budget today and release his vetos of line items in the budget.

The Associated Press reported on Sunday that Scott plans to sign the $74.5 billion budget into law today, and he will announce that he is using his line-item veto power.

The AP reported that an advance copy of the veto message says he will veto the 3 percent tuition increase for university students.

People were scrambling late last week to line up sources after the News Service of Florida suggested that Scott might sign the budget last Friday. He didn't.

The fervor over signing today is because later in the day, Scott is due to fly to Miami for the Latin Chambers of Commerce's 34th annual Hemispheric Congress. and then Tuesday, he and Enterprise Florida officials will begin a three-day trade mission in Santiago, Chile, returning Thursday evening.

» Full story

Scott to okay Medicaid transition money posted on 5/20/13

by Steve Bousquet and Tia Mitchell | Times/Tallahassee Bureau

The state's largest hospitals were relieved to learn Scott will not spike $65 million aimed at easing the transition to a new Medicaid payment system. In return, hospitals agreed not to ask for more such money next year.

Safety net hospitals lobbied heavily for the extra money, saying a new payment system, known as DRG for diagnosis-related groups, caused massive cuts in Medicaid funding. The House insisted on including transition dollars and the Senate agreed to the $65 million.

Scott's office hinted to hospitals last week that he would reject the money and in response they ramped up their lobbying. Those familiar with the governor's rationale said he felt the formula should stand as is, without consideration for winners and losers.

After hearing from hospitals and their advocates, Scott backed down, but not without obtaining concessions from the hospitals that the funding would last for one year. About 20 hospitals sent letters to Scott pledging to reject additional transition dollars next year, many using a form letter.

"Since these funds are intended to mitigate the cost of transition, I will request elimination of the recurring appropriation in the 2014-2015 state fiscal year if you approve the funding for the upcoming state fiscal year," most letters said.

Among those who sent them were Miami's Jackson Health System president and CEO Carlos Migoya, Tampa General Hospital president and CEO Jim Burkhart, Moffitt Cancer Center's Jack Kolosky and Broward Health CEO and president Frank Nask.

When he signs the budget today, Scott will talk about increased transparency and accountability with the DRG system, which pays hospitals according to services they provide and the complexity of a patient's condition, rather than the length of their hospital stays. It's similar to how the federal government pays hospitals for Medicare.

Hospitals may have had an easier time agreeing not to ask for more transition money next year because starting in October 2014, they may no longer be relying on the state for Medicaid funding. That's when Florida anticipates switching to a statewide managed care system, where HMOs will oversee Medicaid patients and their care. The state will pay the managed care companies, which in turn will pay hospitals.

» Full story

Gov. Rick Scott holds power with budget veto pen posted on 5/17/13

by Steve Bousquet | Times/Herald Tallahassee Bureau

TALLAHASSEE — Gov. Rick Scott must soon sign the new state budget, and he's getting intense feedback on all sides: from lawmakers protecting hometown projects, hospitals worried about losing money and a business-backed group criticizing pork-barrel spending.

Scott, who campaigned on a pledge to shrink the size of government, must decide by next Friday how much to prune from the largest budget in state history, $74.5 billion. Already, he has taken the unusual step of asking four possible recipients of tax money to give it back if they fail to meet promises to generate tax revenue for the state.

With Scott in control of the state's purse strings, safety net hospitals that treat many of the poor and uninsured have intensified their lobbying, fearful that Scott will veto $65 million in transitional funding...

Safety net hospitals, meanwhile, are scrambling to save $65 million in funding Scott could veto. The money was added to the budget to reduce losses for hospitals created under a new Medicaid funding formula.

If Scott vetoes the spending, Miami's Jackson Memorial Hospital would lose $23.3 million, Shands Teaching Hospital in Gainesville would lose $11 million and Tampa General Hospital would lose $2 million.

Scott has until May 24 to sign the budget, but he will be in Chile on an official trade mission from May 20-23, so he may act before he leaves the country.

The governor's handling of the state budget is always a closely watched decision, and this year it gives the re-election-minded Scott a chance to make a clear political statement: Is he willing to endorse the spending choices of his fellow Republicans, or is he a fiscal conservative who's willing to veto hundreds of millions of dollars in local projects?

» Full story

Safety net hospitals scrambling to prevent $65 million Sott veto posted on 5/16/13

by TIA MITCHELL | HERALD/TIMES TALLAHASSEE BUREAU

Gov. Rick Scott may veto $65 million in hospital Medicaid funding, although safety net hospitals are mustering all their resources in order to change his mind.

The money is related to the state's transition to a new formula for paying hospitals for Medicaid, one that depends on services provided to patients instead of how long they are in a particular hospital's care. The Legislature provided the extra funding to help reduce the losses over 40 hospitals faced under the new formula, with safety nets among the worst hit.

That extra money was not a part of Scott's initial budget proposal, but the House insisted on it and the Senate agreed. If Scott vetoes it, Miami's Jackson Memorial hospital would lose the most cash: $23.3 million.

Shands Teaching Hospital in Gainesville would lose $11 million and Tampa General Hospital would see its funding slashed by $2 million. A range of rural and specialty hospitals would also lose funding, such as a $1 million loss for Moffitt Cancer Center in Tampa.

Scott's office is still finalizing his veto list, and the governor has until May 24 to sign the budget and announce the funding he eliminated. His office wouldn't say if DRG funding will be on the list.

"We are reviewing the matter, along with the entire budget," spokeswoman Jackie Schutz said.

» Continue reading here

Hospitals lose in states rejecting aid for poor posted on 5/14/13

by Kelli Kennedy | AP

MIAMI - Hospitals nationwide could lose half a billion dollars in federal funding for uninsured patients next year under the national health overhaul — a loss that will hit especially hard in Florida and other states that decided against expanding Medicaid coverage. Cuts could jump to $4 billion in 2020, according to estimates released Monday by federal health officials.

Hospitals that treat a large number of uninsured residents have relied on federal funding in the past to offset the cost. But the Affordable Care Act assumes that more residents will have Medicaid or private health insurance, meaning hospitals would see fewer uninsured patients and need less assistance.

But hospitals in states that declined to expand Medicaid — such as Florida, Texas and Pennsylvania — stand to lose the federal funding without a corresponding increase in Medicaid-covered patients to offset it. The decision not to expand means potentially millions of residents in those states who would have been eligible for the expanded Medicaid coverage will continue going to the emergency room when they are sick — and hospitals will be stuck with the bill.

» Continue reading here