Quotehttp://www.miamiherald.com/2014/07/06/4222062/medicaid-funds-repayment-mark.html
TALLAHASSEE -- The federal government wants to recover $267 million from Florida hospitals it says were paid too much to care for the poor. And it wants the entire amount this year — a demand that is hitting safety-net hospitals like Jackson Memorial in Miami and Tampa General hard.
"Essentially it wipes out any profit we would have next year, so that's kind of why we're struggling with it," said Jackson Health System chief financial officer Mark Knight, noting the state's largest public hospital had operated in the red for years before turning things around.
Jackson stands to lose $47 million in Medicaid funding with this one issue. Tampa General would be out $13.3 million.
Read more here: http://www.miamiherald.com/2014/07/06/4222062/medicaid-funds-repayment-mark.html#storylink=cpy
(http://www.planyouremergency.org/wp-content/uploads/2008/09/TMHinPink.jpg)
Here's a pic for NonRedneck Westsider ;)
So the Feds cut funding for non primary care services through the ACA. The state has not compensated for the cut in fed funding leaving the hospitals with a revenue gap.
Florida says people who don't have primary care use the ER. But ACA says everyone should have a primary care provider and ER cannot be used as primary anymore.
So on the surface this appears to be the feds using reimbursements as leverage to either get states in line with the ACA or come up with their own cash to reimburse hospitals for non primary care.
Similar to what the US Government has done with Title IX, Speed limits and road funding, education mandates, etc.
The "if you follow our rules we will fund, if you follow your rules, you will fund". The problem is Florida will not fund under the new arrangement. (at least right now)
So either hospitals have to stop taking non insured at the ER, (they wont) put more heat on their politicos, (they are) or raise their prices (they cant, private insurance controls payments by contract).
Florida political leaders are going to have to make some value judgements in their current budget.