(a) “Health care provider” has the same meaning as provided in s. 766.105.
(b) “Hospital” means a hospital licensed under chapter 395.
(2) When compensating health care providers, the department must comply with the following
(a) Payments to a hospital or a health care provider may not exceed 110 percent of
the Medicare allowable rate for any health care services provided if there is no contract
between the department and the hospital or the health care provider providing services
at a hospital.
(b) 1. The department may continue to make payments for health care services at the
contracted rates for contracts executed before July 1, 2014, through the current term
of the contract if a contract has been executed between the department and a hospital
or a health care provider providing services at a hospital.
2. Payments may not exceed 110 percent of the Medicare allowable rate after the current
term of the contract expires or after the contract is renewed during the 2013-2014
(c) Payments may not exceed 110 percent of the Medicare allowable rate under a contract
executed on or after July 1, 2014, between the department and a hospital or a health
care provider providing services at a hospital.
(d) Notwithstanding paragraphs (a)-(c), the department may pay up to 125 percent of
the Medicare allowable rate for health care services at a hospital that reports, or
has reported, a negative operating margin for the previous fiscal year to the Agency
for Health Care Administration through hospital-audited financial data.
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