| Community Budget Issue Requests - Tracking Id #2367 | |||||||||
| Global Liver Transplant funding | |||||||||
| Requester: | Wil Trower, CEO/ President | Organization: | North Broward Hospital District | ||||||
| Project Title: | Global Liver Transplant funding | Date Submitted | 1/15/2003 4:51:04 PM | ||||||
| Sponsors: | Bilirakis, Mack | ||||||||
| Statewide Interest: | |||||||||
| Improvement in the availablity and accessibility of Liver Transplants to patients statewide. Equalization of access and quality of care for patients who are on Medicaid throughout the state. Reduction in cost to taxpayers due to improved health status of patients. Improvements in status of health for patients also affords them the opportunity to more readily hold gainful employment and contribute to the community. Fairer payment schedule to providers addressing the issue of inadequate payment for services to medical professionals. | |||||||||
| Recipient: | North Broward Hospital District | Contact: | Charlotte Mather | ||||||
| 303 Southeast 17th Street | Contact Phone: | (954) 355-5180 | |||||||
| Fort Lauderdale 33316 | |||||||||
| Counties: | Broward | ||||||||
| Gov't Entity: | Yes | Private Organization (Profit/Not for Profit): | |||||||
| Project Description: | |||||||||
| Adult Liver transplantation is the surgical replacement of a diseased liver with a healhty liver. The indication for this operation is end-stage liver disease, characterized by patients suffering from reduced liver function, muscle loss, fatigue, encephalopathy, signs of portal hypertension, poor blood clotting, and jaundice. A variety of liver diseases can lead to end stage liver disease. Adult liver transplation under the Medicaid program is currently a covered service for eligible recipients. Providing care to these Medicaid eligible, potential liver recipients in the State has become increasingly difficult due to the reluctance on the part of Florida transplant centers to accept these patients. Florida Transplant Centers that are willing to accept Medicaid patients on the average are only receiving between 10% to 15% of the charges for these cases. The hospital is paid its Medicaid rate up to the 45 day limit, however, often due to extreme risk for catastrophic cases or complications a patient ends up staying beyond the 45 days and the hospital receives no further financial relief. In addition, the increased costs associated with technological changes for liver transplants have added to this financial loss. The reimbursement methodology for liver transplantation is consistent with that used for all surgical procedures within the Medicaid program. Unfortunately, the 45 day inpatient cap with its associated per diem rate and the 1,500 outpatient cap per fiscal year do not cover costs for the high expense of a liver transplantation procedure. AHCA has expressed support for a global liver transplant fee payment for adult liver transplants in place of the current methodology. A global reimbursement would insure adequate and quality care for Medicaid recipients with end-stage liver disease. An all-inclusive global fee would be broken down into components representing the different phases of the transplant process. For the 3/4 fiscal year AHCA is projecting 80 evaluations and 60 transplants could be performed. According to the AHCA analyst these estimates are high and since these are proposed legislative budget related issues they are not official Agency policy yet. | |||||||||
| Is this a water project as described in Chapter 2002-291, Laws of Florida? | No | ||||||||
| Measurable Outcome Anticipated: | |||||||||
| Increased access to liver transplation procedures for patients. Improvement in the health outcomes for individuals who lack health insurance who are in need of liver transplation. | |||||||||
| Amount requested from the State for this project this year: | $3,730,416 | ||||||||
| Identify item(s) in the FY 2003-04 Appropriations Bill to be reduced: | |||||||||
| Specific Appropriation #: | 222 | ||||||||
| Specific Appropriation Title: | Hospital Inpatient services | ||||||||
| Amount to be reduced: | $ | ||||||||
| Total cost of the project: | $8,556,000 | ||||||||
| Request has been made to fund: | Operations | ||||||||
| What type of match exists for this project? | Federal | ||||||||
| Cash Amount | $4,825,584 | ||||||||
| Was this project previously funded by the state? | No | ||||||||
| Is future-year funding likely to be requested? | Yes | Amount: | $3,730,416 | To Fund: | Operations | ||||
| Was this project included in an Agency's Budget Request? | Yes | ||||||||
| Agency | Agency For Health Care Administration | ||||||||
| Was this project included in the Governor's Recommended Budget? | Unknown | ||||||||
| Is there a documented need for this project? | Yes | ||||||||
| Documentation: | North Broward Hospital District patient data, Broward County data, Transplant Center statistics | ||||||||
| Was this project request heard before a publicly noticed meeting of a body of elected officials (municipal, county, or state)? | Yes | ||||||||
| Hearing Body: | North Broward Hospital District Board of Commissioners NBHD, Broward County Commission | ||||||||
| Hearing Meeting Date: | 05/22/2002 | ||||||||