Rate Year 2020-21 Hospital Directed Payment Program Payments ... - Florida

Rate Year 2020-21 Hospital Directed Payment Program

Payments by Provider

Medicaid ID

Provider Name

010323300 Ascension Sacred Heart Emerald Coast

010076500 Ascension Sacred Heart Pensacola

010074900 Baptist Hospital

011132500 Fort Walton Beach Medical Center

010188500 Healthmark Regional Medical Center

010173700 Jay Hospital

010126500 North Okaloosa Medical Center

010174500 Santa Rosa Medical Center

010368300 Select Specialty Hospital - Pensacola

010125700 Twin Cities Hospital

011321200 West Florida Hospital

010006400 Ascension Sacred Heart Bay

002012700 Ascension Sacred Heart Gulf

010026900 Calhoun-Liberty Hospital

011980600 Capital Regional Medical Center

016911900 Eastside Psychiatric Hospital

105750000 Emerald Coast Behavioral Hospital

010275000 Encompass Health Rehabilitation Hospital of Panama City

012033200 Encompass Health Rehabilitation Hospital of Tallahassee

011761700 Gulf Coast Regional Medical Center

010190700 Northwest Florida Community Hospital

010343800 Select Specialty Hospital - Panama City

010374800 Select Specialty Hospital - Tallahassee

010113300 Tallahassee Memorial Hospital

010103600 Doctors Memorial Hospital

010180000 Doctors' Memorial Hospital

010080300 George E Weems Memorial Hospital

010106100 Jackson Hospital

010115000 Madison County Memorial Hospital

010117600 AdventHealth Ocala

010109500 AdventHealth Waterman

010087100 Bayfront Health Brooksville

011998900 Bayfront Health Seven Rivers

010219900 Citrus Memorial Hospital

008369200 Encompass Health Rehabilitation Hospital of Ocala

010355100 Encompass Health Rehabilitation Hospital of Spring Hill

010353500 Kindred Hospital Ocala

010822700 Lake Butler Hospital

011976800 Lake City Medical Center

010862600 North Florida Regional Medical Center

012007300 Oak Hill Hospital

010988600 Ocala Regional Medical Center

010108700 Orlando Health South Lake Hospital

011351400 Putnam Community Medical Center

010114100 Regional General Hospital Williston

010377200 Select Specialty Hospital - Gainesville

013800200 Select Specialty Hospital -The Villages Inc

010033100 Shands Lake Shore Regional Medical Center

016552600 Springbrook Hospital

160000100 The Vines Hospital

010107900 UF Health Leesburg Hospital Inc

103449400 UF Health Rehab Hospital

010003000 UF Health Shands Hospital

010317900 UF Health The Villages Hospital

010186900 AdventHealth Daytona Beach

010187700 AdventHealth DeLand

010182600 AdventHealth Fish Memorial

010183400 AdventHealth New Smyrna Beach

010189300 AdventHealth Palm Coast

009701300 Ascension St. Vincent's Clay County

010073100 Ascension St. Vincent's Riverside

010373000 Ascension St. Vincent's Southside

010232600 Baptist Medical Center - Beaches

010064100 Baptist Medical Center Jacksonville

010123100 Baptist Medical Center Nassau

010064105 Baptist North

010064106 Wolfson Childrens Hospital

010271700 Brooks Rehabilitation Hospital

010171100 Flagler Hospital

010267900 Kindred Hospital-North Florida

010072200 Mayo Clinic

105531100 Medical Center of Deltona

010193100 Memorial Hospital Jacksonville

011174100 Orange Park Medical Center

024058800 River Point Behavioral Health

016486300 Select Specialty Hospital - Daytona Beach

017706400 Sma Behavioral Health Services

010647000 Specialty Hospital - Jacksonville

010067600 UF Health Jacksonville

008589300 Wekiva Springs Center

010004800 Ed Fraser Memorial Hospital

Hospital

Ownership

Type

Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Public Public Public Public Public Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Public

Region DPP Payment

1$

5,594,203

1$

29,413,358

1$

14,006,746

1$

7,638,213

1$

517,513

1$

465,663

1$

4,444,367

1$

4,091,415

1$

85,590

1$

788,509

1$

11,811,838

2$

4,561,747

2$

1,319,029

2$

1,019,195

2$

18,372,985

2$

341,833

2$

3,582,641

2$

18,032

2$

113,614

2$

19,252,075

2$

447,023

2$

47,213

2$

291,834

2$

10,437,713

2$

145,429

2$

48,186

2$

93,047

2$

1,750,996

2$

193,871

3$

10,232,670

3$

4,087,338

3$

3,508,398

3$

1,817,624

3$

3,261,914

3$

-

3$

-

3$

-

3$

133,992

3$

3,808,524

3$

11,454,549

3$

6,670,421

3$

9,445,957

3$

4,467,436

3$

5,654,664

3$

-

3$

26,565

3$

-

3$

-

3$

1,994,197

3$

1,397,097

3$

3,389,468

3$

534,573

3$

81,912,060

3$

805,331

4$

6,063,858

4$

3,420,060

4$

3,035,251

4$

1,494,141

4$

3,813,843

4$

2,276,989

4$

5,808,218

4$

3,340,580

4$

1,382,809

4$

21,236,650

4$

1,411,162

4$

472,184

4$

27,027,888

4$

5,148,927

4$

6,026,538

4$

-

4$

5,860

4$

146,816

4$

11,732,943

4$

12,918,916

4$

3,250,315

4$

-

4$

199,304

4$

-

4$

32,060,774

4$

1,266,525

4$

603,914

Total DPP IGTs

Provided

$

1,888,217

$

9,927,920

$

4,727,711

$

2,578,134

$

174,677

$

157,176

$

1,500,112

$

1,380,979

$

28,889

$

266,146

$

3,986,862

$

1,539,731

$

445,213

$

344,010

$

6,201,452

$

115,379

$

1,209,252

$

6,086

$

38,348

$

6,498,172

$

150,884

$

15,936

$

98,503

$

3,523,052

$

49,087

$

16,264

$

31,406

$

591,016

$

65,437

$

3,453,843

$

1,379,603

$

1,184,193

$

613,504

$

1,100,997

$

-

$

-

$

-

$

45,226

$

1,285,495

$

3,866,265

$

2,251,474

$

3,188,303

$

1,507,898

$

1,908,625

$

-

$

8,966

$

-

$

-

$

673,103

$

471,564

$

1,144,050

$

180,435

$ 27,647,860

$

271,824

$

2,046,740

$

1,154,376

$

1,024,491

$

504,319

$

1,287,290

$

768,554

$

1,960,454

$

1,127,549

$

466,741

$

7,168,028

$

476,311

$

159,377

$

9,122,750

$

1,737,923

$

2,034,143

$

-

$

1,978

$

49,555

$

3,960,232

$

4,360,534

$

1,097,082

$

-

$

67,271

$

-

$ 10,821,505

$

427,492

$

203,840

Net (DPP

Payment - DPP

IGTs)

$ 3,705,986

$ 19,485,438

$ 9,279,035

$ 5,060,079

$

342,836

$

308,487

$ 2,944,256

$ 2,710,436

$

56,700

$

522,363

$ 7,824,977

$ 3,022,016

$

873,816

$

675,185

$ 12,171,533

$

226,453

$ 2,373,389

$

11,946

$

75,266

$ 12,753,903

$

296,139

$

31,277

$

193,331

$ 6,914,661

$

96,342

$

31,922

$

61,641

$ 1,159,981

$

128,433

$ 6,778,827

$ 2,707,735

$ 2,324,205

$ 1,204,120

$ 2,160,917

$

-

$

-

$

-

$

88,765

$ 2,523,029

$ 7,588,284

$ 4,418,947

$ 6,257,653

$ 2,959,538

$ 3,746,040

$

-

$

17,598

$

-

$

-

$ 1,321,094

$

925,534

$ 2,245,417

$

354,138

$ 54,264,201

$

533,507

$ 4,017,118

$ 2,265,684

$ 2,010,759

$

989,822

$ 2,526,552

$ 1,508,434

$ 3,847,765

$ 2,213,031

$

916,068

$ 14,068,622

$

934,851

$

312,807

$ 17,905,138

$ 3,411,005

$ 3,992,394

$

-

$

3,882

$

97,261

$ 7,772,711

$ 8,558,381

$ 2,153,233

$

-

$

132,033

$

-

$ 21,239,269

$

839,034

$

400,074

Agency for Health Care Administration

Bureau of Medicaid Program Finance

1

12/10/2021

Rate Year 2020-21 Hospital Directed Payment Program

Payments by Provider

Medicaid ID

Provider Name

010184200 Halifax Health Medical Center 026002900 Northeast Florida State Hospital 000949600 AdventHealth Connerton 010959200 AdventHealth Dade City 010161300 AdventHealth North Pinellas 005456800 AdventHealth Wesley Chapel 010149400 AdventHealth Zephyrhills 010372100 BayCare Alliant Hospital 003300300 Baycare Behavioral Health 010156700 Bayfront Health St Petersburg 010175300 Encompass Health Rehabilitation Hospital of Largo 010151600 Johns Hopkins All Children's Hospital 010276800 Kindred Hospital-Bay Area-St Petersburg 011974100 Largo Medical Center 012008100 Mease Countryside Hospital 010154100 Mease Dunedin Hospital 010552000 Medical Center of Trinity 010158300 Morton Plant Hospital 010150800 Morton Plant North Bay Hospital 011669400 North Tampa Behavioral Health 011519300 Northside Hospital 012011100 Palms of Pasadena Hospital 011988100 Regional Medical Center Bayonet Point 012022700 St. Anthony's Hospital 012010300 St. Petersburg General Hospital 010823300 Windmoor Healthcare of Clearwater 012032400 H. Lee Moffitt Cancer Center & Research Institute Hospital 010094300 AdventHealth Carrollwood 010228800 AdventHealth Heart Of Florida 010166400 AdventHealth Lake Wales 010090100 AdventHealth Sebring 010102800 AdventHealth Tampa 010260100 AdventHealth Wauchula 012041300 Bartow Regional Medical Center 011021300 Blake Medical Center 011807900 Brandon Regional Hospital 010089700 Highlands Regional Medical Center 010234200 Kindred Hospital-Bay Area-Tampa 010230000 Kindred Hospital-Central Tampa 010164800 Lakeland Regional Medical Center 010342000 Lakewood Ranch Medical Center 010116800 Manatee Memorial Hospital 011279800 Memorial Hospital of Tampa 017634500 Mental Health Care, Inc. 104784700 Palm Shores Behavioral Health Center 070565916 Palm Shores Behavioral Health Center 017662800 Peace River Center 002576600 Shriners Hospital for Children - Tampa 011994600 South Bay Hospital 010098600 South Florida Baptist Hospital 010097802 St. Joseph's Hospital 016924000 Suncoast Behavioral Health Center 011984900 Tampa Community Hospital 010099400 Tampa General Hospital 010169900 Winter Haven Hospital 010129000 AdventHealth Celebration 010009900 Cape Canaveral Hospital 017079000 Central Florida Behavioral Hospital 010178800 Central Florida Regional Hospital 016552300 Circles of Care, Inc. 014235500 Encompass Health Rehabilitation Hospital of Altamonte Springs 010008100 Holmes Regional Medical Center 001681500 Kindred Hospital Melbourne 017078300 Lakeside Behavioral Healthcare Inc. 010320900 Melbourne Regional Medical Center 004087600 Nemours Children's Hospital 010135400 Orlando Health - Health Central Hospital 010346200 Orlando Health St. Cloud Hospital 010133800 Orlando Regional Medical Center 010138900 Osceola Regional Medical Center 021094100 Oviedo Medical Center 003297500 Palm Bay Hospital 101334000 Palm Point Behavioral Health 009268300 Poinciana Medical Center 010011100 Rockledge Regional Medical Center 012042100 Sea Pines Rehabilitation Hospital Affiliate of Encompass Health 010339000 Select Specialty Hospital - Orlando (North Campus) 360086617 University Behavioral Center 003158800 Viera Hospital 010010200 Parrish Medical Center 010028500 Bayfront Health Port Charlotte

Hospital

Ownership

Type

Public Public Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Cancer Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Public Private

Region DPP Payment

4$

25,491,126

4$

-

5$

-

5$

-

5$

-

5$

-

5$

-

5$

-

5$

-

5$

-

5$

-

5$

-

5$

-

5$

-

5$

-

5$

-

5$

-

5$

-

5$

-

5$

-

5$

-

5$

-

5$

-

5$

-

5$

-

5$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

6$

-

7 $ 127,631,975

7$

1,695,539

7$

10,380,776

7$

7,029,126

7$

782,500

7$

-

7$

6,620,581

7$

170,225

7$

1,843,295

7$

1,693,463

7$

54,297,775

7$

7,890,889

7$

2,522,586

7 $ 123,503,667

7$

17,373,381

7$

2,941,039

7$

1,668,438

7$

1,806,330

7$

4,099,646

7$

6,399,845

7$

13,770

7$

-

7$

5,163,099

7$

501,106

7$

6,134,796

8$

5,636,709

Total DPP IGTs

Provided

$

8,604,045

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$ 43,079,748

$

572,297

$

3,503,834

$

2,372,548

$

264,118

$

-

$

2,234,651

$

57,456

$

622,169

$

571,596

$ 18,327,182

$

2,663,420

$

851,451

$ 41,686,316

$

5,864,055

$

992,692

$

563,149

$

609,692

$

1,383,758

$

2,160,146

$

4,648

$

-

$

1,742,706

$

169,139

$

2,070,684

$

1,902,564

Net (DPP

Payment - DPP

IGTs)

$ 16,887,081

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$ 84,552,227

$ 1,123,242

$ 6,876,942

$ 4,656,578

$

518,382

$

-

$ 4,385,930

$

112,769

$ 1,221,126

$ 1,121,866

$ 35,970,592

$ 5,227,469

$ 1,671,135

$ 81,817,350

$ 11,509,326

$ 1,948,347

$ 1,105,288

$ 1,196,638

$ 2,715,888

$ 4,239,699

$

9,122

$

-

$ 3,420,393

$

331,967

$ 4,064,112

$ 3,734,145

Agency for Health Care Administration

Bureau of Medicaid Program Finance

2

12/10/2021

Rate Year 2020-21 Hospital Directed Payment Program

Payments by Provider

Medicaid ID

Provider Name

010027700 Bayfront Health Punta Gorda 017738500 David Lawrence Center 011995400 Doctors Hospital Of Sarasota 012038300 Encompass Health Rehabilitation Hospital of Sarasota 010253900 Englewood Community Hospital 011746300 Fawcett Memorial Hospital 016431100 Landmark Hospital of Southwest Florida 010111700 Lehigh Regional Medical Center 010031500 Naples Community Hospital 010356000 PAM Specialty Hospital of Sarasota 016551100 Park Royal Hospital 010314400 Physicians Regional Medical Center - Pine Ridge 013854800 Select Specialty Hospital - Fort Myers 011973300 Venice Regional Bayfront Health 011971700 Cape Coral Hospital 010192300 Desoto Memorial Hospital 011134100 Gulf Coast Medical Center Lee Memorial Health System 010086200 Hendry Regional Medical Center 010110900 Lee Memorial Hospital 010176100 Sarasota Memorial Hospital 010140100 Bethesda Hospital East 010141900 Boca Raton Regional Hospital 010104400 Cleveland Clinic Indian River Hospital 010118400 Cleveland Clinic Martin North Hospital 022041500 Coral Shores Behavioral Health 012009000 Delray Medical Center 009587500 Encompass Health Rehab Hospital an Affiliate of Martin Health 012034100 Encompass Health Rehabilitation Hospital of Treasure Coast 010152400 Good Samaritan Medical Center 010146000 JFK Medical Center 012029400 Jupiter Medical Center 000417000 Kindred Hospital The Palm Beaches 011969500 Lawnwood Regional Medical Center & Heart Institute 010210500 Palm Beach Gardens Medical Center 012026000 Palms West Hospital 004805200 Port St. Lucie Hospital 011975000 Raulerson Hospital 070694917 Sandy Pines Behavioral 010376400 Select Specialty Hospital - Palm Beach 011997100 St. Lucie Medical Center 010148600 St. Mary's Medical Center 012001400 Steward Sebastian River Medical Center 010213000 Wellington Regional Medical Center 012024300 West Boca Medical Center 010144300 Lakeside Medical Center 010220200 Cleveland Clinic Hospital 012027800 Encompass Health Rehabilitation Hospital of Sunrise 029582516 Florida Palms Academy 010357800 Fort Lauderdale Hospital 010018800 Holy Cross Hospital 010019600 Kindred Hospital-South Florida-Ft Lauderdale 010191500 Kindred Hospital-South Florida-Hollywood 015775700 Larkin Community Hospital Behavioral Health 010459100 Northwest Medical Center 012000600 Plantation General Hospital 016972100 St John's Rehabilitation Hospital 010240700 St. Anthony's Rehabilitation Hospital 011280100 University Hospital and Medical Center 011230500 Westside Regional Medical Center 012040500 Broward Health Coral Springs 010821900 Broward Health Imperial Point 010012900 Broward Health Medical Center 010021800 Broward Health North 010345400 Memorial Hospital Miramar 010222900 Memorial Hospital Pembroke 010252100 Memorial Hospital West 010020000 Memorial Regional Hospital 026004500 South Florida State Hospital 010047100 University of Miami Hospital and Clinics 012037500 Aventura Hospital and Medical Center 010035800 Baptist Hospital of Miami 017707300 Community Health of South Florida Inc 010960600 Coral Gables Hospital 010354300 Doctors Hospital 010277600 Douglas Gardens Hospital 010270900 Encompass Health Rehabilitation Hospital of Miami 010120600 Fishermen's Hospital 010041200 Hialeah Hospital 010226100 Homestead Hospital 012013800 Kendall Regional Medical Center 011993800 Kindred Hospital-South Florida-Coral Gables

Hospital

Ownership

Type

Private Private Private Private Private Private Private Private Private Private Private Private Private Private Public Public Public Public Public Public Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Public Private Private Private Private Private Private Private Private Private Private Private Private Private Private Public Public Public Public Public Public Public Public Public Cancer Private Private Private Private Private Private Private Private Private Private Private Private

Region DPP Payment

8$ 8$ 8$ 8$ 8$ 8$ 8$ 8$ 8$ 8$ 8$ 8$ 8$ 8$ 8$ 8$ 8$ 8$ 8$ 8$ 9$ 9$ 9$ 9$ 9$ 9$ 9$ 9$ 9$ 9$ 9$ 9$ 9$ 9$ 9$ 9$ 9$ 9$ 9$ 9$ 9$ 9$ 9$ 9$ 9$ 10 $ 10 $ 10 $ 10 $ 10 $ 10 $ 10 $ 10 $ 10 $ 10 $ 10 $ 10 $ 10 $ 10 $ 10 $ 10 $ 10 $ 10 $ 10 $ 10 $ 10 $ 10 $ 10 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $

1,784,322 -

2,722,343 18,455

870,721 3,554,107

182,200 1,594,234 8,517,569

5,960,300 3,548,422

11,025 1,335,874 9,073,936 5,050,307 8,178,216 2,893,469 28,327,978 26,706,424 10,079,539 1,509,673 5,839,791 11,186,432 1,017,248 5,176,070

75,561 -

8,136,541 16,873,330

2,697,173 82,002

20,224,019 3,969,537

13,051,515 1,833,692 5,497,558 3,866,615 533,819 5,893,449

37,271,834 1,457,786 6,431,471 8,035,094 4,810,567 -

11,740,760 4,926,975

42,381,247 9,873,190 9,052,759 5,584,245

16,614,880 80,246,330

9,641,172 15,711,839 2,815,456 652,877 752 474,557 202,558 6,868,474 7,610,993 21,497,752 404,644

Total DPP IGTs

Provided

$

602,264

$

-

$

918,875

$

6,229

$

293,895

$

1,199,621

$

61,498

$

538,103

$

2,874,943

$

-

$

2,011,786

$

1,197,703

$

3,721

$

450,899

$

3,062,735

$

1,704,635

$

2,760,401

$

976,636

$

9,561,571

$

9,014,246

$

3,402,157

$

509,561

$

1,971,111

$

3,775,768

$

343,353

$

1,747,084

$

25,504

$

-

$

2,746,335

$

5,695,272

$

910,379

$

27,678

$

6,826,233

$

1,339,842

$

4,405,291

$

618,928

$

1,855,596

$

1,305,103

$

180,181

$

1,989,222

$ 12,580,399

$

492,048

$

2,170,821

$

2,712,093

$

1,623,716

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

3,962,871

$

1,663,007

$ 14,304,985

$

3,332,508

$

3,055,587

$

1,884,856

$

5,608,037

$ 27,085,624

$

-

$

-

$

3,254,194

$

5,303,233

$

-

$

950,304

$

220,366

$

254

$

160,178

$

68,370

$

2,318,323

$

2,568,946

$

7,256,158

$

136,580

Net (DPP

Payment - DPP

IGTs)

$ 1,182,058

$

-

$ 1,803,468

$

12,226

$

576,825

$ 2,354,486

$

120,702

$ 1,056,130

$ 5,642,625

$

-

$ 3,948,514

$ 2,350,720

$

7,304

$

884,975

$ 6,011,201

$ 3,345,672

$ 5,417,814

$ 1,916,834

$ 18,766,407

$ 17,692,178

$ 6,677,382

$ 1,000,112

$ 3,868,681

$ 7,410,664

$

673,895

$ 3,428,986

$

50,057

$

-

$ 5,390,206

$ 11,178,058

$ 1,786,793

$

54,324

$ 13,397,786

$ 2,629,695

$ 8,646,224

$ 1,214,764

$ 3,641,961

$ 2,561,513

$

353,639

$ 3,904,227

$ 24,691,434

$

965,738

$ 4,260,650

$ 5,323,001

$ 3,186,852

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$

-

$ 7,777,890

$ 3,263,968

$ 28,076,262

$ 6,540,682

$ 5,997,172

$ 3,699,389

$ 11,006,843

$ 53,160,706

$

-

$

-

$ 6,386,977

$ 10,408,606

$

-

$ 1,865,152

$

432,511

$

498

$

314,380

$

134,189

$ 4,550,151

$ 5,042,047

$ 14,241,594

$

268,064

Agency for Health Care Administration

Bureau of Medicaid Program Finance

3

12/10/2021

Rate Year 2020-21 Hospital Directed Payment Program

Medicaid ID

Provider Name

012005700 Larkin Community Hospital 010053600 Larkin Community Hospital Palm Springs Campus 010119200 Lower Keys Medical Center 010121400 Mariners Hospital 012000601 Mercy Hospital 013968500 Miami Gardens Dialysis 010046300 Mount Sinai Medical Center 010060900 Nicklaus Children's Hospital 010049800 North Shore Medical Center 010460400 Palmetto General Hospital 010337300 Select Specialty Hospital - Miami 019556500 Select Specialty Hospital - Miami Lakes 010058700 South Miami Hospital 016949600 Southern Winds 012002200 St. Catherine's Rehabilitation Hospital 010170200 West Gables Rehabilitation Hospital 003226500 West Kendall Baptist Hospital 010062500 Westchester General Hospital 010042100 Jackson Memorial Hospital 010042139 Jackson Memorial Hospital - Psych Unit 010042146 Jackson Memorial Hospital - Tuberculosis

Payments by Provider

Hospital Ownership

Type

Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Private Public Public Public

Region DPP Payment

11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $ 11 $

Total $

1,501,052 806,293

2,850,334 510,304

11,477,040 118,995

6,146,650 147,463,428

20,097,562 15,036,983

25,723 -

11,531,078 2,234,382 374,499 2,682,638 5,284,995 1,435,211

186,942,861 1,705,208

20,259,219

1,843,598,932

Total DPP IGTs

Provided

$

506,652

$

272,149

$

962,076

$

172,243

$

3,873,857

$

40,165

$

2,074,685

$ 49,773,478

$

6,783,550

$

5,075,448

$

8,682

$

-

$

3,892,096

$

754,173

$

126,405

$

905,473

$

1,783,850

$

484,428

$ 63,099,011

$

575,560

$

6,838,115

$ 622,271,791

Net (DPP

Payment - DPP

IGTs)

$

994,401

$

534,144

$ 1,888,258

$

338,060

$ 7,603,183

$

78,831

$ 4,071,965

$ 97,689,950

$ 13,314,012

$ 9,961,535

$

17,041

$

-

$ 7,638,981

$ 1,480,209

$

248,094

$ 1,777,164

$ 3,501,145

$

950,783

$ 123,843,850

$ 1,129,647

$ 13,421,105

$ 1,221,327,141

Agency for Health Care Administration

Bureau of Medicaid Program Finance

4

12/10/2021

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