Do Florida's inmate-medical-fee caps apply when a private prison already has a contract with the provider?

Plain-English summary

Representative Jimmy Patronis asked, on behalf of health care providers in his district who serve a private prison, whether the new payment limits in section 945.6041, Florida Statutes, would disturb their existing contracts. Assistant Attorney General Joslyn Wilson explained that the office could not issue a formal opinion: the questions involved the duties of other state agencies (such as the Department of Corrections and the Department of Management Services), and a formal opinion requires a request from the agency responsible. She offered informal comments instead.

On the substance, section 945.6041, effective July 1, 2009, caps compensation to a health care provider for inmate medical services at 110 percent of the Medicare allowable rate, or 125 percent if the provider has no such contract and reported a negative operating margin the prior year. The same 110 percent cap applies to emergency medical transportation services. The key qualifier is that these caps apply only when the provider does not have a contract with the Department of Corrections or the private correctional facility (as defined in section 944.710). Reading the statute by its plain meaning, the comments concluded that if a private correctional facility does have a contract with the health care provider for inmate medical or emergency transport services, the section 945.6041 rate limits would not appear to apply. As for the separate 2008-2009 appropriations-act proviso the representative asked about, the office noted that proviso had expired (the state was operating under the 2009-2010 act) and that, unlike the proviso, section 945.6041 contains no language requiring reduced payments when a contract expires or is renewed. The office repeatedly noted it had no information about the specific contracts.

Currency note

This opinion was issued in 2009. Subsequent statutory amendments, court decisions, or later AG opinions may have changed the analysis. Treat this page as historical context, not current legal advice. Verify current law before relying on any specific rule, deadline, or remedy mentioned here.

Common questions

Q: Do the inmate-medical-pay caps apply if the provider has a contract with the prison?
A: The informal comments concluded they would not appear to apply. Section 945.6041's caps are written to apply only when the provider does not have a contract with the Department of Corrections or the private correctional facility. A contract appears to take the arrangement outside the rate limits.

Q: What are the rate limits in section 945.6041?
A: Compensation for inmate medical services may not exceed 110 percent of the Medicare allowable rate when there is no contract, rising to 125 percent if the provider also reported a negative operating margin the prior year. Emergency medical transportation services are capped at 110 percent when there is no contract.

Q: Why didn't the Attorney General issue a formal opinion?
A: Because the questions involved the official duties of other state agencies responsible for correctional facilities and contracting, and a formal opinion requires a request from the responsible agency. The office offered only informal comments to be of assistance.

Q: Does the old 2008-2009 budget proviso still matter?
A: The office noted that proviso had expired, since the state was then operating under the 2009-2010 appropriations act. It also pointed out that section 945.6041, unlike that proviso, does not expressly require reduced payments when a contract expires or comes up for renewal.

Background and statutory framework

Section 945.6041, created by Chapter 2009-63, Laws of Florida, was the Legislature's standing rule on what the state or a private prison pays outside providers for inmate medical care. It ties compensation to the Medicare allowable rate but only for providers without a contract, leaving contracted rates to the contract. "Private correctional facility" is defined in section 944.710, "health care provider" by reference to section 766.105, and "emergency medical transportation services" by reference to section 401.23.

Layered on top in the prior year was a budget proviso, Specific Appropriation 786 of the 2008-2009 General Appropriations Act and its implementing act (Chapters 2008-152 and 2008-153). That proviso applied its own Medicare-rate limits to Department of Corrections contracts with hospitals licensed under Chapter 395, including a rule that payments drop to 110 percent if a contract expired or was renewed during the fiscal year. The opinion's informal comments distinguished the expired proviso from the permanent statute, noting the statute lacks the contract-expiration language, and relied on the plain-meaning canon from M.W. v. Davis and McLaughlin v. State to read section 945.6041 as written.

Citations and references

Statutes:

• s. 945.6041, Fla. Stat. (compensation limits for inmate medical services)
• s. 944.710, Fla. Stat. (definition of private correctional facility)
• Ch. 2009-63, Laws of Fla. (creating s. 945.6041)
• Ch. 2008-152 and Ch. 2008-153, Laws of Fla. (2008-2009 appropriations and implementing act)

Cases:

• M.W. v. Davis, 756 So. 2d 90 (Fla. 2000), plain-meaning rule of statutory construction
• McLaughlin v. State, 721 So. 2d 1170 (Fla. 1998)

Source

• Landing page: https://www.myfloridalegal.com/ag-opinions/correctional-facilities-medical-services-contracts
• Original PDF: https://www.myfloridalegal.com/print/pdf/node/8208

Original opinion text

The Honorable Jimmy Patronis

Representative, District 6

455 Harrison Avenue, Suite A

Panama City, Florida 32401

Dear Representative Patronis:

You ask whether the limitations contained in section 945.6041(2) and (3), Florida Statutes, apply to a private correctional facility where the management contract to house inmates was in effect prior to July 1, 2009, has an expiration date of June 30, 2010, and is not the subject of a pending procurement process.[1] This office, however, has no information as to the terms contained in such a contract.

You also ask whether the compensation to a health care provider to provide inmate medical services or emergency medical services is subject to the statute’s limitations when a private correctional facility has a contract with the health care provider to provide medical care or with an entity to provide emergency medical transportation services. Finally, you inquire whether proviso language contained in specific appropriation 786, 2008-2009 General Appropriations Act, applies to health care providers and hospitals providing medical services to inmates housed in private correctional facilities pursuant to a contract with the state and the private correctional facility.

According to your letter, you ask these questions "so that health care providers in my district who are providing services to the private prison can fully understand what limitations if any exist that could change their existing contractual relationships."

The authority of the Attorney General to issue opinions is limited to public officials on questions relating to their own official duties under state law. Your inquiry necessarily involves other state agencies that are responsible for providing correctional facilities to the state, or for contracting with private correctional facilities to provide such services.[2] In the absence of a request by such agencies, this office is precluded from formally commenting upon these issues. In an effort to be of assistance, however, the following informal comments are offered.

Section 945.6041, Florida Statutes, provides in pertinent part:

"(2) Compensation to a health care provider to provide inmate medical services may not exceed 110 percent of the Medicare allowable rate if the health care provider[3] does not have a contract to provide services with the department or the private correctional facility, as defined in s. 944.710, which houses the inmate. However, compensation to a health care provider may not exceed 125 percent of the Medicare allowable rate if:

(a) The health care provider does not have a contract to provide services with the department or the private correctional facility, as defined in s. 944.710, which houses the inmate; and

(b) The health care provider reported a negative operating margin for the previous year to the Agency for Health Care Administration through hospital-audited financial data.

(3) Compensation to an entity to provide emergency medical transportation services[4] for inmates may not exceed 110 percent of the Medicare allowable rate if the entity does not have a contract with the department or a private correctional facility, as defined in s. 944.710, to provide the services."

The statute, which became effective July 1, 2009,[5] does not apply to charges for medical services provided at a hospital operated by the department.[6]

Your first question relates to the effect of the new legislation on a private correctional facility’s existing management contract that existed prior to July 1, 2009, and does not expire until June 30, 2010. While a management contract to house inmates would not appear to be a contract between a health care provider and a private correctional facility to provide medical services, this office has no information relating to the terms of such a contract. Therefore, this office cannot comment on the possible effect of the new legislation on such a contract.

Section 945.6041(2), Florida Statutes, however, clearly states that the compensation to a health care provider for inmate medical services "may not exceed 110 percent of the Medicare allowable rate if the health care provider does not have a contract to provide services with the department or the private correctional facility, as defined in s. 944.710, which houses the inmate." (e.s.) An exception is recognized if the health care provider reported a negative operating margin for the previous year to the Agency for Health Care Administration, in which case the compensation for such services may not exceed 125 percent of the Medicare allowable rate. It is a basic principle of statutory construction that when the language of a statute is clear, the statute must be given its plain and obvious meaning.[7] Thus, if a private correctional facility has a contract with a health care provider, as defined in section 945.6041(1)(b), Florida Statutes, to provide inmate medical services or emergency medical transportation services, as defined in section 945.6041(1)(a), Florida Statutes, the rate limitations contained in section 945.6041, Florida Statutes, would not appear to be applicable.

You also inquire about language contained in the 2008-2009 appropriations act which provided:

"In order to implement Specific Appropriation 786, the Department of Corrections shall comply with the following reimbursement limitations: (1) If no contract exists between the Department of Corrections and a hospital licensed under chapter 395, Florida Statutes, or a health care provider providing services at a hospital licensed under chapter 395, Florida Statutes regarding services, payments shall not exceed 110 percent of the Medicare allowable rate; (2) If a contract has been executed between the Department of Corrections and a hospital licensed under chapter 395, Florida Statutes, or a health care provider providing services at a hospital licensed under chapter 395, Florida Statutes, payments shall continue at the currently contracted rates through the current term of the contract; however, if the contract expires or is subject to renewal during this fiscal year, the payments shall not exceed 110 percent of Medicare allowable rate; (3) If the Department of Corrections enters into a new contract with a hospital licensed under chapter 395, Florida Statutes, or a health care provider providing services at a hospital licensed under chapter 395, Florida Statutes, the payments shall not exceed 110 percent of the Medicare allowable rate. (4) Notwithstanding the limitations of subsections (1), (2), and (3) to the contrary, the department may pay up to 125% of the Medicare allowable rate for hospitals licensed under chapter 395, Florida Statutes, that reported to the Agency for Health Care Administration, through hospital audited financial data, a negative operating margin for the previous year. The department shall not negotiate contracts for medical services at hospitals licensed under chapter 395, Florida Statutes, for rates other than rates based on a percentage of the Medicare allowable rate."[8]

The limitations contained in the 2008-2009 appropriations act have expired as the state is currently operating under the 2009-2010 appropriations act. A contract, however, that was negotiated during the 2008-2009 fiscal year would have been subject to the language contained in the 2008-2009 appropriations act and implementing act that stated that if the contract expires or is subject to renewal during that fiscal year, the payments shall not exceed 110 percent of Medicare allowable rate. This office, however, does not have sufficient information regarding any existing contract that may be called into question. This office would note that unlike the language in the 2008-2009 appropriations act and implementing act, section 945.6041, Florida Statutes, does not contain language expressly requiring the department or a private correctional facility, if the contract expires or is subject to renewal, to limit payments to those specified in the statute under the new contract.

I hope that the above informal advisory comments may be of assistance. Thank you for contacting the Attorney General’s Office.

Sincerely,

Joslyn Wilson

Assistant Attorney General

JW/tsh

[1] Your letter refers to Senate Bill 1772 (2009 general session). The bill was enacted as Ch. 2009-63, Laws of Fla. Section 8 of Ch. 2009-63 creates section 945.6041, Florida Statutes, relating to inmate medical services.

[2] Cf. s. 944.105, Fla. Stat., authorizing the Department of Corrections to enter into contracts with private vendors for the provision of the operation and maintenance of correctional facilities and the supervision of inmates. And see s. 945.6033, Fla. Stat., authorizing the Department of Corrections to enter into continuing contracts with licensed health care providers for the provision of inmate health care services which the department is unable to provide in its facilities. In your letter, you refer to a contract between a private correctional facility and the Department of Management Services.

[3] See s. 945.6041(1)(b), Fla. Stat., stating that "Health care provider" for purposes of this statute has the same meaning as provided in s. 766.105, Fla. Stat.

[4] See s. 945.6041(1)(a), Fla. Stat., stating that "Emergency medical transportation services" as used in the statute "includes, but is not limited to, services rendered by ambulances, emergency medical services vehicles, and air ambulances as those terms are defined in s. 401.23."

[5] See s. 18, Ch. 2009-63, Laws of Fla., stating that "[t]his act shall take effect July 1, 2009."

[6] See s. 945.6041(4), Fla. Stat.

[7] See, e.g., M.W. v. Davis, 756 So. 2d 90 (Fla. 2000) (when language of statute is clear and unambiguous and conveys a clear and definite meaning, there is no occasion for resorting to rules of statutory interpretation and construction as statute must be given its plain and obvious meaning); McLaughlin v. State, 721 So. 2d 1170 (Fla. 1998); In re Order on Prosecution of Criminal Appeals by Tenth Judicial Circuit Public Defender, 561 So. 2d 1130 (Fla. 1990) (best evidence of intent of Legislature is generally plain meaning of statute); Op. Att’y Gen. Fla. 00-46 (2000) (where language of statute is plain and definite in meaning without ambiguity, it fixes the legislative intention such that interpretation and construction are not needed).

[8] Section 4 , Specific Appropriation 786, Ch. 2008-152, Laws of Fla. And see s. 11, Ch. 2008-153, Laws of Fla., implementing the 2008-2009 General Appropriations Act and providing legislative intent, which states:

"In order to implement Specific Appropriation 786 of the 2008-2009 General Appropriations Act, the Department of Corrections shall comply with the following reimbursement limitations:

(1) If no contract exists between the Department of Corrections and a hospital licensed under chapter 395 or a health care provider providing services at a hospital licensed under chapter 395 regarding services, payments may not exceed 110 percent of the Medicare allowable rate.

(2) If a contract has been executed between the Department of Corrections and a hospital licensed under chapter 395 or a health care provider providing services at a hospital licensed under chapter 395, payments shall continue at the currently contracted rates through the current term of the contract; however, if the contract expires or is subject to renewal during the 2007-2008 fiscal year, the payments may not exceed 110 percent of Medicare allowable rate.

(3) If the Department of Corrections enters into a new contract with a hospital licensed under chapter 395 or a health care provider providing services at a hospital licensed under chapter 395, the payments may not exceed 110 percent of the Medicare allowable rate.

(4) Notwithstanding the limitations of subsections (1), (2), and (3) to the contrary, the Department of Corrections may pay up to 125 percent of the Medicare allowable rate for hospitals licensed under chapter 395 that reported to the Agency for Health Care Administration, through hospital audited financial data, a negative operating margin for the previous year.

(5) This section shall not be applicable to charges for medical services provided at any hospital operated by the Department of Corrections.

The Department of Corrections may not negotiate contracts for medical services at hospitals licensed under chapter 395 for rates other than rates based on a percentage of the Medicare allowable rate. This section expires July 1, 2009."