9 Actions Florida Should Take to Help Taxpayers Impacted by Hurricane Ian

1.     Postpone tax notices and waive penalties or interest for late tax filings in affected areas

2.     Extend the date for residents to take advantage of the tax discounts they would normally receive for paying property taxes and special assessments in November and postpone or defer the deadline for property tax installment payments

3.     Protect individual and business taxpayers from the risks for notices that they will likely not receive because their home or business addresses is not accessible anymore

4.     Issue no new audits in severely impacted areas, extend the statute of limitations and postpone existing audits that haven’t reached the assessment stage because these can’t be responded to while entire communities are still recovering

5.     Create procedures for fairly estimating taxes which can’t be calculated because records have been destroyed by the storm, moving away from the current method which significantly overestimates activity if no records are available

6.     Initiate procedures to offer payment plan assistance for late taxes, rather than resorting to the standard collection methods, like liens, levies, or bank freezes

7.     Retroactively apply the recently passed law that provides property tax refunds for residential property rendered uninhabitable as a result of a catastrophic event

8.     Provide tangible personal property relief and allow n on-residential properties rendered uninhabitable to receive property tax refunds

9.     Get Congress to pass a Disaster Tax Relief Act that includes provisions from past packages, including elements such as an Employee Retention Credit, an enhanced casualty loss deduction, and other relief provisions

Other Resources

Florida TaxWatch Statement on Hurricane Ian Recovery

Community Involvement

/ Categories: Research, Health Care

Evaluating Hospice Certificate of Need (CON) in Florida

For those who know in advance that the end of life is near, decisions about medical care and other kinds of support are personal and sensitive. Central to this discussion is hospice, which is the primary model for end of life care in the United States. Hospice services focus on palliative care, the provision of relief from symptoms, pain, and stress, with the goal of maintaining or improving the quality of life for enrollees. Hospice enrollees generate thousands of dollars in per-patient cost savings compared to individuals near the end of life who do not participate in hospice. Savings are primarily attributable to reductions in emergency care and in-patient hospitalizations among hospice enrollees.

In Florida, the expansion of hospice programs and other health care facilities and services is guided by the “Certificate of Need” (“CON”) process. Since the CON approval requires that providers enroll all eligible individuals seeking care within their assigned service area, hospices in Florida see relatively high utilization rates.

Given the relatively high numbers and levels of care provided in Florida, it would be unsurprising that the state outspends many others in per beneficiary costs. When standardized to remove geographic differences in payment rates for individual services, Florida spends an average of $13,519 per beneficiary, placing it 8th in spending. In general, hospice CON states outspend their non-CON peers, an average of $11,200 per beneficiary to $10,842, or about three percent more per enrollee. 

Those who would rush to judgment and recommend that Florida, like many other states, repeal CON for hospice should consider the likely consequences: first, the demand for health care professionals trained to care for older adults continues to outpace the supply of geriatric specialists; second, the incidence of fraud is likely to increase, and Florida already leads the nation in many types of Medicaid and Medicare fraud; third, the increased competition that will likely result from the repeal of CON is not likely to reduce the costs of hospice care because most hospice services are funded by government programs (e.g., Medicare and Medicaid) that reimburse providers at a fixed per diem rate; and finally, repealing CON for hospice providers is likely to limit access for rural patients. 

Characteristic of states whose hospice programs are regulated through a CON program, Florida has a large number of patients, a small number of providers, and a large patient-to-provider ratio. While much of the country has experienced explosive growth in the number of hospice providers, CON oversight has resulted in a more modest growth rate for Florida. Florida TaxWatch recommends the CON process be retained, and that hospice regulators continue to identify ways that Florida hospice providers can better control hospice costs, improve the quality of hospice care, and direct investments into medically-needy areas.

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