Gov. Rick Scott will soon take a close look at the special taxing districts -- as he did the water management districts last summer -- that proliferate across Florida.

Meanwhile, hospital districts in Florida could be ranked as part of efforts to reduce Medicaid reimbursement costs and make the facilities more efficient.

Jerry McDaniel, director of policy and budget in the executive office of the governor, said an executive order may be issued by Jan. 1 regarding the special taxing districts.

McDaniel did not specify what the order may entail, but suggested it could be similar to cuts the governor imposed on the state’s water management districts in June.

“I imagine we won’t try to take them all on in a short time frame, but community development districts and other things are out there where districts have the ability to tax people and they may not be aware of how their money is being used and what tax rates are being applied to,” McDaniel told members of the Senate Budget Committee on Thursday.

McDaniel said no midyear budget readjustments are forecast for the current year’s budget as he gave committee members an overview of the $66.4 billion budget Scott unveiled on Wednesday.

Scott's proposed budget is $4.6 billion below the current year’s operating expenses.

There are more than 1,600 special taxing districts across the state that collectively impose $15.5 billion in taxes.

“A lot of these things are rolled into (homeowners) escrow accounts and (homeowners) pay them blindly and they’re really not familiar with what taxes they’re paying,” McDaniel said.

“If it’s anything like what we found with the water management districts, it’s probably some certain practices should stop and we should just understand them better.”

In June, Scott signed a bill that capped the taxes at the state’s five water management districts, reducing assessments by as much as 36 percent. The move is expected to save property owners $210.5 million.

Scott’s proposed $66.4 billion budget for fiscal year 2012 also includes $2 billion in savings in Medicaid costs, in part through the imposition of a “flat rate” reimbursement program for all hospitals and by limiting hospital and emergency-room stays.

With Medicaid expected to cost $21 billion this fiscal year, Scott on Wednesday -- pointing to a chart on annual Medicaid costs -- said, "If we do nothing, this line will bankrupt our state."

Under a flat rate, procedures would be required to cost the same regardless of the hospital.

The cut will reduce the average 6.9 percent profit that the medical centers currently receive, said McDaniel.

Safety Net Hospital Alliance of Florida, a lobbying group for nearly half of the state’s largest hospitals, has estimated that Jackson Memorial Hospital in Miami could lose $133.5 million under the flat rate proposal, while All Children’s Hospital in St. Petersburg could find itself down $39 million.

Senate Democratic Leader Nan Rich, D-Weston, called the hospital  proposal “devastating” as the largest cut in the governor’s budget “is to hospitals.”

Sen. John Thrasher, R-Jacksonville, cautioned the governor’s office not to compromise the quality of health care at hospitals that are doing a good job.

Sen. J.D. Alexander, R-Lake Wales, the chairman of the budget committee, suggested the governor consider rewards for hospitals that show reductions in infection rates or readmissions without the loss of quality.

McDaniel said they are also considering a reward program based upon a formula that could rank the facilities.

Scott, who built Columbia/HCA, “believes, because it has succeeded for him with the 343 hospitals he ran, he ranked them all,” McDaniel said. “Somebody was 1, somebody was 343. The 343 guy never wanted to be 343. He always wanted to be better, he wanted to improve. Nobody went out of business. Everybody continued to strive to be better.”