Florida Senate - 2009                        COMMITTEE AMENDMENT
       Bill No. PCS (224390) for SB 1986
       
       
       
       
       
       
                                Barcode 275632                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  03/25/2009           .                                
                                       .                                
                                       .                                
                                       .                                
       —————————————————————————————————————————————————————————————————




       —————————————————————————————————————————————————————————————————
       The Committee on Health Regulation (Gaetz) recommended the
       following:
       
    1         Senate Amendment 
    2  
    3         Delete lines 483 - 554
    4  and insert:
    5         (b)Terminated for cause, pursuant to the appeals
    6  procedures established by the state or federal government, from
    7  any state Medicaid program or the federal Medicare program.
    8         Section 11. Subsection (4) of section 409.905, Florida
    9  Statutes, is amended to read:
   10         409.905 Mandatory Medicaid services.—The agency may make
   11  payments for the following services, which are required of the
   12  state by Title XIX of the Social Security Act, furnished by
   13  Medicaid providers to recipients who are determined to be
   14  eligible on the dates on which the services were provided. Any
   15  service under this section shall be provided only when medically
   16  necessary and in accordance with state and federal law.
   17  Mandatory services rendered by providers in mobile units to
   18  Medicaid recipients may be restricted by the agency. Nothing in
   19  this section shall be construed to prevent or limit the agency
   20  from adjusting fees, reimbursement rates, lengths of stay,
   21  number of visits, number of services, or any other adjustments
   22  necessary to comply with the availability of moneys and any
   23  limitations or directions provided for in the General
   24  Appropriations Act or chapter 216.
   25         (4) HOME HEALTH CARE SERVICES.—The agency shall pay for
   26  nursing and home health aide services, supplies, appliances, and
   27  durable medical equipment, necessary to assist a recipient
   28  living at home. An entity that provides services pursuant to
   29  this subsection shall be licensed under part III of chapter 400.
   30  These services, equipment, and supplies, or reimbursement
   31  therefor, may be limited as provided in the General
   32  Appropriations Act and do not include services, equipment, or
   33  supplies provided to a person residing in a hospital or nursing
   34  facility.
   35         (a) In providing home health care services, the agency may
   36  require prior authorization of care based on diagnosis or
   37  utilization rates. The agency shall require prior authorization
   38  for visits for home health services that are not associated with
   39  a skilled nursing visit when the home health agency utilization
   40  rates exceed the state average by 50 percent or more. The home
   41  health agency must submit the recipient’s plan of care and
   42  documentation that supports the recipient’s diagnosis to the
   43  agency when requesting prior authorization.
   44         (b) The agency shall implement a comprehensive utilization
   45  management program that requires prior authorization of all
   46  private duty nursing services, an individualized treatment plan
   47  that includes information about medication and treatment orders,
   48  treatment goals, methods of care to be used, and plans for care
   49  coordination by nurses and other health professionals. The
   50  utilization management program shall also include a process for
   51  periodically reviewing the ongoing use of private duty nursing
   52  services. The assessment of need shall be based on a child’s
   53  condition, family support and care supplements, a family’s
   54  ability to provide care, and a family’s and child’s schedule
   55  regarding work, school, sleep, and care for other family
   56  dependents. When implemented, the private duty nursing
   57  utilization management program shall replace the current
   58  authorization program used by the Agency for Health Care
   59  Administration and the Children’s Medical Services program of
   60  the Department of Health. The agency may competitively bid on a
   61  contract to select a qualified organization to provide
   62  utilization management of private duty nursing services. The
   63  agency is authorized to seek federal waivers to implement this
   64  initiative.
   65         (c)The agency may not pay for home health services, unless
   66  the services are medically necessary, and:
   67         1.The services are ordered by a physician.
   68         2.The written prescription for the services is signed and
   69  dated by the recipient’s physician before the development of a
   70  plan of care and before any request requiring prior
   71  authorization.
   72         3.The physician ordering the services is not employed,
   73  under contract with, or otherwise affiliated with the home
   74  health agency rendering the services.
   75         4.The physician ordering the services has examined the
   76  recipient within the 30 days preceding the initial request for
   77  the services and biannually thereafter.
   78