Florida Senate - 2016                                     SB 994
       
       
        
       By Senator Negron
       
       
       
       
       
       32-00900A-16                                           2016994__
    1                        A bill to be entitled                      
    2         An act relating to the sunset review of Medicaid
    3         Dental Services; amending s. 409.973, F.S.; providing
    4         for the future removal of dental services as a minimum
    5         benefit of managed care plans; requiring the Agency
    6         for Health Care Administration to provide a report to
    7         the Governor and the Legislature; specifying
    8         requirements for the report; providing for the use of
    9         the report’s findings; requiring the agency to
   10         implement a statewide Medicaid prepaid dental health
   11         program upon the occurrence of certain conditions;
   12         specifying requirements for the program and the
   13         selection of providers; providing effective dates.
   14          
   15  Be It Enacted by the Legislature of the State of Florida:
   16  
   17         Section 1. Effective March 1, 2019, subsection (1) of
   18  section 409.973, Florida Statutes, is amended to read:
   19         409.973 Benefits.—
   20         (1) MINIMUM BENEFITS.—Managed care plans shall cover, at a
   21  minimum, the following services:
   22         (a) Advanced registered nurse practitioner services.
   23         (b) Ambulatory surgical treatment center services.
   24         (c) Birthing center services.
   25         (d) Chiropractic services.
   26         (e) Dental services.
   27         (e)(f) Early periodic screening diagnosis and treatment
   28  services for recipients under age 21.
   29         (f)(g) Emergency services.
   30         (g)(h) Family planning services and supplies. Pursuant to
   31  42 C.F.R. s. 438.102, plans may elect to not provide these
   32  services due to an objection on moral or religious grounds, and
   33  must notify the agency of that election when submitting a reply
   34  to an invitation to negotiate.
   35         (h)(i) Healthy start services, except as provided in s.
   36  409.975(4).
   37         (i)(j) Hearing services.
   38         (j)(k) Home health agency services.
   39         (k)(l) Hospice services.
   40         (l)(m) Hospital inpatient services.
   41         (m)(n) Hospital outpatient services.
   42         (n)(o) Laboratory and imaging services.
   43         (o)(p) Medical supplies, equipment, prostheses, and
   44  orthoses.
   45         (p)(q) Mental health services.
   46         (q)(r) Nursing care.
   47         (r)(s) Optical services and supplies.
   48         (s)(t) Optometrist services.
   49         (t)(u) Physical, occupational, respiratory, and speech
   50  therapy services.
   51         (u)(v) Physician services, including physician assistant
   52  services.
   53         (v)(w) Podiatric services.
   54         (w)(x) Prescription drugs.
   55         (x)(y) Renal dialysis services.
   56         (y)(z) Respiratory equipment and supplies.
   57         (z)(aa) Rural health clinic services.
   58         (aa)(bb) Substance abuse treatment services.
   59         (bb)(cc) Transportation to access covered services.
   60         Section 2. Subsection (5) is added to section 409.973,
   61  Florida Statutes, to read:
   62         409.973 Benefits.—
   63         (5) PROVISION OF DENTAL SERVICES.—
   64         (a) The agency shall provide a comprehensive report on the
   65  provision of dental services under part IV of this chapter to
   66  the Governor, the President of the Senate, and the Speaker of
   67  the House of Representatives by December 1, 2016. The agency is
   68  authorized to contract with an independent third party to assist
   69  in the preparation of the report required by this paragraph.
   70         1. The report must examine the effectiveness of medical
   71  managed care plans in increasing patient access to dental care,
   72  improving dental health, achieving satisfactory outcomes for
   73  Medicaid recipients and the dental provider community, providing
   74  outreach to Medicaid recipients, and delivering value and
   75  transparency to the state’s taxpayers regarding the dollars
   76  intended for, and spent on, actual dental services.
   77  Additionally, the report must examine, by plan and in the
   78  aggregate, the historical trends of rates paid to dental
   79  providers and to dental plan subcontractors, dental provider
   80  participation in plan networks, and provider willingness to
   81  treat Medicaid recipients. The report must also compare current
   82  and historical efforts and trends and the experiences of other
   83  states in delivering dental services, increasing patient access
   84  to dental care, and improving dental health.
   85         2. The Legislature may use the findings of this report in
   86  setting the scope of minimum benefits set forth in this section
   87  for future procurements of eligible plans as described in s.
   88  409.966. Specifically, the decision to include dental services
   89  as a minimum benefit under this section, or to provide Medicaid
   90  recipients with dental benefits separate from the Medicaid
   91  managed medical assistance program described in part IV of this
   92  chapter, may take into consideration the data and findings of
   93  the report.
   94         (b) In the event the Legislature takes no action before
   95  July 1, 2017, with respect to the report findings required under
   96  subparagraph (a)2., the agency shall implement a statewide
   97  Medicaid prepaid dental health program for children and adults
   98  with a choice of at least two licensed dental managed care
   99  providers who must have substantial experience in providing
  100  dental care to Medicaid enrollees and children eligible for
  101  medical assistance under Title XXI of the Social Security Act
  102  and who meet all agency standards and requirements. The
  103  contracts for program providers shall be awarded through a
  104  competitive procurement process. The contracts must be for 5
  105  years and may not be renewed; however, the agency may extend the
  106  term of a plan contract to cover delays during a transition to a
  107  new plan provider. The agency shall include in the contracts a
  108  medical loss ratio provision consistent with s. 409.967(4). The
  109  agency is authorized to seek any necessary state plan amendment
  110  or federal waiver to commence enrollment in the Medicaid prepaid
  111  dental health program no later than March 1, 2019.
  112         Section 3. Except as otherwise expressly provided in this
  113  act, this act shall take effect July 1, 2016.