Florida Senate - 2016                        COMMITTEE AMENDMENT
       Bill No. SB 526
       
       
       
       
       
       
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                              LEGISLATIVE ACTION                        
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       The Committee on Health Policy (Grimsley) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Subsection (11) of section 409.908, Florida
    6  Statutes, is amended to read:
    7         409.908 Reimbursement of Medicaid providers.—Subject to
    8  specific appropriations, the agency shall reimburse Medicaid
    9  providers, in accordance with state and federal law, according
   10  to methodologies set forth in the rules of the agency and in
   11  policy manuals and handbooks incorporated by reference therein.
   12  These methodologies may include fee schedules, reimbursement
   13  methods based on cost reporting, negotiated fees, competitive
   14  bidding pursuant to s. 287.057, and other mechanisms the agency
   15  considers efficient and effective for purchasing services or
   16  goods on behalf of recipients. If a provider is reimbursed based
   17  on cost reporting and submits a cost report late and that cost
   18  report would have been used to set a lower reimbursement rate
   19  for a rate semester, then the provider’s rate for that semester
   20  shall be retroactively calculated using the new cost report, and
   21  full payment at the recalculated rate shall be effected
   22  retroactively. Medicare-granted extensions for filing cost
   23  reports, if applicable, shall also apply to Medicaid cost
   24  reports. Payment for Medicaid compensable services made on
   25  behalf of Medicaid eligible persons is subject to the
   26  availability of moneys and any limitations or directions
   27  provided for in the General Appropriations Act or chapter 216.
   28  Further, nothing in this section shall be construed to prevent
   29  or limit the agency from adjusting fees, reimbursement rates,
   30  lengths of stay, number of visits, or number of services, or
   31  making any other adjustments necessary to comply with the
   32  availability of moneys and any limitations or directions
   33  provided for in the General Appropriations Act, provided the
   34  adjustment is consistent with legislative intent.
   35         (11) A provider of independent laboratory services shall be
   36  reimbursed on the basis of competitive bidding or for the least
   37  of the amount billed by the provider, the provider’s usual and
   38  customary charge, or the Medicaid maximum allowable fee
   39  established by the agency. For purposes of ss. 409.901-409.9201
   40  and with respect to a provider of independent laboratory
   41  services, the term “usual and customary charge” means the amount
   42  routinely billed by the provider to an uninsured consumer for
   43  services or goods before the application of any discount,
   44  rebate, or supplemental plan. Free or discounted charges for
   45  services or goods based on a person’s uninsured or indigent
   46  status or other financial hardship are not usual and customary
   47  charges. This subsection is intended to be remedial in nature
   48  and to clarify existing law, and shall apply retroactively.
   49         Section 2.  This act shall take effect July 1, 2016.
   50  
   51  ================= T I T L E  A M E N D M E N T ================
   52  And the title is amended as follows:
   53         Delete everything before the enacting clause
   54  and insert:
   55                        A bill to be entitled                      
   56         An act relating to Medicaid providers of independent
   57         laboratory services; amending s. 409.908, F.S.;
   58         providing a definition of “usual and customary charge”
   59         for providers of independent laboratory services;
   60         providing for applicability; providing an effective
   61         date.