Florida Senate - 2016 SENATOR AMENDMENT
Bill No. SB 994
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LEGISLATIVE ACTION
Senate . House
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Floor: 1/AD/2R .
03/04/2016 12:54 PM .
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Senator Negron moved the following:
1 Senate Amendment (with title amendment)
2
3 Delete everything after the enacting clause
4 and insert:
5 Section 1. Effective March 1, 2019, subsection (1) of
6 section 409.973, Florida Statutes, is amended to read:
7 409.973 Benefits.—
8 (1) MINIMUM BENEFITS.—Managed care plans shall cover, at a
9 minimum, the following services:
10 (a) Advanced registered nurse practitioner services.
11 (b) Ambulatory surgical treatment center services.
12 (c) Birthing center services.
13 (d) Chiropractic services.
14 (e) Dental services.
15 (e)(f) Early periodic screening diagnosis and treatment
16 services for recipients under age 21.
17 (f)(g) Emergency services.
18 (g)(h) Family planning services and supplies. Pursuant to
19 42 C.F.R. s. 438.102, plans may elect to not provide these
20 services due to an objection on moral or religious grounds, and
21 must notify the agency of that election when submitting a reply
22 to an invitation to negotiate.
23 (h)(i) Healthy start services, except as provided in s.
24 409.975(4).
25 (i)(j) Hearing services.
26 (j)(k) Home health agency services.
27 (k)(l) Hospice services.
28 (l)(m) Hospital inpatient services.
29 (m)(n) Hospital outpatient services.
30 (n)(o) Laboratory and imaging services.
31 (o)(p) Medical supplies, equipment, prostheses, and
32 orthoses.
33 (p)(q) Mental health services.
34 (q)(r) Nursing care.
35 (r)(s) Optical services and supplies.
36 (s)(t) Optometrist services.
37 (t)(u) Physical, occupational, respiratory, and speech
38 therapy services.
39 (u)(v) Physician services, including physician assistant
40 services.
41 (v)(w) Podiatric services.
42 (w)(x) Prescription drugs.
43 (x)(y) Renal dialysis services.
44 (y)(z) Respiratory equipment and supplies.
45 (z)(aa) Rural health clinic services.
46 (aa)(bb) Substance abuse treatment services.
47 (bb)(cc) Transportation to access covered services.
48 Section 2. Subsection (5) is added to section 409.973,
49 Florida Statutes, to read:
50 409.973 Benefits.—
51 (5) PROVISION OF DENTAL SERVICES.—
52 (a) The Office of Program Policy Analysis and Government
53 Accountability shall provide a comprehensive report on the
54 provision of dental services under this part to the Governor,
55 the President of the Senate, and the Speaker of the House of
56 Representatives by December 1, 2016. The Office of Program
57 Policy Analysis and Government Accountability is authorized to
58 contract with an independent third party to assist in the
59 preparation of the report required by this paragraph.
60 1. The report must examine the effectiveness of medical
61 managed care plans in increasing patient access to dental care,
62 improving dental health, achieving satisfactory outcomes for
63 Medicaid recipients and the dental provider community, providing
64 outreach to Medicaid recipients, and delivering value and
65 transparency to the state’s taxpayers regarding the dollars
66 intended for, and spent on, actual dental services.
67 Additionally, the report must examine, by plan and in the
68 aggregate, the historical trends of rates paid to dental
69 providers and to dental plan subcontractors, dental provider
70 participation in plan networks, and provider willingness to
71 treat Medicaid recipients. The report must also compare current
72 and historical efforts and trends and the experiences of other
73 states in delivering dental services, increasing patient access
74 to dental care, and improving dental health.
75 2. The Legislature may use the findings of this report in
76 setting the scope of minimum benefits set forth in this section
77 for future procurements of eligible plans as described in s.
78 409.966. Specifically, the decision to include dental services
79 as a minimum benefit under this section, or to provide Medicaid
80 recipients with dental benefits separate from the Medicaid
81 managed medical assistance program described in this part, may
82 take into consideration the data and findings of the report.
83 (b) In the event the Legislature takes no action before
84 July 1, 2017, with respect to the report findings required under
85 subparagraph (a)2., the agency shall implement a statewide
86 Medicaid prepaid dental health program for children and adults
87 with a choice of at least two licensed dental managed care
88 providers who must have substantial experience in providing
89 dental care to Medicaid enrollees and children eligible for
90 medical assistance under Title XXI of the Social Security Act
91 and who meet all agency standards and requirements. To qualify
92 as a provider under the prepaid dental health program, the
93 entity must be licensed as a prepaid limited health service
94 organization under part I of chapter 636 or as a health
95 maintenance organization under part I of chapter 641. The
96 contracts for program providers shall be awarded through a
97 competitive procurement process. The contracts must be for 5
98 years and may not be renewed; however, the agency may extend the
99 term of a plan contract to cover delays during a transition to a
100 new plan provider. The agency shall include in the contracts a
101 medical loss ratio provision consistent with s. 409.967(4). The
102 agency is authorized to seek any necessary state plan amendment
103 or federal waiver to commence enrollment in the Medicaid prepaid
104 dental health program no later than March 1, 2019.
105 Section 3. Except as otherwise expressly provided in this
106 act, this act shall take effect July 1, 2016.
107
108 ================= T I T L E A M E N D M E N T ================
109 And the title is amended as follows:
110 Delete everything before the enacting clause
111 and insert:
112 A bill to be entitled
113 An act relating to the sunset review of Medicaid
114 Dental Services; amending s. 409.973, F.S.; providing
115 for the future removal of dental services as a minimum
116 benefit of managed care plans; requiring the Office of
117 Program Policy Analysis and Government Accountability
118 to provide a report to the Governor and Legislature;
119 specifying requirements for the report; providing for
120 use of the report’s findings; requiring the Agency for
121 Health Care Administration to implement a statewide
122 Medicaid prepaid dental health program upon the
123 occurrence of certain conditions; specifying
124 requirements for the program and the selection of
125 providers; providing effective dates.