Florida Senate - 2016                          SENATOR AMENDMENT
       Bill No. SB 994
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                Floor: 1/AD/2R         .                                
             03/04/2016 12:54 PM       .                                

       Senator Negron moved the following:
    1         Senate Amendment (with title amendment)
    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.—
   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.
  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.