CODING: Words stricken are deletions; words underlined are additions.





                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3895

    Amendment No.     (for drafter's use only)

                            CHAMBER ACTION
              Senate                               House
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 4                                                                

 5                                           ORIGINAL STAMP BELOW

 6

 7

 8

 9

10                                                                

11  Representative(s) Albright offered the following:

12

13         Amendment (with title amendment) 

14         On page 10, between lines 18 and 19, of the bill

15

16  insert:

17         Section 7.  New subsection (33) is added to section

18  409.912, Florida Statutes, to read:

19         409.912  Cost-effective purchasing of health care.--The

20  agency shall purchase goods and services for Medicaid

21  recipients in the most cost-effective manner consistent with

22  the delivery of quality medical care.  The agency shall

23  maximize the use of prepaid per capita and prepaid aggregate

24  fixed-sum basis services when appropriate and other

25  alternative service delivery and reimbursement methodologies,

26  including competitive bidding pursuant to s. 287.057, designed

27  to facilitate the cost-effective purchase of a case-managed

28  continuum of care. The agency shall also require providers to

29  minimize the exposure of recipients to the need for acute

30  inpatient, custodial, and other institutional care and the

31  inappropriate or unnecessary use of high-cost services.

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    File original & 9 copies    04/07/98
    hci0002                     06:36 pm         03895-0024-763867




                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3895

    Amendment No.     (for drafter's use only)





 1         (33)  The Agency for Health Care Administration is

 2  directed to issue a request for proposal or intent to

 3  negotiate to implement on a demonstration basis an outpatient

 4  specialty services pilot project in a rural and urban county

 5  in the state.  As used in this subsection, the term

 6  "outpatient specialty services" means clinical laboratory,

 7  diagnostic imaging, and specified home medical services to

 8  include durable medical equipment, prosthetics and orthotics,

 9  and infusion therapy.

10         (a)  The entity that is awarded the contract to provide

11  Medicaid managed care outpatient specialty services shall, at

12  a minimum, meet the following criteria:

13         1.  The entity shall be licensed by the Department of

14  Insurance under part II of chapter 641.

15         2.  The entity shall be experienced in providing

16  outpatient specialty services.

17         3.  The entity shall demonstrate to the satisfaction of

18  the agency that it provides high-quality services to its

19  patients.

20         4.  The entity shall demonstrate that it has in place a

21  complaints and grievance process to assist Medicaid recipients

22  enrolled in the pilot managed care program to resolve

23  complaints and grievances.

24         (b)  The pilot managed care program shall operate for a

25  period of three years.  The objective of the pilot program

26  shall be to determine the cost-effectiveness and effects on

27  utilization, access, and quality of providing outpatient

28  specialty services to Medicaid recipients on a prepaid,

29  capitated basis.

30         (c)  The agency shall conduct a quality-assurance

31  review of the prepaid limited health service organization each

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    File original & 9 copies    04/07/98
    hci0002                     06:36 pm         03895-0024-763867




                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3895

    Amendment No.     (for drafter's use only)





 1  year that the demonstration program is in effect.  The prepaid

 2  limited health service organization is responsible for all

 3  expenses incurred by the agency in conducting a quality

 4  assurance review.

 5         (d)  The entity that is awarded the contract to provide

 6  outpatient specialty services to Medicaid recipients shall

 7  report data required by the agency in a format specified by

 8  the agency, for the purpose of conducting the evaluation

 9  required in paragraph (e).

10         (e)  The agency shall conduct an evaluation of the

11  pilot managed care program and report its findings to the

12  Governor and the Legislature by no later than January 1, 2001.

13         (f)  Nothing in this subsection is intended to conflict

14  with the provision of the 1997-98 General Appropriations Act

15  which authorizes competitive bidding for Medicaid home health,

16  clinical laboratory, or x-ray services.

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19  ================ T I T L E   A M E N D M E N T ===============

20  And the title is amended as follows:

21         On page 1, line 24,

22

23  insert after the semicolon:

24         amending s. 409.912, F.S., directing the Agency

25         for Health Care Administration to establish an

26         outpatient specialty services pilot project;

27         providing definitions; providing criteria for

28         participation; requiring an evaluation and a

29         report to the Governor and Legislature;

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31

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    File original & 9 copies    04/07/98
    hci0002                     06:36 pm         03895-0024-763867