Senate Bill 2242

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    Florida Senate - 2000                                  SB 2242

    By Senator Saunders





    25-646B-00

  1                      A bill to be entitled

  2         An act relating to health care; amending s.

  3         409.901, F.S.; amending definitions of terms

  4         used in ss. 409.910-409.920, F.S.; amending s.

  5         409.902, F.S.; providing that the Department of

  6         Children and Family Services is responsible for

  7         Medicaid eligibility determinations; amending

  8         s. 409.903, F.S.; providing responsibility for

  9         determinations of eligibility for payments for

10         medical assistance and related services;

11         amending s. 409.905, F.S.; increasing the

12         maximum amount that may be paid under Medicaid

13         for hospital outpatient services; amending s.

14         409.906, F.S.; allowing the Department of

15         Children and Family Services to transfer funds

16         to the Agency for Health Care Administration to

17         cover state match requirements as specified;

18         amending s. 409.907, F.S.; revising

19         requirements relating to the minimum amount of

20         the surety bond which each provider is required

21         to maintain; specifying grounds on which

22         provider applications may be denied; amending

23         s. 409.908, F.S.; increasing the maximum amount

24         of reimbursement allowable to Medicaid

25         providers for hospital inpatient care; creating

26         s. 409.919, F.S.; creating a

27         disproportionate-share program for children's

28         hospitals; providing formulas governing

29         payments made to hospitals under the program;

30         providing for withholding payments from a

31         hospital that is not complying with agency

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  1         rules; amending s. 409.912, F.S.; providing for

  2         the transfer of certain unexpended Medicaid

  3         funds from the Department of Elderly Affairs to

  4         the Agency for Health Care Administration;

  5         providing for the adoption and the transfer of

  6         certain rules relating to the determination of

  7         Medicaid eligibility; providing for the Agency

  8         for Health Care Administration to seek a

  9         federal waiver allowing the agency to undertake

10         a pilot project that involves contracting with

11         skilled nursing facilities for the provision of

12         rehabilitation services to ventilator-dependent

13         patients; providing for evaluation of the pilot

14         program; providing an effective date.

15

16  Be It Enacted by the Legislature of the State of Florida:

17

18         Section 1.  Subsections (3), (15), and (18) of section

19  409.901, Florida Statutes, are amended to read:

20         409.901  Definitions.--As used in ss. 409.901-409.920,

21  except as otherwise specifically provided, the term:

22         (3)  "Applicant" means an individual whose written

23  application for medical assistance provided by Medicaid under

24  ss. 409.903-409.906 has been submitted to the department

25  agency, or to the Social Security Administration if the

26  application is for Supplemental Security Income, but has not

27  received final action.  This term includes an individual, who

28  need not be alive at the time of application, whose

29  application is submitted through a representative or a person

30  acting for the individual.

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  1         (15)  "Medicaid program" means the program authorized

  2  under Title XIX of the federal Social Security Act which

  3  provides for payments for medical items or services, or both,

  4  on behalf of any person who is determined by the Department of

  5  Children and Family Services, or, for Supplemental Security

  6  Income, by the Social Security Administration, to be eligible

  7  on the date of service for Medicaid assistance.

  8         (18)  "Medicaid recipient" or "recipient" means an

  9  individual whom the Department of Children and Family

10  Services, or, for Supplemental Security Income, the Social

11  Security Administration, determines is eligible, pursuant to

12  federal and state law, to receive medical assistance and

13  related services for which the agency may make payments under

14  the Medicaid program. For the purposes of determining

15  third-party liability, the term includes an individual

16  formerly determined to be eligible for Medicaid, an individual

17  who has received medical assistance under the Medicaid

18  program, or an individual on whose behalf Medicaid has become

19  obligated.

20         Section 2.  Section 409.902, Florida Statutes, is

21  amended to read:

22         409.902  Designated single state agency; payment

23  requirements; program title.--The Agency for Health Care

24  Administration is designated as the single state agency

25  authorized to make payments for medical assistance and related

26  services under Title XIX of the Social Security Act.  These

27  payments shall be made, subject to any limitations or

28  directions provided for in the General Appropriations Act,

29  only for services included in the program, shall be made only

30  on behalf of eligible individuals, and shall be made only to

31  qualified providers in accordance with federal requirements

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  1  for Title XIX of the Social Security Act and the provisions of

  2  state law.  This program of medical assistance is designated

  3  the "Medicaid program." The Department of Children and Family

  4  Services is responsible for Medicaid eligibility

  5  determinations, including policy, rules, and the agreement

  6  with the Social Security Administration for Medicaid

  7  eligibility determinations for Supplemental Security Income

  8  recipients, as well as the actual determination of

  9  eligibility.

10         Section 3.  Section 409.903, Florida Statutes, is

11  amended to read:

12         409.903  Mandatory payments for eligible persons.--The

13  agency shall make payments for medical assistance and related

14  services on behalf of the following persons who the

15  department, or the Social Security Administration by contract

16  with the Department of Children and Family Services, agency

17  determines to be eligible, subject to the income, assets, and

18  categorical eligibility tests set forth in federal and state

19  law.  Payment on behalf of these Medicaid eligible persons is

20  subject to the availability of moneys and any limitations

21  established by the General Appropriations Act or chapter 216.

22         (1)  Low-income families with children are eligible for

23  Medicaid provided they meet the following requirements:

24         (a)  The family includes a dependent child who is

25  living with a caretaker relative.

26         (b)  The family's income does not exceed the gross

27  income test limit.

28         (c)  The family's countable income and resources do not

29  exceed the applicable Aid to Families with Dependent Children

30  (AFDC) income and resource standards under the AFDC state plan

31  in effect in July 1996, except as amended in the Medicaid

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  1  state plan to conform as closely as possible to the

  2  requirements of the WAGES Program as created in s. 414.015, to

  3  the extent permitted by federal law.

  4         (2)  A person who receives payments from, who is

  5  determined eligible for, or who was eligible for but lost cash

  6  benefits from the federal program known as the Supplemental

  7  Security Income program (SSI).  This category includes a

  8  low-income person age 65 or over and a low-income person under

  9  age 65 considered to be permanently and totally disabled.

10         (3)  A child under age 21 living in a low-income,

11  two-parent family, and a child under age 7 living with a

12  nonrelative, if the income and assets of the family or child,

13  as applicable, do not exceed the resource limits under the

14  WAGES Program.

15         (4)  A child who is eligible under Title IV-E of the

16  Social Security Act for subsidized board payments, foster

17  care, or adoption subsidies, and a child for whom the state

18  has assumed temporary or permanent responsibility and who does

19  not qualify for Title IV-E assistance but is in foster care,

20  shelter or emergency shelter care, or subsidized adoption.

21         (5)  A pregnant woman for the duration of her pregnancy

22  and for the post partum period as defined in federal law and

23  rule, or a child under age 1, if either is living in a family

24  that has an income which is at or below 150 percent of the

25  most current federal poverty level, or, effective January 1,

26  1992, that has an income which is at or below 185 percent of

27  the most current federal poverty level.  Such a person is not

28  subject to an assets test. Further, a pregnant woman who

29  applies for eligibility for the Medicaid program through a

30  qualified Medicaid provider must be offered the opportunity,

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  1  subject to federal rules, to be made presumptively eligible

  2  for the Medicaid program.

  3         (6)  A child born after September 30, 1983, living in a

  4  family that has an income which is at or below 100 percent of

  5  the current federal poverty level, who has attained the age of

  6  6, but has not attained the age of 19.  In determining the

  7  eligibility of such a child, an assets test is not required.

  8         (7)  A child living in a family that has an income

  9  which is at or below 133 percent of the current federal

10  poverty level, who has attained the age of 1, but has not

11  attained the age of 6.  In determining the eligibility of such

12  a child, an assets test is not required.

13         (8)  A person who is age 65 or over or is determined by

14  the agency to be disabled, whose income is at or below 100

15  percent of the most current federal poverty level and whose

16  assets do not exceed limitations established by the agency.

17  However, the agency may only pay for premiums, coinsurance,

18  and deductibles, as required by federal law, unless additional

19  coverage is provided for any or all members of this group by

20  s. 409.904(1).

21         Section 4.  Subsection (6) of section 409.905, Florida

22  Statutes, is amended to read:

23         409.905  Mandatory Medicaid services.--The agency may

24  make payments for the following services, which are required

25  of the state by Title XIX of the Social Security Act,

26  furnished by Medicaid providers to recipients who are

27  determined to be eligible on the dates on which the services

28  were provided.  Any service under this section shall be

29  provided only when medically necessary and in accordance with

30  state and federal law. Nothing in this section shall be

31  construed to prevent or limit the agency from adjusting fees,

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  1  reimbursement rates, lengths of stay, number of visits, number

  2  of services, or any other adjustments necessary to comply with

  3  the availability of moneys and any limitations or directions

  4  provided for in the General Appropriations Act or chapter 216.

  5         (6)  HOSPITAL OUTPATIENT SERVICES.--The agency shall

  6  pay for preventive, diagnostic, therapeutic, or palliative

  7  care and other services provided to a recipient in the

  8  outpatient portion of a hospital licensed under part I of

  9  chapter 395, and provided under the direction of a licensed

10  physician or licensed dentist, except that payment for such

11  care and services is limited to $1,500 $1,000 per state fiscal

12  year per recipient, unless an exception has been made by the

13  agency, and with the exception of a Medicaid recipient under

14  age 21, in which case the only limitation is medical

15  necessity.

16         Section 5.  Subsection (5) of section 409.906, Florida

17  Statutes, is amended to read:

18         409.906  Optional Medicaid services.--Subject to

19  specific appropriations, the agency may make payments for

20  services which are optional to the state under Title XIX of

21  the Social Security Act and are furnished by Medicaid

22  providers to recipients who are determined to be eligible on

23  the dates on which the services were provided.  Any optional

24  service that is provided shall be provided only when medically

25  necessary and in accordance with state and federal law.

26  Nothing in this section shall be construed to prevent or limit

27  the agency from adjusting fees, reimbursement rates, lengths

28  of stay, number of visits, or number of services, or making

29  any other adjustments necessary to comply with the

30  availability of moneys and any limitations or directions

31  provided for in the General Appropriations Act or chapter 216.

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  1  If necessary to safeguard the state's systems of providing

  2  services to elderly and disabled persons and subject to the

  3  notice and review provisions of s. 216.177, the Governor may

  4  direct the Agency for Health Care Administration to amend the

  5  Medicaid state plan to delete the optional Medicaid service

  6  known as "Intermediate Care Facilities for the Developmentally

  7  Disabled."  Optional services may include:

  8         (5)  CASE MANAGEMENT SERVICES.--The agency may pay for

  9  primary care case management services rendered to a recipient

10  pursuant to a federally approved waiver, and targeted case

11  management services for specific groups of targeted

12  recipients, for which funding has been provided and which are

13  rendered pursuant to federal guidelines. The agency is

14  authorized to limit reimbursement for targeted case management

15  services in order to comply with any limitations or directions

16  provided for in the General Appropriations Act.

17  Notwithstanding s. 216.292, the Department of Children and

18  Family Services may transfer general funds to the Agency for

19  Health Care Administration to cover state match requirements

20  exceeding the amount specified in the General Appropriations

21  Act for targeted case management services.

22         Section 6.  Subsections (7), (9), and (10) of section

23  409.907, Florida Statutes, are amended to read:

24         409.907  Medicaid provider agreements.--The agency may

25  make payments for medical assistance and related services

26  rendered to Medicaid recipients only to an individual or

27  entity who has a provider agreement in effect with the agency,

28  who is performing services or supplying goods in accordance

29  with federal, state, and local law, and who agrees that no

30  person shall, on the grounds of handicap, race, color, or

31  national origin, or for any other reason, be subjected to

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  1  discrimination under any program or activity for which the

  2  provider receives payment from the agency.

  3         (7)  The agency may require, as a condition of

  4  participating in the Medicaid program and before entering into

  5  the provider agreement, that the provider submit information

  6  concerning the professional, business, and personal background

  7  of the provider and permit an onsite inspection of the

  8  provider's service location by agency staff or other personnel

  9  designated by the agency to perform assist in this function.

10  Before entering into the provider agreement, or as a condition

11  of continuing participation in the Medicaid program, the

12  agency and may also require a surety bond from the provider

13  not to exceed $50,000 or the total amount billed by the

14  provider to the program during the current or most recent

15  calendar year, whichever is greater. For new providers, the

16  agency shall determine the amount of the surety bond based on

17  the provider's estimate of its first year's billing. If the

18  provider's billing during the first year exceeds the bond

19  amount, the agency may require the provider to acquire an

20  additional bond in an amount such that the aggregate amount of

21  the surety bonds equals the amount billed by the provider. If

22  the provider is a corporation, partnership, association, or

23  other entity, the agency may require the provider to submit

24  information concerning the background of that entity and of

25  any principal of the entity, including any partner or

26  shareholder having an ownership interest in the entity equal

27  to 5 percent or greater, and any treating provider who

28  participates in or intends to participate in Medicaid through

29  the entity. The information must include:

30         (a)  Proof of holding a valid license or operating

31  certificate, as applicable, if required by the state or local

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  1  jurisdiction in which the provider is located or if required

  2  by the Federal Government.

  3         (b)  Information concerning any prior violation, fine,

  4  suspension, termination, or other administrative action taken

  5  under the Medicaid laws, rules, or regulations of this state

  6  or of any other state or the Federal Government; any prior

  7  violation of the laws, rules, or regulations relating to the

  8  Medicare program; any prior violation of the rules or

  9  regulations of any other public or private insurer; and any

10  prior violation of the laws, rules, or regulations of any

11  regulatory body of this or any other state.

12         (c)  Full and accurate disclosure of any financial or

13  ownership interest that the provider, or any principal,

14  partner, or major shareholder thereof, may hold in any other

15  Medicaid provider or health care related entity or any other

16  entity that is licensed by the state to provide health or

17  residential care and treatment to persons.

18         (d)  If a group provider, identification of all members

19  of the group and attestation that all members of the group are

20  enrolled in or have applied to enroll in the Medicaid program.

21         (9)  Upon receipt of a completed, signed, and dated

22  application, and completion of any necessary background

23  investigation and criminal history record check, the agency

24  must either:

25         (a)  Enroll the applicant as a Medicaid provider; or

26         (b)  Deny the application if the agency finds that,

27  based on the grounds listed in subsection (10), it is in the

28  best interest of the Medicaid program to do so, specifying the

29  reasons for denial. The agency may consider the factors listed

30  in subsection (10), as well as any other factor that could

31  affect the effective and efficient administration of the

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  1  program, including, but not limited to, the current

  2  availability of medical care, services, or supplies to

  3  recipients, taking into account geographic location and

  4  reasonable travel time.

  5         (10)  The agency may consider whether deny enrollment

  6  in the Medicaid program to a provider if the provider, or any

  7  officer, director, agent, managing employee, or affiliated

  8  person, or any partner or shareholder having an ownership

  9  interest equal to 5 percent or greater in the provider if the

10  provider is a corporation, partnership, or other business

11  entity, has:

12         (a)  Made a false representation or omission of any

13  material fact in making the application, including the

14  submission of an application that conceals the controlling or

15  ownership interest of any officer, director, agent, managing

16  employee, affiliated person, or partner or shareholder who may

17  not be eligible to participate;

18         (b)  Been or is currently excluded, suspended,

19  terminated from, or has involuntarily withdrawn from

20  participation in, Florida's Medicaid program or any other

21  state's Medicaid program, or from participation in any other

22  governmental or private health care or health insurance

23  program;

24         (c)  Been convicted of a criminal offense relating to

25  the delivery of any goods or services under Medicaid or

26  Medicare or any other public or private health care or health

27  insurance program including the performance of management or

28  administrative services relating to the delivery of goods or

29  services under any such program;

30         (d)  Been convicted under federal or state law of a

31  criminal offense related to the neglect or abuse of a patient

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  1  in connection with the delivery of any health care goods or

  2  services;

  3         (e)  Been convicted under federal or state law of a

  4  criminal offense relating to the unlawful manufacture,

  5  distribution, prescription, or dispensing of a controlled

  6  substance;

  7         (f)  Been convicted of any criminal offense relating to

  8  fraud, theft, embezzlement, breach of fiduciary

  9  responsibility, or other financial misconduct;

10         (g)  Been convicted under federal or state law of a

11  crime punishable by imprisonment of a year or more which

12  involves moral turpitude;

13         (h)  Been convicted in connection with the interference

14  or obstruction of any investigation into any criminal offense

15  listed in this subsection;

16         (i)  Been found to have violated federal or state laws,

17  rules, or regulations governing Florida's Medicaid program or

18  any other state's Medicaid program, the Medicare program, or

19  any other publicly funded federal or state health care or

20  health insurance program, and been sanctioned accordingly;

21         (j)  Been previously found by a licensing, certifying,

22  or professional standards board or agency to have violated the

23  standards or conditions relating to licensure or certification

24  or the quality of services provided; or

25         (k)  Failed to pay any fine or overpayment properly

26  assessed under the Medicaid program in which no appeal is

27  pending or after resolution of the proceeding by stipulation

28  or agreement, unless the agency has issued a specific letter

29  of forgiveness or has approved a repayment schedule to which

30  the provider agrees to adhere.

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  1         Section 7.  Paragraph (a) of subsection (1) of section

  2  409.908, Florida Statutes, is amended to read:

  3         409.908  Reimbursement of Medicaid providers.--Subject

  4  to specific appropriations, the agency shall reimburse

  5  Medicaid providers, in accordance with state and federal law,

  6  according to methodologies set forth in the rules of the

  7  agency and in policy manuals and handbooks incorporated by

  8  reference therein.  These methodologies may include fee

  9  schedules, reimbursement methods based on cost reporting,

10  negotiated fees, competitive bidding pursuant to s. 287.057,

11  and other mechanisms the agency considers efficient and

12  effective for purchasing services or goods on behalf of

13  recipients.  Payment for Medicaid compensable services made on

14  behalf of Medicaid eligible persons is subject to the

15  availability of moneys and any limitations or directions

16  provided for in the General Appropriations Act or chapter 216.

17  Further, nothing in this section shall be construed to prevent

18  or limit the agency from adjusting fees, reimbursement rates,

19  lengths of stay, number of visits, or number of services, or

20  making any other adjustments necessary to comply with the

21  availability of moneys and any limitations or directions

22  provided for in the General Appropriations Act, provided the

23  adjustment is consistent with legislative intent.

24         (1)  Reimbursement to hospitals licensed under part I

25  of chapter 395 must be made prospectively or on the basis of

26  negotiation.

27         (a)  Reimbursement for inpatient care is limited as

28  provided for in s. 409.905(5). Reimbursement for hospital

29  outpatient care is limited to $1,500 $1,000 per state fiscal

30  year per recipient, except for:

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  1         1.  Such care provided to a Medicaid recipient under

  2  age 21, in which case the only limitation is medical

  3  necessity;

  4         2.  Renal dialysis services; and

  5         3.  Other exceptions made by the agency.

  6         Section 8.  Section 409.9119, Florida Statutes, is

  7  created to read:

  8         409.9119  Disproportionate-share program for children's

  9  hospitals.--In addition to the payments made under s. 409.911,

10  the Agency for Health Care Administration shall develop and

11  implement a system under which disproportionate-share payments

12  are made to those hospitals that are licensed by the state as

13  a children's hospital. This system of payments must conform to

14  federal requirements and must distribute funds in each fiscal

15  year for which an appropriation is made by making quarterly

16  Medicaid payments. Notwithstanding s. 409.915, counties are

17  exempt from contributing toward the cost of this special

18  reimbursement for hospitals that serve a disproportionate

19  share of low-income patients.

20         (1)  The agency shall use the following formula to

21  calculate the total amount earned for hospitals that

22  participate in the children's hospital disproportionate-share

23  program:

24                      TAE = DSR x BMPD x MD

25  Where:

26         TAE = total amount earned by a children's hospital.

27         DSR = disproportionate-share rate.

28         BMPD = base Medicaid per diem.

29         MD = Medicaid days.

30

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  1         (2)  The agency shall calculate the total additional

  2  payment for hospitals that participate in the children's

  3  hospital disproportionate-share program as follows:

  4

  5                         TAP = (TAE x TA)

  6                                         

  7                               STAE

  8  Where:

  9         TAP = total additional payment for a children's

10  hospital.

11         TAE = total amount earned by a children's hospital.

12         STAE = sum of total amount earned by each hospital that

13  participates in the children's hospital disproportionate-share

14  program.

15         TA = total appropriation for the children's hospital

16  disproportionate-share program.

17

18         (3)  A hospital may not receive any payments under this

19  section until it achieves full compliance with the applicable

20  rules of the agency. A hospital that is not in compliance for

21  two or more consecutive quarters may not receive its share of

22  the funds. Any forfeited funds must be distributed to the

23  remaining participating children's hospitals that are in

24  compliance.

25         Section 9.  Subsection (9) of section 409.912, Florida

26  Statutes, is amended to read:

27         409.912  Cost-effective purchasing of health care.--The

28  agency shall purchase goods and services for Medicaid

29  recipients in the most cost-effective manner consistent with

30  the delivery of quality medical care.  The agency shall

31  maximize the use of prepaid per capita and prepaid aggregate

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  1  fixed-sum basis services when appropriate and other

  2  alternative service delivery and reimbursement methodologies,

  3  including competitive bidding pursuant to s. 287.057, designed

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

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

  6  minimize the exposure of recipients to the need for acute

  7  inpatient, custodial, and other institutional care and the

  8  inappropriate or unnecessary use of high-cost services.

  9         (9)  The agency, after notifying the Legislature, may

10  apply for waivers of applicable federal laws and regulations

11  as necessary to implement more appropriate systems of health

12  care for Medicaid recipients and reduce the cost of the

13  Medicaid program to the state and federal governments and

14  shall implement such programs, after legislative approval,

15  within a reasonable period of time after federal approval.

16  These programs must be designed primarily to reduce the need

17  for inpatient care, custodial care and other long-term or

18  institutional care, and other high-cost services.

19         (a)  Before Prior to seeking legislative approval of

20  such a waiver as authorized by this subsection, the agency

21  must shall provide notice and an opportunity for public

22  comment.  Notice must shall be provided to all persons who

23  have made requests of the agency for advance notice and must

24  shall be published in the Florida Administrative Weekly not

25  less than 28 days before prior to the intended action.

26         (b)  Notwithstanding s. 216.292, funds that are

27  appropriated to the Department of Elderly Affairs for the

28  Assisted Living for the Elderly Medicaid waiver and are not

29  expended must be transferred to the agency to fund

30  Medicaid-reimbursed nursing home care.

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  1         Section 10.  Section 409.919, Florida Statutes, is

  2  amended to read:

  3         409.919  Rules.--The agency shall adopt any rules

  4  necessary to comply with or administer ss. 409.901-409.920 and

  5  all rules necessary to comply with federal requirements. In

  6  addition, the Department of Children and Family Services shall

  7  adopt and accept transfer of any rules necessary to comply

  8  with or administer ss. 409.901-409.904 and 409.906 and any

  9  other provisions necessary to the determination of Medicaid

10  eligibility.

11         Section 11.  The Agency for Health Care Administration

12  may submit to the Health Care Financing Administration a

13  request for waiver that will allow the agency to undertake a

14  pilot project that would implement a coordinated system of

15  care for ventilator-dependent patients. Under this pilot

16  program, the agency shall identify a sophisticated

17  case-management network of skilled nursing facilities that

18  will provide to ventilator patients who are moved out of

19  acute-care facilities and into the skilled nursing facilities

20  intensive rehabilitative efforts aimed at getting the patients

21  off ventilators and into their own homes. The agency shall

22  contract with those skilled nursing facilities for the

23  provision of such rehabilitative services under a capitation

24  arrangement. An eligible patient would be enrolled into the

25  management program as soon as he or she goes on a ventilator.

26  Each patient's benefits would be extended for 180 days to

27  allow for the placement of the patient into a skilled nursing

28  facility. The pilot project would allow the agency to evaluate

29  a coordinated and focused system of care for ventilator

30  patients to determine the overall cost-effectiveness and

31  improved outcomes for such patients.

                                  17

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






    Florida Senate - 2000                                  SB 2242
    25-646B-00




  1         Section 12.  This act shall take effect July 1, 2000.

  2

  3            *****************************************

  4                          SENATE SUMMARY

  5    Relates to health care, primarily that which is provided
      under Medicaid. Amends definitions of terms used in ss.
  6    409.910-409.920, F.S. Provides that the Department of
      Children and Family Services is responsible for Medicaid
  7    eligibility determinations. Provides responsibility for
      determinations of eligibility for payments for medical
  8    assistance and related services. Increases from $1,000 to
      $1,500 the maximum amount that may be paid under Medicaid
  9    for hospital outpatient services. Allows the Department
      of Children and Family Services to transfer funds to the
10    Agency for Health Care Administration to cover state
      match requirements as specified. Revises requirements
11    relating to the minimum amount of the surety bond which
      each provider is required to maintain. Specifies grounds
12    on which provider applications may be denied. Increases
      from $1,000 to $1,500 the maximum amount of reimbursement
13    allowable to Medicaid providers for hospital inpatient
      care. Creates a disproportionate-share program for
14    children's hospitals. Provides formulas governing
      payments made to hospitals under the program. Provides
15    for withholding payments from hospitals that are not in
      compliance with agency rules. Provides for the transfer
16    of certain unexpended Medicaid funds from the Department
      of Elderly Affairs to the Agency for Health Care
17    Administration. Provides for the adoption and the
      transfer of certain rules relating to the determination
18    of Medicaid eligibility. Provides for the Agency for
      Health Care Administration to seek a federal waiver
19    allowing the agency to undertake a pilot project that
      involves contracting with skilled nursing facilities for
20    the provision of rehabilitation services to
      ventilator-dependent patients. Provides for an evaluation
21    of the pilot program.

22

23

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27

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31

                                  18