HB 1257

1	A bill to be entitled
2	An act relating to Medicaid fraud; creating s. 409.9201,
3	F.S.; making it unlawful to sell or attempt or conspire to
4	sell, or to purchase or attempt or conspire to purchase,
5	certain Medicaid program prescription drugs; making it
6	unlawful to make certain false statements to obtain
7	certain Medicaid program goods or services; providing
8	criminal penalties; providing a definition; creating s.
9	812.0191, F.S.; providing definitions; making it unlawful
10	to deal in property paid for under the Medicaid program;
11	making it unlawful to engage in activities to obtain or
12	traffic in such property; providing criminal penalties;
13	amending s. 409.912, F.S.; requiring the Agency for Health
14	Care Administration to manage drug therapies for certain
15	patients; requiring mandatory enrollment of certain
16	persons in the Medicaid drug benefit management program;
17	amending s. 409.913, F.S.; restricting unauthorized
18	physicians from prescribing medications to certain
19	patients; providing exceptions; restricting health care
20	vendors from knowingly filling such prescriptions;
21	providing for reimbursement; providing civil penalties;
22	restricting the agency from reimbursing certain claims;
23	amending s. 16.56, F.S.; expanding the authority of the
24	Office of Statewide Prosecution to investigate and
25	prosecute certain additional offenses; amending s. 895.02,
26	F.S.; expanding the definition of the term "racketeering
27	activity" to include certain additional offenses; amending
28	s. 905.34, F.S.; expanding the subject matter jurisdiction
29	of the statewide grand jury to include certain additional
30	offenses; amending ss. 409.9071 and 409.9131, F.S.;
31	revising cross references to conform; providing an
32	effective date.
33
34	Be It Enacted by the Legislature of the State of Florida:
35
36	Section 1.  Section 409.9201, Florida Statutes, is created
37	to read:
38	409.9201  Medicaid recipient fraud.--
39	(1)  It is unlawful for any person receiving legend drugs
40	pursuant to a prescription funded by the Medicaid program to
41	sell or attempt or conspire to sell, or to cause any other
42	person to sell or attempt or conspire to sell, the legend drugs
43	involved. Any person who violates this subsection commits a
44	felony, as follows:
45	(a)  If the value of the legend drugs involved is less than
46	$20,000, a felony of the third degree, punishable as provided in
47	s. 775.082, s. 775.083, or s. 775.084.
48	(b)  If the value of the legend drugs involved is $20,000
49	or more, but less than $100,000, a felony of the second degree,
50	punishable as provided in s. 775.082, s. 775.083, or s. 775.084.
51	(c)  If the value of the legend drugs involved is $100,000
52	or more, a felony of the first degree, punishable as provided in
53	s. 775.082, s. 775.083, or s. 775.084.
54	(2)  It is unlawful for any person to purchase or attempt
55	or conspire to purchase legend drugs intended for a recipient
56	pursuant to a prescription funded by the Medicaid program. Any
57	person who violates this subsection commits a felony, as
58	follows:
59	(a)  If the value of the legend drugs involved is less than
60	$20,000, a felony of the third degree, punishable as provided in
61	s. 775.082, s. 775.083, or s. 775.084.
62	(b)  If the value of the legend drugs involved is $20,000
63	or more, but less than $100,000, a felony of the second degree,
64	punishable as provided in s. 775.082, s. 775.083, or s. 775.084.
65	(c)  If the value of the legend drugs involved is $100,000
66	or more, a felony of the first degree, punishable as provided in
67	s. 775.082, s. 775.083, or s. 775.084.
68	(3)  It is unlawful for any person to make or cause to be
69	made, or to attempt or conspire to make or cause to be made, any
70	false statement or representation to any person for the purpose
71	of obtaining goods or services under the Medicaid program. Any
72	person who violates this subsection commits a felony, as
73	follows:
74	(a)  If the value of the goods or services involved is less
75	than $20,000, a felony of the third degree, punishable as
76	provided in s. 775.082, s. 775.083, or s. 775.084.
77	(b)  If the value of the goods or services involved is
78	$20,000 or more, but less than $100,000, a felony of the second
79	degree, punishable as provided in s. 775.082, s. 775.083, or s.
80	775.084.
81	(c)  If the value of the goods or services involved is
82	$100,000 or more, a felony of the first degree, punishable as
83	provided in s. 775.082, s. 775.083, or s. 775.084.
84	(4)  As used in this section, the term "value" means the
85	market value of the property at the time and place of the
86	offense or the amount billed to Medicaid for the property or, if
87	such value cannot be satisfactorily ascertained, the cost of
88	replacement of the property within a reasonable time after the
89	offense. Values of separate amounts of legend drugs or other
90	goods or services involved in distinct transactions committed
91	pursuant to one scheme or course of conduct, whether involving
92	the same person or several persons, may be aggregated in
93	determining the punishment for the offense.
94	Section 2.  Section 812.0191, Florida Statutes, is created
95	to read:
96	812.0191  Dealing in property paid for in whole or in part
97	by the Medicaid program.--
98	(1)  For the purposes of this section:
99	(a)  "Property paid for in whole or in part by the Medicaid
100	program" includes any device, service, drug, or other property
101	furnished or intended to be furnished to a recipient under the
102	Medicaid or the Medicare program.
103	(b)  "Value" has the same definition as provided in s.
104	812.012, but shall also include the amount billed or intended to
105	be billed to Medicaid for the property.
106	(2)  It is unlawful for any person to traffic in or
107	endeavor to traffic in property that he or she knows or should
108	have known was paid for in whole or in part by the Medicaid
109	program. Any person who violates this subsection commits a
110	felony, as follows:
111	(a)  If the value of the property involved is less than
112	$20,000, a felony of the third degree, punishable as provided in
113	s. 775.082, s. 775.083, or s. 775.084.
114	(b)  If the value of the property involved is $20,000 or
115	more, but less than $100,000, a felony of the second degree,
116	punishable as provided in s. 775.082, s. 775.083, or s. 775.084.
117	(c)  If the value of the property involved is $100,000 or
118	more, a felony of the first degree, punishable as provided in s.
119	775.082, s. 775.083, or s. 775.084.
120	(3)  It is unlawful for any person to initiate, organize,
121	plan, finance, direct, manage, or supervise the obtaining of
122	property paid for in whole or in part by the Medicaid program
123	and to traffic in or endeavor to traffic in such property. Any
124	person who violates this subsection commits a felony of the
125	first degree, punishable as provided in s. 775.082, s. 775.083,
126	or s. 775.084.
127	Section 3.  Paragraph (a) of subsection (40) of section
128	409.912, Florida Statutes, is amended to read:
129	409.912  Cost-effective purchasing of health care.--The
130	agency shall purchase goods and services for Medicaid recipients
131	in the most cost-effective manner consistent with the delivery
132	of quality medical care. The agency shall maximize the use of
133	prepaid per capita and prepaid aggregate fixed-sum basis
134	services when appropriate and other alternative service delivery
135	and reimbursement methodologies, including competitive bidding
136	pursuant to s. 287.057, designed to facilitate the cost-
137	effective purchase of a case-managed continuum of care. The
138	agency shall also require providers to minimize the exposure of
139	recipients to the need for acute inpatient, custodial, and other
140	institutional care and the inappropriate or unnecessary use of
141	high-cost services. The agency may establish prior authorization
142	requirements for certain populations of Medicaid beneficiaries,
143	certain drug classes, or particular drugs to prevent fraud,
144	abuse, overuse, and possible dangerous drug interactions. The
145	Pharmaceutical and Therapeutics Committee shall make
146	recommendations to the agency on drugs for which prior
147	authorization is required. The agency shall inform the
148	Pharmaceutical and Therapeutics Committee of its decisions
149	regarding drugs subject to prior authorization.
150	(40)(a)  The agency shall implement a Medicaid prescribed-
151	drug spending-control program that includes the following
152	components:
153	1.  Medicaid prescribed-drug coverage for brand-name drugs
154	for adult Medicaid recipients is limited to the dispensing of
155	four brand-name drugs per month per recipient. Children are
156	exempt from this restriction. Antiretroviral agents are excluded
157	from this limitation. No requirements for prior authorization or
158	other restrictions on medications used to treat mental illnesses
159	such as schizophrenia, severe depression, or bipolar disorder
160	may be imposed on Medicaid recipients. Medications that will be
161	available without restriction for persons with mental illnesses
162	include atypical antipsychotic medications, conventional
163	antipsychotic medications, selective serotonin reuptake
164	inhibitors, and other medications used for the treatment of
165	serious mental illnesses. The agency shall also limit the amount
166	of a prescribed drug dispensed to no more than a 34-day supply.
167	The agency shall continue to provide unlimited generic drugs,
168	contraceptive drugs and items, and diabetic supplies. Although a
169	drug may be included on the preferred drug formulary, it would
170	not be exempt from the four-brand limit. The agency may
171	authorize exceptions to the brand-name-drug restriction based
172	upon the treatment needs of the patients, only when such
173	exceptions are based on prior consultation provided by the
174	agency or an agency contractor, but the agency must establish
175	procedures to ensure that:
176	a.  There will be a response to a request for prior
177	consultation by telephone or other telecommunication device
178	within 24 hours after receipt of a request for prior
179	consultation;
180	b.  A 72-hour supply of the drug prescribed will be
181	provided in an emergency or when the agency does not provide a
182	response within 24 hours as required by sub-subparagraph a.; and
183	c.  Except for the exception for nursing home residents and
184	other institutionalized adults and except for drugs on the
185	restricted formulary for which prior authorization may be sought
186	by an institutional or community pharmacy, prior authorization
187	for an exception to the brand-name-drug restriction is sought by
188	the prescriber and not by the pharmacy. When prior authorization
189	is granted for a patient in an institutional setting beyond the
190	brand-name-drug restriction, such approval is authorized for 12
191	months and monthly prior authorization is not required for that
192	patient.
193	2.  Reimbursement to pharmacies for Medicaid prescribed
194	drugs shall be set at the average wholesale price less 13.25
195	percent.
196	3.  The agency shall develop and implement a process for
197	managing the drug therapies of Medicaid recipients who are using
198	significant numbers of prescribed drugs each month. The
199	management process may include, but is not limited to,
200	comprehensive, physician-directed medical-record reviews, claims
201	analyses, and case evaluations to determine the medical
202	necessity and appropriateness of a patient's treatment plan and
203	drug therapies. The agency may contract with a private
204	organization to provide drug-program-management services. The
205	Medicaid drug benefit management program shall include
206	initiatives to manage drug therapies for HIV/AIDS patients,
207	patients using 20 or more unique prescriptions in a 180-day
208	period, and the top 1,000 patients in annual spending, and
209	patients identified as abusers. Enrollment in this program shall
210	be mandatory for all recipients in these categories.
211	4.  The agency may limit the size of its pharmacy network
212	based on need, competitive bidding, price negotiations,
213	credentialing, or similar criteria. The agency shall give
214	special consideration to rural areas in determining the size and
215	location of pharmacies included in the Medicaid pharmacy
216	network. A pharmacy credentialing process may include criteria
217	such as a pharmacy's full-service status, location, size,
218	patient educational programs, patient consultation, disease-
219	management services, and other characteristics. The agency may
220	impose a moratorium on Medicaid pharmacy enrollment when it is
221	determined that it has a sufficient number of Medicaid-
222	participating providers.
223	5.  The agency shall develop and implement a program that
224	requires Medicaid practitioners who prescribe drugs to use a
225	counterfeit-proof prescription pad for Medicaid prescriptions.
226	The agency shall require the use of standardized counterfeit-
227	proof prescription pads by Medicaid-participating prescribers or
228	prescribers who write prescriptions for Medicaid recipients. The
229	agency may implement the program in targeted geographic areas or
230	statewide.
231	6.  The agency may enter into arrangements that require
232	manufacturers of generic drugs prescribed to Medicaid recipients
233	to provide rebates of at least 15.1 percent of the average
234	manufacturer price for the manufacturer's generic products.
235	These arrangements shall require that if a generic-drug
236	manufacturer pays federal rebates for Medicaid-reimbursed drugs
237	at a level below 15.1 percent, the manufacturer must provide a
238	supplemental rebate to the state in an amount necessary to
239	achieve a 15.1-percent rebate level.
240	7.  The agency may establish a preferred drug formulary in
241	accordance with 42 U.S.C. s. 1396r-8, and, pursuant to the
242	establishment of such formulary, it is authorized to negotiate
243	supplemental rebates from manufacturers that are in addition to
244	those required by Title XIX of the Social Security Act and at no
245	less than 10 percent of the average manufacturer price as
246	defined in 42 U.S.C. s. 1936 on the last day of a quarter unless
247	the federal or supplemental rebate, or both, equals or exceeds
248	25 percent. There is no upper limit on the supplemental rebates
249	the agency may negotiate. The agency may determine that specific
250	products, brand-name or generic, are competitive at lower rebate
251	percentages. Agreement to pay the minimum supplemental rebate
252	percentage will guarantee a manufacturer that the Medicaid
253	Pharmaceutical and Therapeutics Committee will consider a
254	product for inclusion on the preferred drug formulary. However,
255	a pharmaceutical manufacturer is not guaranteed placement on the
256	formulary by simply paying the minimum supplemental rebate.
257	Agency decisions will be made on the clinical efficacy of a drug
258	and recommendations of the Medicaid Pharmaceutical and
259	Therapeutics Committee, as well as the price of competing
260	products minus federal and state rebates. The agency is
261	authorized to contract with an outside agency or contractor to
262	conduct negotiations for supplemental rebates. For the purposes
263	of this section, the term "supplemental rebates" may include, at
264	the agency's discretion, cash rebates and other program benefits
265	that offset a Medicaid expenditure. Such other program benefits
266	may include, but are not limited to, disease management
267	programs, drug product donation programs, drug utilization
268	control programs, prescriber and beneficiary counseling and
269	education, fraud and abuse initiatives, and other services or
270	administrative investments with guaranteed savings to the
271	Medicaid program in the same year the rebate reduction is
272	included in the General Appropriations Act. The agency is
273	authorized to seek any federal waivers to implement this
274	initiative.
275	8.  The agency shall establish an advisory committee for
276	the purposes of studying the feasibility of using a restricted
277	drug formulary for nursing home residents and other
278	institutionalized adults. The committee shall be comprised of
279	seven members appointed by the Secretary of Health Care
280	Administration. The committee members shall include two
281	physicians licensed under chapter 458 or chapter 459; three
282	pharmacists licensed under chapter 465 and appointed from a list
283	of recommendations provided by the Florida Long-Term Care
284	Pharmacy Alliance; and two pharmacists licensed under chapter
285	465.
286	9.  The Agency for Health Care Administration shall expand
287	home delivery of pharmacy products. To assist Medicaid patients
288	in securing their prescriptions and reduce program costs, the
289	agency shall expand its current mail-order-pharmacy diabetes-
290	supply program to include all generic and brand-name drugs used
291	by Medicaid patients with diabetes. Medicaid recipients in the
292	current program may obtain nondiabetes drugs on a voluntary
293	basis. This initiative is limited to the geographic area covered
294	by the current contract. The agency may seek and implement any
295	federal waivers necessary to implement this subparagraph.
296	Section 4.  Subsections (8) through (31) of section
297	409.913, Florida Statutes, are renumbered as subsections (9)
298	through (32), respectively, present subsections (14) and (15)
299	are amended, and a new subsection (8) is added to said section
300	to read:
301	409.913  Oversight of the integrity of the Medicaid
302	program.--The agency shall operate a program to oversee the
303	activities of Florida Medicaid recipients, and providers and
304	their representatives, to ensure that fraudulent and abusive
305	behavior and neglect of recipients occur to the minimum extent
306	possible, and to recover overpayments and impose sanctions as
307	appropriate. Beginning January 1, 2003, and each year
308	thereafter, the agency and the Medicaid Fraud Control Unit of
309	the Department of Legal Affairs shall submit a joint report to
310	the Legislature documenting the effectiveness of the state's
311	efforts to control Medicaid fraud and abuse and to recover
312	Medicaid overpayments during the previous fiscal year. The
313	report must describe the number of cases opened and investigated
314	each year; the sources of the cases opened; the disposition of
315	the cases closed each year; the amount of overpayments alleged
316	in preliminary and final audit letters; the number and amount of
317	fines or penalties imposed; any reductions in overpayment
318	amounts negotiated in settlement agreements or by other means;
319	the amount of final agency determinations of overpayments; the
320	amount deducted from federal claiming as a result of
321	overpayments; the amount of overpayments recovered each year;
322	the amount of cost of investigation recovered each year; the
323	average length of time to collect from the time the case was
324	opened until the overpayment is paid in full; the amount
325	determined as uncollectible and the portion of the uncollectible
326	amount subsequently reclaimed from the Federal Government; the
327	number of providers, by type, that are terminated from
328	participation in the Medicaid program as a result of fraud and
329	abuse; and all costs associated with discovering and prosecuting
330	cases of Medicaid overpayments and making recoveries in such
331	cases. The report must also document actions taken to prevent
332	overpayments and the number of providers prevented from
333	enrolling in or reenrolling in the Medicaid program as a result
334	of documented Medicaid fraud and abuse and must recommend
335	changes necessary to prevent or recover overpayments. For the
336	2001-2002 fiscal year, the agency shall prepare a report that
337	contains as much of this information as is available to it.
338	(8)  Except in instances involving bona fide emergencies,
339	physicians who are not authorized Medicaid providers shall not
340	prescribe medications, medical supplies, or medical services to
341	Medicaid recipients when such non-Medicaid physicians know or
342	should know that a claim for reimbursement of any portion of the
343	cost of the prescribed medications, medical supplies, or medical
344	services will be submitted to the Medicaid program. Likewise,
345	except in instances involving bona fide emergencies, health care
346	vendors of prescription medications, medical supplies, or
347	medical services otherwise authorized to submit claims for
348	Medicaid reimbursements shall not submit claims for Medicaid
349	reimbursements when such health care vendors know or should know
350	the physician prescribing the medications, medical supplies, or
351	medical services is not an authorized Medicaid provider. Any
352	person or entity who knowingly violates this subsection or
353	knowingly participates in a plan or scheme to cause others to
354	violate this subsection shall be required to reimburse the
355	Medicaid program for the full amount of the Medicaid claim
356	submitted in violation of this subsection and shall be subject
357	to penalties equal to three times the amount of the unlawful
358	Medicaid claim submitted, together with civil monetary
359	assessments of up to $5,000 for each Medicaid claim submitted
360	for medications, medical equipment, or medical services in
361	violation of this subsection, as well as investigation and
362	prosecution costs and attorney's fees. The remedies set forth in
363	this subsection are in addition to all other available remedies.
364	The agency shall not reimburse providers for any claims that do
365	not meet all of the preceding criteria.
366	(15)(14)  The agency may seek any remedy provided by law,
367	including, but not limited to, the remedies provided in
368	subsections (13) (12) and (16) (15) and s. 812.035, if:
369	(a)  The provider's license has not been renewed, or has
370	been revoked, suspended, or terminated, for cause, by the
371	licensing agency of any state;
372	(b)  The provider has failed to make available or has
373	refused access to Medicaid-related records to an auditor,
374	investigator, or other authorized employee or agent of the
375	agency, the Attorney General, a state attorney, or the Federal
376	Government;
377	(c)  The provider has not furnished or has failed to make
378	available such Medicaid-related records as the agency has found
379	necessary to determine whether Medicaid payments are or were due
380	and the amounts thereof;
381	(d)  The provider has failed to maintain medical records
382	made at the time of service, or prior to service if prior
383	authorization is required, demonstrating the necessity and
384	appropriateness of the goods or services rendered;
385	(e)  The provider is not in compliance with provisions of
386	Medicaid provider publications that have been adopted by
387	reference as rules in the Florida Administrative Code; with
388	provisions of state or federal laws, rules, or regulations; with
389	provisions of the provider agreement between the agency and the
390	provider; or with certifications found on claim forms or on
391	transmittal forms for electronically submitted claims that are
392	submitted by the provider or authorized representative, as such
393	provisions apply to the Medicaid program;
394	(f)  The provider or person who ordered or prescribed the
395	care, services, or supplies has furnished, or ordered the
396	furnishing of, goods or services to a recipient which are
397	inappropriate, unnecessary, excessive, or harmful to the
398	recipient or are of inferior quality;
399	(g)  The provider has demonstrated a pattern of failure to
400	provide goods or services that are medically necessary;
401	(h)  The provider or an authorized representative of the
402	provider, or a person who ordered or prescribed the goods or
403	services, has submitted or caused to be submitted false or a
404	pattern of erroneous Medicaid claims that have resulted in
405	overpayments to a provider or that exceed those to which the
406	provider was entitled under the Medicaid program;
407	(i)  The provider or an authorized representative of the
408	provider, or a person who has ordered or prescribed the goods or
409	services, has submitted or caused to be submitted a Medicaid
410	provider enrollment application, a request for prior
411	authorization for Medicaid services, a drug exception request,
412	or a Medicaid cost report that contains materially false or
413	incorrect information;
414	(j)  The provider or an authorized representative of the
415	provider has collected from or billed a recipient or a
416	recipient's responsible party improperly for amounts that should
417	not have been so collected or billed by reason of the provider's
418	billing the Medicaid program for the same service;
419	(k)  The provider or an authorized representative of the
420	provider has included in a cost report costs that are not
421	allowable under a Florida Title XIX reimbursement plan, after
422	the provider or authorized representative had been advised in an
423	audit exit conference or audit report that the costs were not
424	allowable;
425	(l)  The provider is charged by information or indictment
426	with fraudulent billing practices. The sanction applied for this
427	reason is limited to suspension of the provider's participation
428	in the Medicaid program for the duration of the indictment
429	unless the provider is found guilty pursuant to the information
430	or indictment;
431	(m)  The provider or a person who has ordered, or
432	prescribed the goods or services is found liable for negligent
433	practice resulting in death or injury to the provider's patient;
434	(n)  The provider fails to demonstrate that it had
435	available during a specific audit or review period sufficient
436	quantities of goods, or sufficient time in the case of services,
437	to support the provider's billings to the Medicaid program;
438	(o)  The provider has failed to comply with the notice and
439	reporting requirements of s. 409.907;
440	(p)  The agency has received reliable information of
441	patient abuse or neglect or of any act prohibited by s. 409.920;
442	or
443	(q)  The provider has failed to comply with an agreed-upon
444	repayment schedule.
445	(16)(15)  The agency shall impose any of the following
446	sanctions or disincentives on a provider or a person for any of
447	the acts described in subsection (15) (14):
448	(a)  Suspension for a specific period of time of not more
449	than 1 year.
450	(b)  Termination for a specific period of time of from more
451	than 1 year to 20 years.
452	(c)  Imposition of a fine of up to $5,000 for each
453	violation. Each day that an ongoing violation continues, such as
454	refusing to furnish Medicaid-related records or refusing access
455	to records, is considered, for the purposes of this section, to
456	be a separate violation. Each instance of improper billing of a
457	Medicaid recipient; each instance of including an unallowable
458	cost on a hospital or nursing home Medicaid cost report after
459	the provider or authorized representative has been advised in an
460	audit exit conference or previous audit report of the cost
461	unallowability; each instance of furnishing a Medicaid recipient
462	goods or professional services that are inappropriate or of
463	inferior quality as determined by competent peer judgment; each
464	instance of knowingly submitting a materially false or erroneous
465	Medicaid provider enrollment application, request for prior
466	authorization for Medicaid services, drug exception request, or
467	cost report; each instance of inappropriate prescribing of drugs
468	for a Medicaid recipient as determined by competent peer
469	judgment; and each false or erroneous Medicaid claim leading to
470	an overpayment to a provider is considered, for the purposes of
471	this section, to be a separate violation.
472	(d)  Immediate suspension, if the agency has received
473	information of patient abuse or neglect or of any act prohibited
474	by s. 409.920. Upon suspension, the agency must issue an
475	immediate final order under s. 120.569(2)(n).
476	(e)  A fine, not to exceed $10,000, for a violation of
477	paragraph (15)(14)(i).
478	(f)  Imposition of liens against provider assets,
479	including, but not limited to, financial assets and real
480	property, not to exceed the amount of fines or recoveries
481	sought, upon entry of an order determining that such moneys are
482	due or recoverable.
483	(g)  Prepayment reviews of claims for a specified period of
484	time.
485	(h)  Comprehensive followup reviews of providers every 6
486	months to ensure that they are billing Medicaid correctly.
487	(i)  Corrective-action plans that would remain in effect
488	for providers for up to 3 years and that would be monitored by
489	the agency every 6 months while in effect.
490	(j)  Other remedies as permitted by law to effect the
491	recovery of a fine or overpayment.
492
493	The Secretary of Health Care Administration may make a
494	determination that imposition of a sanction or disincentive is
495	not in the best interest of the Medicaid program, in which case
496	a sanction or disincentive shall not be imposed.
497	Section 5.  Paragraph (a) of subsection (1) of section
498	16.56, Florida Statutes, is amended to read:
499	16.56  Office of Statewide Prosecution.--
500	(1)  There is created in the Department of Legal Affairs an
501	Office of Statewide Prosecution. The office shall be a separate
502	"budget entity" as that term is defined in chapter 216. The
503	office may:
504	(a)  Investigate and prosecute the offenses of:
505	1.  Bribery, burglary, criminal usury, extortion, gambling,
506	kidnapping, larceny, murder, prostitution, perjury, robbery,
507	carjacking, and home-invasion robbery;
508	2.  Any crime involving narcotic or other dangerous drugs;
509	3.  Any violation of the provisions of the Florida RICO
510	(Racketeer Influenced and Corrupt Organization) Act, including
511	any offense listed in the definition of racketeering activity in
512	s. 895.02(1)(a), providing such listed offense is investigated
513	in connection with a violation of s. 895.03 and is charged in a
514	separate count of an information or indictment containing a
515	count charging a violation of s. 895.03, the prosecution of
516	which listed offense may continue independently if the
517	prosecution of the violation of s. 895.03 is terminated for any
518	reason;
519	4.  Any violation of the provisions of the Florida Anti-
520	Fencing Act;
521	5.  Any violation of the provisions of the Florida
522	Antitrust Act of 1980, as amended;
523	6.  Any crime involving, or resulting in, fraud or deceit
524	upon any person;
525	7.  Any violation of s. 847.0135, relating to computer
526	pornography and child exploitation prevention, or any offense
527	related to a violation of s. 847.0135;
528	8.  Any violation of the provisions of chapter 815; or
529	9.  Any criminal violation of part I of chapter 499; or
530	10.  Any criminal violation of the provisions of chapter
531	409 relating to Medicaid provider and recipient fraud;
532
533	or any attempt, solicitation, or conspiracy to commit any of the
534	crimes specifically enumerated above. The office shall have such
535	power only when any such offense is occurring, or has occurred,
536	in two or more judicial circuits as part of a related
537	transaction, or when any such offense is connected with an
538	organized criminal conspiracy affecting two or more judicial
539	circuits.
540	Section 6.  Paragraph (a) of subsection (1) of section
541	895.02, Florida Statutes, is amended to read:
542	895.02  Definitions.--As used in ss. 895.01-895.08, the
543	term:
544	(1)  "Racketeering activity" means to commit, to attempt to
545	commit, to conspire to commit, or to solicit, coerce, or
546	intimidate another person to commit:
547	(a)  Any crime which is chargeable by indictment or
548	information under the following provisions of the Florida
549	Statutes:
550	1.  Section 210.18, relating to evasion of payment of
551	cigarette taxes.
552	2.  Section 403.727(3)(b), relating to environmental
553	control.
554	3.  Section 414.39, relating to public assistance fraud.
555	4.  Sections Section 409.920 and 409.9201, relating to
556	Medicaid provider and recipient fraud.
557	5.  Section 440.105 or s. 440.106, relating to workers'
558	compensation.
559	6.  Sections 499.0051, 499.0052, 499.0053, 499.0054, and
560	499.0691, relating to crimes involving contraband and
561	adulterated drugs.
562	7.  Part IV of chapter 501, relating to telemarketing.
563	8.  Chapter 517, relating to sale of securities and
564	investor protection.
565	9.  Section 550.235, s. 550.3551, or s. 550.3605, relating
566	to dogracing and horseracing.
567	10.  Chapter 550, relating to jai alai frontons.
568	11.  Chapter 552, relating to the manufacture,
569	distribution, and use of explosives.
570	12.  Chapter 560, relating to money transmitters, if the
571	violation is punishable as a felony.
572	13.  Chapter 562, relating to beverage law enforcement.
573	14.  Section 624.401, relating to transacting insurance
574	without a certificate of authority, s. 624.437(4)(c)1., relating
575	to operating an unauthorized multiple-employer welfare
576	arrangement, or s. 626.902(1)(b), relating to representing or
577	aiding an unauthorized insurer.
578	15.  Section 655.50, relating to reports of currency
579	transactions, when such violation is punishable as a felony.
580	16.  Chapter 687, relating to interest and usurious
581	practices.
582	17.  Section 721.08, s. 721.09, or s. 721.13, relating to
583	real estate timeshare plans.
584	18.  Chapter 782, relating to homicide.
585	19.  Chapter 784, relating to assault and battery.
586	20.  Chapter 787, relating to kidnapping.
587	21.  Chapter 790, relating to weapons and firearms.
588	22.  Section 796.03, s. 796.04, s. 796.05, or s. 796.07,
589	relating to prostitution.
590	23.  Chapter 806, relating to arson.
591	24.  Section 810.02(2)(c), relating to specified burglary
592	of a dwelling or structure.
593	25.  Chapter 812, relating to theft, robbery, and related
594	crimes.
595	26.  Chapter 815, relating to computer-related crimes.
596	27.  Chapter 817, relating to fraudulent practices, false
597	pretenses, fraud generally, and credit card crimes.
598	28.  Chapter 825, relating to abuse, neglect, or
599	exploitation of an elderly person or disabled adult.
600	29.  Section 827.071, relating to commercial sexual
601	exploitation of children.
602	30.  Chapter 831, relating to forgery and counterfeiting.
603	31.  Chapter 832, relating to issuance of worthless checks
604	and drafts.
605	32.  Section 836.05, relating to extortion.
606	33.  Chapter 837, relating to perjury.
607	34.  Chapter 838, relating to bribery and misuse of public
608	office.
609	35.  Chapter 843, relating to obstruction of justice.
610	36.  Section 847.011, s. 847.012, s. 847.013, s. 847.06, or
611	s. 847.07, relating to obscene literature and profanity.
612	37.  Section 849.09, s. 849.14, s. 849.15, s. 849.23, or s.
613	849.25, relating to gambling.
614	38.  Chapter 874, relating to criminal street gangs.
615	39.  Chapter 893, relating to drug abuse prevention and
616	control.
617	40.  Chapter 896, relating to offenses related to financial
618	transactions.
619	41.  Sections 914.22 and 914.23, relating to tampering with
620	a witness, victim, or informant, and retaliation against a
621	witness, victim, or informant.
622	42.  Sections 918.12 and 918.13, relating to tampering with
623	jurors and evidence.
624	Section 7.  Subsections (8) and (9) of section 905.34,
625	Florida Statutes, are amended, and subsection (10) is added to
626	said section, to read:
627	905.34  Powers and duties; law applicable.--The
628	jurisdiction of a statewide grand jury impaneled under this
629	chapter shall extend throughout the state. The subject matter
630	jurisdiction of the statewide grand jury shall be limited to the
631	offenses of:
632	(8)  Any violation of s. 847.0135, s. 847.0137, or s.
633	847.0138 relating to computer pornography and child exploitation
634	prevention, or any offense related to a violation of s.
635	847.0135, s. 847.0137, or s. 847.0138; or
636	(9)  Any criminal violation of part I of chapter 499; or
637	(10)  Any criminal violation of the provisions of chapter
638	409 relating to Medicaid provider and recipient fraud;
639
640	or any attempt, solicitation, or conspiracy to commit any
641	violation of the crimes specifically enumerated above, when any
642	such offense is occurring, or has occurred, in two or more
643	judicial circuits as part of a related transaction or when any
644	such offense is connected with an organized criminal conspiracy
645	affecting two or more judicial circuits. The statewide grand
646	jury may return indictments and presentments irrespective of the
647	county or judicial circuit where the offense is committed or
648	triable. If an indictment is returned, it shall be certified and
649	transferred for trial to the county where the offense was
650	committed. The powers and duties of, and law applicable to,
651	county grand juries shall apply to a statewide grand jury except
652	when such powers, duties, and law are inconsistent with the
653	provisions of ss. 905.31-905.40.
654	Section 8.  Subsection (1) of section 409.9071, Florida
655	Statutes, is amended to read:
656	409.9071  Medicaid provider agreements for school districts
657	certifying state match.--
658	(1)  The agency shall submit a state plan amendment by
659	September 1, 1997, for the purpose of obtaining federal
660	authorization to reimburse school-based services as provided in
661	former s. 236.0812 pursuant to the rehabilitative services
662	option provided under 42 U.S.C. s. 1396d(a)(13). For purposes of
663	this section, billing agent consulting services shall be
664	considered billing agent services, as that term is used in s.
665	409.913(10)(9), and, as such, payments to such persons shall not
666	be based on amounts for which they bill nor based on the amount
667	a provider receives from the Medicaid program. This provision
668	shall not restrict privatization of Medicaid school-based
669	services. Subject to any limitations provided for in the General
670	Appropriations Act, the agency, in compliance with appropriate
671	federal authorization, shall develop policies and procedures and
672	shall allow for certification of state and local education funds
673	which have been provided for school-based services as specified
674	in s. 1011.70 and authorized by a physician's order where
675	required by federal Medicaid law. Any state or local funds
676	certified pursuant to this section shall be for children with
677	specified disabilities who are eligible for both Medicaid and
678	part B or part H of the Individuals with Disabilities Education
679	Act (IDEA), or the exceptional student education program, or who
680	have an individualized educational plan.
681	Section 9.  Subsection (3) of section 409.9131, Florida
682	Statutes, is amended to read:
683	409.9131  Special provisions relating to integrity of the
684	Medicaid program.--
685	(3)  ONSITE RECORDS REVIEW.--As specified in s.
686	409.913(9)(8), the agency may investigate, review, or analyze a
687	physician's medical records concerning Medicaid patients. The
688	physician must make such records available to the agency during
689	normal business hours. The agency must provide notice to the
690	physician at least 24 hours before such visit. The agency and
691	physician shall make every effort to set a mutually agreeable
692	time for the agency's visit during normal business hours and
693	within the 24-hour period. If such a time cannot be agreed upon,
694	the agency may set the time.
695	Section 10.  This act shall take effect July 1, 2004.

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