Florida Senate - 2005 SENATOR AMENDMENT
Bill No. CS for CS for SB 838
Barcode 743378
CHAMBER ACTION
Senate House
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05/03/2005 12:10 PM .
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11 Senator Saunders moved the following amendment:
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13 Senate Amendment
14 On page 57, between lines 17 and 18,
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16 insert:
17 (50) The agency may contract with established
18 federally qualified health centers that provide services to
19 historically underserved and uninsured patients. The networks
20 must provide cost-effective Medicaid services, comply with the
21 requirements of a MediPass provider, and provide their primary
22 care physicians with access to data and other management tools
23 necessary to assist them in ensuring the appropriate use of
24 services, including inpatient hospital services and
25 pharmaceuticals.
26 (a) The agency may provide for the development and
27 expansion of federally qualified health center based provider
28 service networks in each service area to provide services to
29 Medicaid recipients who are eligible to participate under
30 federal law and rules.
31 (b) The agency may reimburse each federally qualified
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10:44 AM 05/03/05 s0838c2b-37-bz1
Florida Senate - 2005 SENATOR AMENDMENT
Bill No. CS for CS for SB 838
Barcode 743378
1 health center based network as a fee-for-service provider,
2 including the case management fee for primary care or as a
3 capitated rate provider for Medicaid services. Any savings
4 shall be shared with the federally qualified health center
5 networks under the contract.
6 (c) For purposes of this subsection, the term
7 "cost-effective" means that a network's per-member, per-month
8 costs to the state, including, but not limited to,
9 fee-for-service costs, administrative costs, and
10 case-management fees must be no greater than the state's costs
11 associated with contracts for Medicaid services, which shall
12 be actuarially adjusted for case mix, model, and service area.
13 The agency shall conduct actuarially sound audits adjusted for
14 case mix and model in order to ensure such cost-effectiveness
15 and shall publish the audit results on its Internet website
16 and submit the audit results annually to the Governor, the
17 President of the Senate, and the Speaker of the House of
18 Representatives no later than December 31.
19 (d) The agency may apply for any federal waivers
20 needed to administer this subsection.
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22 (Redesignate subsequent sections.)
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