Senate Bill sb2226c1

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    Florida Senate - 2006                           CS for SB 2226

    By the Committee on Health Care; and Senator Rich





    587-2313-06

  1                      A bill to be entitled

  2         An act relating to developmental disabilities;

  3         amending s. 409.912, F.S.; requiring the Agency

  4         for Health Care Administration to develop a

  5         waiver program to serve children and adults

  6         with specified disorders; providing an

  7         effective date.

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

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11         Section 1.  Subsection (51) of section 409.912, Florida

12  Statutes, is amended to read:

13         409.912  Cost-effective purchasing of health care.--The

14  agency shall purchase goods and services for Medicaid

15  recipients in the most cost-effective manner consistent with

16  the delivery of quality medical care. To ensure that medical

17  services are effectively utilized, the agency may, in any

18  case, require a confirmation or second physician's opinion of

19  the correct diagnosis for purposes of authorizing future

20  services under the Medicaid program. This section does not

21  restrict access to emergency services or poststabilization

22  care services as defined in 42 C.F.R. part 438.114. Such

23  confirmation or second opinion shall be rendered in a manner

24  approved by the agency. The agency shall maximize the use of

25  prepaid per capita and prepaid aggregate fixed-sum basis

26  services when appropriate and other alternative service

27  delivery and reimbursement methodologies, including

28  competitive bidding pursuant to s. 287.057, designed to

29  facilitate the cost-effective purchase of a case-managed

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

31  minimize the exposure of recipients to the need for acute

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    Florida Senate - 2006                           CS for SB 2226
    587-2313-06




 1  inpatient, custodial, and other institutional care and the

 2  inappropriate or unnecessary use of high-cost services. The

 3  agency shall contract with a vendor to monitor and evaluate

 4  the clinical practice patterns of providers in order to

 5  identify trends that are outside the normal practice patterns

 6  of a provider's professional peers or the national guidelines

 7  of a provider's professional association. The vendor must be

 8  able to provide information and counseling to a provider whose

 9  practice patterns are outside the norms, in consultation with

10  the agency, to improve patient care and reduce inappropriate

11  utilization. The agency may mandate prior authorization, drug

12  therapy management, or disease management participation for

13  certain populations of Medicaid beneficiaries, certain drug

14  classes, or particular drugs to prevent fraud, abuse, overuse,

15  and possible dangerous drug interactions. The Pharmaceutical

16  and Therapeutics Committee shall make recommendations to the

17  agency on drugs for which prior authorization is required. The

18  agency shall inform the Pharmaceutical and Therapeutics

19  Committee of its decisions regarding drugs subject to prior

20  authorization. The agency is authorized to limit the entities

21  it contracts with or enrolls as Medicaid providers by

22  developing a provider network through provider credentialing.

23  The agency may competitively bid single-source-provider

24  contracts if procurement of goods or services results in

25  demonstrated cost savings to the state without limiting access

26  to care. The agency may limit its network based on the

27  assessment of beneficiary access to care, provider

28  availability, provider quality standards, time and distance

29  standards for access to care, the cultural competence of the

30  provider network, demographic characteristics of Medicaid

31  beneficiaries, practice and provider-to-beneficiary standards,

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    Florida Senate - 2006                           CS for SB 2226
    587-2313-06




 1  appointment wait times, beneficiary use of services, provider

 2  turnover, provider profiling, provider licensure history,

 3  previous program integrity investigations and findings, peer

 4  review, provider Medicaid policy and billing compliance

 5  records, clinical and medical record audits, and other

 6  factors. Providers shall not be entitled to enrollment in the

 7  Medicaid provider network. The agency shall determine

 8  instances in which allowing Medicaid beneficiaries to purchase

 9  durable medical equipment and other goods is less expensive to

10  the Medicaid program than long-term rental of the equipment or

11  goods. The agency may establish rules to facilitate purchases

12  in lieu of long-term rentals in order to protect against fraud

13  and abuse in the Medicaid program as defined in s. 409.913.

14  The agency may seek federal waivers necessary to administer

15  these policies.

16         (51)  The agency shall work with the Agency for Persons

17  with Disabilities to develop a model home and community-based

18  waiver to serve children and adults who are diagnosed with

19  familial dysautonomia or Riley-Day syndrome caused by a

20  mutation of the IKBKAP gene on chromosome 9. The agency shall

21  seek federal waiver approval and implement the approved waiver

22  subject to the availability of funds and any limitations

23  provided in the General Appropriations Act. The agency may

24  adopt rules to implement this waiver program.

25         Section 2.  This act shall take effect upon becoming a

26  law.

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    Florida Senate - 2006                           CS for SB 2226
    587-2313-06




 1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
 2                         Senate Bill 2226

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 4  The committee substitute reinstates current statutory language
    requiring the approved waiver to be subject to the
 5  availability of funds and any limitations provided in the
    General Appropriations Act, and deletes an appropriation.
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