CS/CS/HB 1175

1
A bill to be entitled
2An act relating to transportation services for the
3transportation disadvantaged; amending s. 409.908, F.S.;
4authorizing the Agency for Health Care Administration to
5continue to contract for Medicaid nonemergency
6transportation services in a specified agency service area
7with managed care plans under certain conditions; amending
8s. 427.011, F.S.; revising definitions; defining the term
9"purchasing agency"; amending s. 427.012, F.S.; revising
10the number of members required for a quorum at a meeting
11of the Commission for the Transportation Disadvantaged;
12amending s. 427.013, F.S.; revising responsibilities of
13the commission; deleting a requirement that the commission
14establish by rule acceptable ranges of trip costs;
15removing a provision for functioning and oversight of the
16quality assurance and management review program; requiring
17the commission to incur expenses for promotional services
18and items; amending s. 427.0135, F.S.; revising and
19creating duties and responsibilities for agencies that
20purchase transportation services for the transportation
21disadvantaged; providing requirements for the payment of
22rates; requiring an agency to negotiate with the
23commission before procuring transportation disadvantaged
24services; requiring an agency to identify its allocation
25for transportation disadvantaged services in its
26legislative budget request; amending s. 427.015, F.S.;
27revising provisions relating to the function of the
28metropolitan planning organization or designated official
29planning agency; amending s. 427.0155, F.S.; revising
30duties of community transportation coordinators; amending
31s. 427.0157, F.S.; revising duties of coordinating boards;
32amending s. 427.0158, F.S.; deleting provisions requiring
33the school board to provide information relating to school
34buses to the transportation coordinator; providing for the
35transportation coordinator to request certain information
36regarding public transportation; amending s. 427.0159,
37F.S.; revising provisions relating to the Transportation
38Disadvantaged Trust Fund; providing for the deposit of
39funds by an agency purchasing transportation services;
40amending s. 427.016, F.S.; providing for construction and
41application of specified provisions to certain acts of a
42purchasing agency in lieu of the Medicaid agency;
43requiring that an agency identify the allocation of funds
44for transportation disadvantaged services in its
45legislative budget request; providing an effective date.
46
47Be It Enacted by the Legislature of the State of Florida:
48
49     Section 1.  Subsection (18) of section 409.908, Florida
50Statutes, is amended to read:
51     409.908  Reimbursement of Medicaid providers.--Subject to
52specific appropriations, the agency shall reimburse Medicaid
53providers, in accordance with state and federal law, according
54to methodologies set forth in the rules of the agency and in
55policy manuals and handbooks incorporated by reference therein.
56These methodologies may include fee schedules, reimbursement
57methods based on cost reporting, negotiated fees, competitive
58bidding pursuant to s. 287.057, and other mechanisms the agency
59considers efficient and effective for purchasing services or
60goods on behalf of recipients. If a provider is reimbursed based
61on cost reporting and submits a cost report late and that cost
62report would have been used to set a lower reimbursement rate
63for a rate semester, then the provider's rate for that semester
64shall be retroactively calculated using the new cost report, and
65full payment at the recalculated rate shall be effected
66retroactively. Medicare-granted extensions for filing cost
67reports, if applicable, shall also apply to Medicaid cost
68reports. Payment for Medicaid compensable services made on
69behalf of Medicaid eligible persons is subject to the
70availability of moneys and any limitations or directions
71provided for in the General Appropriations Act or chapter 216.
72Further, nothing in this section shall be construed to prevent
73or limit the agency from adjusting fees, reimbursement rates,
74lengths of stay, number of visits, or number of services, or
75making any other adjustments necessary to comply with the
76availability of moneys and any limitations or directions
77provided for in the General Appropriations Act, provided the
78adjustment is consistent with legislative intent.
79     (18)  Unless otherwise provided for in the General
80Appropriations Act, a provider of transportation services shall
81be reimbursed the lesser of the amount billed by the provider or
82the Medicaid maximum allowable fee established by the agency,
83except when the agency has entered into a direct contract with
84the provider, or with a community transportation coordinator,
85for the provision of an all-inclusive service, or when services
86are provided pursuant to an agreement negotiated between the
87agency and the provider. The agency, as provided for in s.
88427.0135, shall purchase transportation services through the
89community coordinated transportation system, if available,
90unless the agency determines a more cost-effective method for
91Medicaid clients. Nothing in this subsection shall be construed
92to limit or preclude the agency from contracting for services
93using a prepaid capitation rate or from establishing maximum fee
94schedules, individualized reimbursement policies by provider
95type, negotiated fees, prior authorization, competitive bidding,
96increased use of mass transit, or any other mechanism that the
97agency considers efficient and effective for the purchase of
98services on behalf of Medicaid clients, including implementing a
99transportation eligibility process. The agency shall not be
100required to contract with any community transportation
101coordinator or transportation operator that has been determined
102by the agency, the Department of Legal Affairs Medicaid Fraud
103Control Unit, or any other state or federal agency to have
104engaged in any abusive or fraudulent billing activities. The
105agency is authorized to competitively procure transportation
106services or make other changes necessary to secure approval of
107federal waivers needed to permit federal financing of Medicaid
108transportation services at the service matching rate rather than
109the administrative matching rate. Notwithstanding the provisions
110of chapter 427, the agency is authorized to continue contracting
111for Medicaid nonemergency transportation services in agency
112service area 11 with managed care plans that were under contract
113for those services prior to July 1, 2004.
114     Section 2.  Subsections (8), (12), and (13) of section
115427.011, Florida Statutes, are amended to read:
116     427.011  Definitions.--For the purposes of ss. 427.011-
117427.017:
118     (8)  "Purchasing agency" "Member department" means a
119department or agency whose head is an ex officio, nonvoting
120advisor to a member of the commission, or an agency that
121purchases transportation services for the transportation
122disadvantaged.
123     (12)  "Annual budget estimate" means a budget estimate of
124funding resources available for providing transportation
125services to the transportation disadvantaged and which is
126prepared annually to cover a period of 1 state fiscal year.
127     (12)(13)  "Nonsponsored transportation disadvantaged
128services" means transportation disadvantaged services that are
129not sponsored or subsidized by any funding source other than the
130Transportation Disadvantaged Trust Fund.
131     Section 3.  Subsection (4) of section 427.012, Florida
132Statutes, is amended to read:
133     427.012  The Commission for the Transportation
134Disadvantaged.--There is created the Commission for the
135Transportation Disadvantaged in the Department of
136Transportation.
137     (4)  The commission shall meet at least quarterly, or more
138frequently at the call of the chairperson. Four Five members of
139the commission constitute a quorum, and a majority vote of the
140members present is necessary for any action taken by the
141commission.
142     Section 4.  Subsections (7), (8), (9), (14), and (26) of
143section 427.013, Florida Statutes, are amended, and subsection
144(29) is added to that section, to read:
145     427.013  The Commission for the Transportation
146Disadvantaged; purpose and responsibilities.--The purpose of the
147commission is to accomplish the coordination of transportation
148services provided to the transportation disadvantaged. The goal
149of this coordination shall be to assure the cost-effective
150provision of transportation by qualified community
151transportation coordinators or transportation operators for the
152transportation disadvantaged without any bias or presumption in
153favor of multioperator systems or not-for-profit transportation
154operators over single operator systems or for-profit
155transportation operators. In carrying out this purpose, the
156commission shall:
157     (7)  Unless otherwise provided by state or federal law,
158assure that all procedures, guidelines, and directives issued by
159purchasing agencies member departments are conducive to the
160coordination of transportation services.
161     (8)(a)  Assure that purchasing agencies member departments
162purchase all trips within the coordinated system, unless they
163have fulfilled the requirements of s. 427.0135(3) and use a more
164cost-effective alternative provider that meets comparable
165quality and standards.
166     (b)  Provide, by rule, criteria and procedures for
167purchasing agencies member departments to use if they wish to
168use an alternative provider. Agencies Departments must
169demonstrate either that the proposed alternative provider can
170provide a trip of comparable acceptable quality and standards
171for the clients at a lower cost than that provided within the
172coordinated system, or that the coordinated system cannot
173accommodate the agency's department's clients, or that the
174agency has satisfied the requirements of s. 427.0135(3).
175     (9)  Develop by rule standards for community transportation
176coordinators and any transportation operator or coordination
177contractor from whom service is purchased or arranged by the
178community transportation coordinator covering coordination,
179operation, safety, insurance, eligibility for service, costs,
180and utilization of transportation disadvantaged services. Such
181rules shall not apply to purchasing agencies meeting the
182requirements of s. 427.0135(3) and using an alternative
183provider. These standards and rules must include, but are not
184limited to:
185     (a)  Inclusion, by rule, of acceptable ranges of trip costs
186for the various modes and types of transportation services
187provided.
188     (a)(b)  Minimum performance standards for the delivery of
189services. These standards must be included in coordinator
190contracts and transportation operator contracts with clear
191penalties for repeated or continuing violations.
192     (b)(c)  Minimum liability insurance requirements for all
193transportation services purchased, provided, or coordinated for
194the transportation disadvantaged through the community
195transportation coordinator.
196     (14)  Consolidate, for each state agency, the annual budget
197estimates for transportation disadvantaged services, and the
198amounts of each agency's actual expenditures, together with the
199actual expenditures annual budget estimates of each official
200planning agency, local government, and directly federally funded
201agency and the amounts collected by each official planning
202agency issue a report.
203     (26)  Develop a quality assurance and management review
204program to monitor, based upon approved commission standards,
205services contracted for by an agency, and those provided by a
206community transportation operator pursuant to s. 427.0155. Staff
207of the quality assurance and management review program shall
208function independently and be directly responsible to the
209executive director.
210     (29)  Incur expenses for the purchase of advertisements,
211marketing services, and promotional items.
212     Section 5.  Section 427.0135, Florida Statutes, is amended
213to read:
214     427.0135  Purchasing agencies Member departments; duties
215and responsibilities.--Each purchasing agency member department,
216in carrying out the policies and procedures of the commission,
217shall:
218     (1)(a)  Use the coordinated transportation system for
219provision of services to its clients, unless each department or
220purchasing agency meets the criteria outlined in rule or statute
221to use an alternative provider.
222     (b)  Subject to the provisions of s. 409.908(18), the
223Medicaid agency shall purchase transportation services through
224the community coordinated transportation system unless a more
225cost-effective method is determined by the agency for Medicaid
226clients or unless otherwise limited or directed by the General
227Appropriations Act.
228     (2)  Pay the rates established in the service plan or
229negotiated statewide contract, unless the purchasing agency has
230completed the procedure for using an alternative provider and
231demonstrated that a proposed alternative provider can provide a
232more cost-effective transportation service of comparable quality
233and standards or unless the agency has satisfied the
234requirements of subsection (3).
235     (3)  Not procure transportation disadvantaged services
236without initially negotiating with the commission, as provided
237in s. 287.057(5)(f)13., or unless otherwise authorized by
238statute. If the purchasing agency, after consultation with the
239commission, determines that it cannot reach mutually acceptable
240contract terms with the commission, the purchasing agency may
241contract for the same transportation services provided in a more
242cost-effective manner and of comparable or higher quality and
243standards than those provided by the commission, as determined
244by the purchasing agency. The Medicaid agency shall implement
245this subsection in a manner consistent with s. 409.908(18) and
246as otherwise limited or directed by the General Appropriations
247Act.
248     (4)  Identify in the legislative budget request provided to
249the Governor each year for the General Appropriations Act the
250specific amount of any money the purchasing agency will allocate
251for the provision of transportation disadvantaged services.
252     (5)(2)  Provide the commission, by September 15 of each
253year, an accounting of all funds spent as well as how many trips
254were purchased with agency funds.
255     (6)(3)  Assist communities in developing coordinated
256transportation systems designed to serve the transportation
257disadvantaged. However, a purchasing agency member department
258may not serve as the community transportation coordinator in any
259designated service area.
260     (7)(4)  Assure that its rules, procedures, guidelines, and
261directives are conducive to the coordination of transportation
262funds and services for the transportation disadvantaged.
263     (8)(5)  Provide technical assistance, as needed, to
264community transportation coordinators or transportation
265operators or participating agencies.
266     Section 6.  Subsections (2) and (3) of section 427.015,
267Florida Statutes, are amended to read:
268     427.015  Function of the metropolitan planning organization
269or designated official planning agency in coordinating
270transportation for the transportation disadvantaged.--
271     (2)  Each metropolitan planning organization or designated
272official planning agency shall recommend to the commission a
273single community transportation coordinator. However, a
274purchasing agency member department may not serve as the
275community transportation coordinator in any designated service
276area. The coordinator may provide all or a portion of needed
277transportation services for the transportation disadvantaged but
278shall be responsible for the provision of those coordinated
279services. Based on approved commission evaluation criteria, the
280coordinator shall subcontract or broker those services that are
281more cost-effectively and efficiently provided by subcontracting
282or brokering. The performance of the coordinator shall be
283evaluated based on the commission's approved evaluation criteria
284by the coordinating board at least annually. A copy of the
285evaluation shall be submitted to the metropolitan planning
286organization or the designated official planning agency, and the
287commission. The recommendation or termination of any community
288transportation coordinator shall be subject to approval by the
289commission.
290     (3)  Each metropolitan planning organization or designated
291official planning agency shall request each local government in
292its jurisdiction to provide the actual expenditures an estimate
293of all local and direct federal funds to be expended for
294transportation for the disadvantaged. The metropolitan planning
295organization or designated official planning agency shall
296consolidate this information into a single report and forward
297it, by September 15 the beginning of each fiscal year, to the
298commission.
299     Section 7.  Subsection (7) of section 427.0155, Florida
300Statutes, is amended to read:
301     427.0155  Community transportation coordinators; powers and
302duties.--Community transportation coordinators shall have the
303following powers and duties:
304     (7)  In cooperation with the coordinating board and
305pursuant to criteria developed by the Commission for the
306Transportation Disadvantaged, establish eligibility guidelines
307and priorities with regard to the recipients of nonsponsored
308transportation disadvantaged services that are purchased with
309Transportation Disadvantaged Trust Fund moneys.
310     Section 8.  Subsection (4) of section 427.0157, Florida
311Statutes, is amended to read:
312     427.0157  Coordinating boards; powers and duties.--The
313purpose of each coordinating board is to develop local service
314needs and to provide information, advice, and direction to the
315community transportation coordinators on the coordination of
316services to be provided to the transportation disadvantaged. The
317commission shall, by rule, establish the membership of
318coordinating boards. The members of each board shall be
319appointed by the metropolitan planning organization or
320designated official planning agency. The appointing authority
321shall provide each board with sufficient staff support and
322resources to enable the board to fulfill its responsibilities
323under this section. Each board shall meet at least quarterly and
324shall:
325     (4)  Assist the community transportation coordinator in
326establishing eligibility guidelines and priorities with regard
327to the recipients of nonsponsored transportation disadvantaged
328services that are purchased with Transportation Disadvantaged
329Trust Fund moneys.
330     Section 9.  Subsections (2) and (3) of section 427.0158,
331Florida Statutes, are amended to read:
332     427.0158  School bus and public transportation.--
333     (2)  The school boards shall cooperate in the utilization
334of their vehicles to enhance coordinated disadvantaged
335transportation disadvantaged services by providing the
336information as requested by the community transportation
337coordinator required by this section and by allowing the use of
338their vehicles at actual cost upon request when those vehicles
339are available for such use and are not transporting students.
340Semiannually, no later than October 1 and April 30, a designee
341from the local school board shall provide the community
342transportation coordinator with copies to the coordinated
343transportation board, the following information for vehicles not
344scheduled 100 percent of the time for student transportation
345use:
346     (a)  The number and type of vehicles by adult capacity,
347including days and times, that the vehicles are available for
348coordinated transportation disadvantaged services;
349     (b)  The actual cost per mile by vehicle type available;
350     (c)  The actual driver cost per hour;
351     (d)  Additional actual cost associated with vehicle use
352outside the established workday or workweek of the entity; and
353     (e)  Notification of lead time required for vehicle use.
354     (3)  The public transit fixed route or fixed schedule
355system shall cooperate in the utilization of its regular service
356to enhance coordinated transportation disadvantaged services by
357providing the information as requested by the community
358transportation coordinator required by this section. Annually,
359no later than October 1, a designee from the local public
360transit fixed route or fixed schedule system shall provide The
361community transportation coordinator may request, without
362limitation, with copies to the coordinated transportation board,
363the following information:
364     (a)  A copy of all current schedules, route maps, system
365map, and fare structure;
366     (b)  A copy of the current charter policy;
367     (c)  A copy of the current charter rates and hour
368requirements; and
369     (d)  Required notification time to arrange for a charter.
370     Section 10.  Subsection (4) is added to section 427.0159,
371Florida Statutes, to read:
372     427.0159  Transportation Disadvantaged Trust Fund.--
373     (4)  A purchasing agency may deposit funds into the
374Transportation Disadvantaged Trust Fund for the commission to
375implement, manage, and administer the purchasing agency's
376transportation disadvantaged funds, as defined in s.
377427.011(10).
378     Section 11.  Paragraph (b) of subsection (1) and subsection
379(2) of section 427.016, Florida Statutes, are amended to read:
380     427.016  Expenditure of local government, state, and
381federal funds for the transportation disadvantaged.--
382     (1)
383     (b)  Nothing in this subsection shall be construed to limit
384or preclude a purchasing the Medicaid agency from establishing
385maximum fee schedules, individualized reimbursement policies by
386provider type, negotiated fees, competitive bidding, or any
387other mechanism, including contracting after initial negotiation
388with the commission, which that the agency considers more cost-
389effective and of comparable or higher quality and standards than
390those of the commission efficient and effective for the purchase
391of services on behalf of its Medicaid clients if it has
392fulfilled the requirements of s. 427.0135(3) or the procedure
393for using an alternative provider. State and local agencies
394shall not contract for any transportation disadvantaged
395services, including Medicaid reimbursable transportation
396services, with any community transportation coordinator or
397transportation operator that has been determined by the Agency
398for Health Care Administration, the Department of Legal Affairs
399Medicaid Fraud Control Unit, or any state or federal agency to
400have engaged in any abusive or fraudulent billing activities.
401     (2)  Each year, each agency, whether or not it is an ex
402officio, nonvoting advisor to a member of the Commission for the
403Transportation Disadvantaged, shall identify in the legislative
404budget request provided to the Governor for the General
405Appropriations Act inform the commission in writing, before the
406beginning of each fiscal year, of the specific amount of any
407money the agency will allocate allocated for the provision of
408transportation disadvantaged services. Additionally, each state
409agency shall, by September 15 of each year, provide the
410commission with an accounting of the actual amount of funds
411expended and the total number of trips purchased.
412     Section 12.  This act shall take effect July 1, 2008.


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