1

Senator Wilson moved the following amendment:

2

3

     Senate Amendment (with title amendment)

4

     Between lines 1219 and 1220,

5

insert:

6

7

     Section 10.  Paragraph (ee) is added to subsection (3) of

8

section 409.91211, Florida Statutes, as amended by chapter 2007-

9

331, Laws of Florida, to read:

10

     409.91211  Medicaid managed care pilot program.--

11

     (3)  The agency shall have the following powers, duties, and

12

responsibilities with respect to the pilot program:

13

     (ee) To implement contractual requirements and adopt rules

14

that will require capitated managed care plans and provider

15

services networks to continue providing any current service,

16

including those services subject to prior authorization, during

17

the period of time in which prior authorization is being

18

requested, processed, or appealed. Services must be continued at

19

the current level until a notice conforming with 42 C.F.R. s.

20

431.200 is sent and at least 10 days after the date of the notice

21

has passed and a hearing is not requested, or, if a hearing is

22

requested, the hearing decision affirms the adverse action.

23

24

================ T I T L E  A M E N D M E N T ================

25

And the title is amended as follows:

26

     On line 42, after the first semicolon,

27

insert:

28

amending s. 409.91211, F.S.; requiring that the Agency for

29

Health Care Administration implement contractual

30

requirements and adopt rules concerning continuation of

31

services with respect to the Medicaid managed care pilot

32

program;

4/9/2008  7:45:00 AM     33-07032-08