Florida Senate - 2011                        COMMITTEE AMENDMENT
       Bill No. SB 1458
       
       
       
       
       
       
                                Barcode 235806                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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       The Committee on Health Regulation (Garcia) recommended the
       following:
       
    1         Senate Amendment to Amendment (423426) (with title
    2  amendment)
    3  
    4         Between lines 75 and 76
    5  insert:
    6         Section 4. Subsection (41) of section 409.912, Florida
    7  Statutes, is amended to read:
    8         409.912 Cost-effective purchasing of health care.—The
    9  agency shall purchase goods and services for Medicaid recipients
   10  in the most cost-effective manner consistent with the delivery
   11  of quality medical care. To ensure that medical services are
   12  effectively utilized, the agency may, in any case, require a
   13  confirmation or second physician’s opinion of the correct
   14  diagnosis for purposes of authorizing future services under the
   15  Medicaid program. This section does not restrict access to
   16  emergency services or poststabilization care services as defined
   17  in 42 C.F.R. part 438.114. Such confirmation or second opinion
   18  shall be rendered in a manner approved by the agency. The agency
   19  shall maximize the use of prepaid per capita and prepaid
   20  aggregate fixed-sum basis services when appropriate and other
   21  alternative service delivery and reimbursement methodologies,
   22  including competitive bidding pursuant to s. 287.057, designed
   23  to facilitate the cost-effective purchase of a case-managed
   24  continuum of care. The agency shall also require providers to
   25  minimize the exposure of recipients to the need for acute
   26  inpatient, custodial, and other institutional care and the
   27  inappropriate or unnecessary use of high-cost services. The
   28  agency shall contract with a vendor to monitor and evaluate the
   29  clinical practice patterns of providers in order to identify
   30  trends that are outside the normal practice patterns of a
   31  provider’s professional peers or the national guidelines of a
   32  provider’s professional association. The vendor must be able to
   33  provide information and counseling to a provider whose practice
   34  patterns are outside the norms, in consultation with the agency,
   35  to improve patient care and reduce inappropriate utilization.
   36  The agency may mandate prior authorization, drug therapy
   37  management, or disease management participation for certain
   38  populations of Medicaid beneficiaries, certain drug classes, or
   39  particular drugs to prevent fraud, abuse, overuse, and possible
   40  dangerous drug interactions. The Pharmaceutical and Therapeutics
   41  Committee shall make recommendations to the agency on drugs for
   42  which prior authorization is required. The agency shall inform
   43  the Pharmaceutical and Therapeutics Committee of its decisions
   44  regarding drugs subject to prior authorization. The agency is
   45  authorized to limit the entities it contracts with or enrolls as
   46  Medicaid providers by developing a provider network through
   47  provider credentialing. The agency may competitively bid single
   48  source-provider contracts if procurement of goods or services
   49  results in demonstrated cost savings to the state without
   50  limiting access to care. The agency may limit its network based
   51  on the assessment of beneficiary access to care, provider
   52  availability, provider quality standards, time and distance
   53  standards for access to care, the cultural competence of the
   54  provider network, demographic characteristics of Medicaid
   55  beneficiaries, practice and provider-to-beneficiary standards,
   56  appointment wait times, beneficiary use of services, provider
   57  turnover, provider profiling, provider licensure history,
   58  previous program integrity investigations and findings, peer
   59  review, provider Medicaid policy and billing compliance records,
   60  clinical and medical record audits, and other factors. Providers
   61  shall not be entitled to enrollment in the Medicaid provider
   62  network. The agency shall determine instances in which allowing
   63  Medicaid beneficiaries to purchase durable medical equipment and
   64  other goods is less expensive to the Medicaid program than long
   65  term rental of the equipment or goods. The agency may establish
   66  rules to facilitate purchases in lieu of long-term rentals in
   67  order to protect against fraud and abuse in the Medicaid program
   68  as defined in s. 409.913. The agency may seek federal waivers
   69  necessary to administer these policies.
   70         (41) The agency shall establish provide for the development
   71  of a demonstration project by establishment in Miami-Dade County
   72  of a long-term-care facility and a psychiatric facility licensed
   73  pursuant to chapter 395 to improve access to health care for a
   74  predominantly minority, medically underserved, and medically
   75  complex population and to evaluate alternatives to nursing home
   76  care and general acute care for such population. Such project is
   77  to be located in a health care condominium and collocated
   78  colocated with licensed facilities providing a continuum of
   79  care. These projects are The establishment of this project is
   80  not subject to the provisions of s. 408.036 or s. 408.039.
   81  
   82  ================= T I T L E  A M E N D M E N T ================
   83         And the title is amended as follows:
   84         Delete lines 2259 - 2268
   85  and insert:
   86         An act relating to assisted care communities; amending
   87         s. 400.141, F.S.; revising licensing requirements for
   88         registered pharmacists under contract with a nursing
   89         home and related health care facilities; amending s.
   90         408.810, F.S.; providing additional licensing
   91         requirements for assisted living facilities; amending
   92         s. 408.820, F.S.; providing that certain assisted
   93         living facilities are exempt from requirements of part
   94         II of ch. 408, F.S., related to health care licensing;
   95         amending s. 409.912, F.S.; requiring the Agency for
   96         Health Care Administration to provide for the
   97         development of a demonstration project for a
   98         psychiatric facility in Miami-Dade County; amending s.
   99         429.01, F.S.;