Florida Senate - 2011                          SENATOR AMENDMENT
       Bill No. CS/HB 7109, 2nd Eng.
                                Barcode 117776                          
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                 Floor: WD/2R          .                                
             05/05/2011 03:25 PM       .                                

       Senator Fasano moved the following:
    1         Senate Amendment (with title amendment)
    3         Between lines 752 and 753
    4  insert:
    5         Section 10. Subsection (18) of section 409.908, Florida
    6  Statutes, is amended to read:
    7         409.908 Reimbursement of Medicaid providers.—Subject to
    8  specific appropriations, the agency shall reimburse Medicaid
    9  providers, in accordance with state and federal law, according
   10  to methodologies set forth in the rules of the agency and in
   11  policy manuals and handbooks incorporated by reference therein.
   12  These methodologies may include fee schedules, reimbursement
   13  methods based on cost reporting, negotiated fees, competitive
   14  bidding pursuant to s. 287.057, and other mechanisms the agency
   15  considers efficient and effective for purchasing services or
   16  goods on behalf of recipients. If a provider is reimbursed based
   17  on cost reporting and submits a cost report late and that cost
   18  report would have been used to set a lower reimbursement rate
   19  for a rate semester, then the provider’s rate for that semester
   20  shall be retroactively calculated using the new cost report, and
   21  full payment at the recalculated rate shall be effected
   22  retroactively. Medicare-granted extensions for filing cost
   23  reports, if applicable, shall also apply to Medicaid cost
   24  reports. Payment for Medicaid compensable services made on
   25  behalf of Medicaid eligible persons is subject to the
   26  availability of moneys and any limitations or directions
   27  provided for in the General Appropriations Act or chapter 216.
   28  Further, nothing in this section shall be construed to prevent
   29  or limit the agency from adjusting fees, reimbursement rates,
   30  lengths of stay, number of visits, or number of services, or
   31  making any other adjustments necessary to comply with the
   32  availability of moneys and any limitations or directions
   33  provided for in the General Appropriations Act, provided the
   34  adjustment is consistent with legislative intent.
   35         (18) Unless otherwise provided for in the General
   36  Appropriations Act, a provider of transportation services shall
   37  be reimbursed the lesser of the amount billed by the provider or
   38  the Medicaid maximum allowable fee established by the agency,
   39  except if when the agency has entered into a direct contract
   40  with the provider, or with a community transportation
   41  coordinator, for the provision of an all-inclusive service, or
   42  if when services are provided pursuant to an agreement
   43  negotiated between the agency and the provider. The agency, as
   44  provided for in s. 427.0135, shall purchase transportation
   45  services through the community coordinated transportation
   46  system, if available, unless the agency, after consultation with
   47  the commission, determines that it cannot reach mutually
   48  acceptable contract terms with the commission. The agency may
   49  then contract for the same transportation services provided in a
   50  more cost-effective manner and of comparable or higher quality
   51  and standards. Nothing in
   52         (a) This subsection does not shall be construed to limit or
   53  preclude the agency from contracting for services using a
   54  prepaid capitation rate or from establishing maximum fee
   55  schedules, individualized reimbursement policies by provider
   56  type, negotiated fees, prior authorization, competitive bidding,
   57  increased use of mass transit, or any other mechanism that the
   58  agency considers efficient and effective for the purchase of
   59  services on behalf of Medicaid clients, including implementing a
   60  transportation eligibility process.
   61         (b) The agency may shall not be required to contract with
   62  any community transportation coordinator or transportation
   63  operator that has been determined by the agency, the Department
   64  of Legal Affairs Medicaid Fraud Control Unit, or any other state
   65  or federal agency to have engaged in any abusive or fraudulent
   66  billing activities.
   67         (c) The agency shall is authorized to competitively procure
   68  transportation services or make other changes necessary to
   69  secure approval of federal waivers needed to permit federal
   70  financing of Medicaid transportation services at the service
   71  matching rate rather than the administrative matching rate.
   72  Notwithstanding chapter 427, the agency is authorized to
   73  continue contracting for Medicaid nonemergency transportation
   74  services in agency service area 11 with managed care plans that
   75  were under contract for those services before July 1, 2004.
   77  ================= T I T L E  A M E N D M E N T ================
   78         And the title is amended as follows:
   79         Delete line 47
   80  and insert:
   81         integrity; amending s. 409.908, F.S.; requiring the
   82         Agency for Health Care Administration to competitively
   83         procure transportation services to permit federal
   84         financing of Medicaid transportation services at the
   85         service matching rate rather than the administrative
   86         matching rate; deleting the provision that authorizes
   87         the agency to continue contracting for Medicaid
   88         nonemergency transportation services in agency service
   89         area 11 with managed care plans that were under
   90         contract for those services before a specified date;
   91         amending s. 409.911, F.S.; providing for