Florida Senate - 2017                              CS for SB 694
       By the Committee on Health Policy; and Senators Hutson and
       588-02954-17                                           2017694c1
    1                        A bill to be entitled                      
    2         An act relating to consolidation of Medicaid waiver
    3         programs; amending s. 409.904, F.S.; authorizing any
    4         state agency or department involved in providing
    5         health, social, or human services to make payments for
    6         medical assistance for certain persons diagnosed with
    7         Acquired Immune Deficiency Syndrome (AIDS); amending
    8         s. 409.906, F.S.; removing the Agency for Health Care
    9         Administration’s ability to consolidate certain home
   10         and community-based services; amending s. 409.912,
   11         F.S.; deleting the requirement that the agency
   12         implement a Medicaid prescription drug management
   13         system; amending s. 409.979, F.S.; requiring that
   14         Medicaid recipients enrolled in certain home and
   15         community-based service Medicaid waivers be
   16         transitioned into the long-term care managed care
   17         program by January 1, 2018; requiring the agency to
   18         seek federal approval to terminate certain waiver
   19         programs once all eligible Medicaid recipients have
   20         transitioned into the long-term care managed care
   21         program; amending ss. 393.0661 and 409.968, F.S.;
   22         conforming cross-references; providing an effective
   23         date.
   25  Be It Enacted by the Legislature of the State of Florida:
   27         Section 1. Subsection (11) is added to section 409.904,
   28  Florida Statutes, to read:
   29         409.904 Optional payments for eligible persons.—The agency
   30  may make payments for medical assistance and related services on
   31  behalf of the following persons who are determined to be
   32  eligible subject to the income, assets, and categorical
   33  eligibility tests set forth in federal and state law. Payment on
   34  behalf of these Medicaid eligible persons is subject to the
   35  availability of moneys and any limitations established by the
   36  General Appropriations Act or chapter 216.
   37         (11) Subject to federal waiver approval, a person diagnosed
   38  with Acquired Immune Deficiency Syndrome (AIDS), who has an
   39  AIDS-related opportunistic infection, who is at risk of
   40  hospitalization as determined by the agency or its designee, and
   41  whose income is at, or below, 300 percent of the federal benefit
   42  rate.
   43         Section 2. Paragraph (b) of subsection (13) of section
   44  409.906, Florida Statutes, is amended to read:
   45         409.906 Optional Medicaid services.—Subject to specific
   46  appropriations, the agency may make payments for services which
   47  are optional to the state under Title XIX of the Social Security
   48  Act and are furnished by Medicaid providers to recipients who
   49  are determined to be eligible on the dates on which the services
   50  were provided. Any optional service that is provided shall be
   51  provided only when medically necessary and in accordance with
   52  state and federal law. Optional services rendered by providers
   53  in mobile units to Medicaid recipients may be restricted or
   54  prohibited by the agency. Nothing in this section shall be
   55  construed to prevent or limit the agency from adjusting fees,
   56  reimbursement rates, lengths of stay, number of visits, or
   57  number of services, or making any other adjustments necessary to
   58  comply with the availability of moneys and any limitations or
   59  directions provided for in the General Appropriations Act or
   60  chapter 216. If necessary to safeguard the state’s systems of
   61  providing services to elderly and disabled persons and subject
   62  to the notice and review provisions of s. 216.177, the Governor
   63  may direct the Agency for Health Care Administration to amend
   64  the Medicaid state plan to delete the optional Medicaid service
   65  known as “Intermediate Care Facilities for the Developmentally
   66  Disabled.” Optional services may include:
   68         (b) The agency may consolidate types of services offered in
   69  the Aged and Disabled Waiver, the Channeling Waiver, the Project
   70  AIDS Care Waiver, and the Traumatic Brain and Spinal Cord Injury
   71  Waiver programs in order to group similar services under a
   72  single service, or continue a service upon evidence of the need
   73  for including a particular service type in a particular waiver.
   74  The agency is authorized to seek a Medicaid state plan amendment
   75  or federal waiver approval to implement this policy.
   76         Section 3. Paragraph (a) of subsection (8) of section
   77  409.912, Florida Statutes, is amended to read:
   78         409.912 Cost-effective purchasing of health care.—The
   79  agency shall purchase goods and services for Medicaid recipients
   80  in the most cost-effective manner consistent with the delivery
   81  of quality medical care. To ensure that medical services are
   82  effectively utilized, the agency may, in any case, require a
   83  confirmation or second physician’s opinion of the correct
   84  diagnosis for purposes of authorizing future services under the
   85  Medicaid program. This section does not restrict access to
   86  emergency services or poststabilization care services as defined
   87  in 42 C.F.R. s. 438.114. Such confirmation or second opinion
   88  shall be rendered in a manner approved by the agency. The agency
   89  shall maximize the use of prepaid per capita and prepaid
   90  aggregate fixed-sum basis services when appropriate and other
   91  alternative service delivery and reimbursement methodologies,
   92  including competitive bidding pursuant to s. 287.057, designed
   93  to facilitate the cost-effective purchase of a case-managed
   94  continuum of care. The agency shall also require providers to
   95  minimize the exposure of recipients to the need for acute
   96  inpatient, custodial, and other institutional care and the
   97  inappropriate or unnecessary use of high-cost services. The
   98  agency shall contract with a vendor to monitor and evaluate the
   99  clinical practice patterns of providers in order to identify
  100  trends that are outside the normal practice patterns of a
  101  provider’s professional peers or the national guidelines of a
  102  provider’s professional association. The vendor must be able to
  103  provide information and counseling to a provider whose practice
  104  patterns are outside the norms, in consultation with the agency,
  105  to improve patient care and reduce inappropriate utilization.
  106  The agency may mandate prior authorization, drug therapy
  107  management, or disease management participation for certain
  108  populations of Medicaid beneficiaries, certain drug classes, or
  109  particular drugs to prevent fraud, abuse, overuse, and possible
  110  dangerous drug interactions. The Pharmaceutical and Therapeutics
  111  Committee shall make recommendations to the agency on drugs for
  112  which prior authorization is required. The agency shall inform
  113  the Pharmaceutical and Therapeutics Committee of its decisions
  114  regarding drugs subject to prior authorization. The agency is
  115  authorized to limit the entities it contracts with or enrolls as
  116  Medicaid providers by developing a provider network through
  117  provider credentialing. The agency may competitively bid single
  118  source-provider contracts if procurement of goods or services
  119  results in demonstrated cost savings to the state without
  120  limiting access to care. The agency may limit its network based
  121  on the assessment of beneficiary access to care, provider
  122  availability, provider quality standards, time and distance
  123  standards for access to care, the cultural competence of the
  124  provider network, demographic characteristics of Medicaid
  125  beneficiaries, practice and provider-to-beneficiary standards,
  126  appointment wait times, beneficiary use of services, provider
  127  turnover, provider profiling, provider licensure history,
  128  previous program integrity investigations and findings, peer
  129  review, provider Medicaid policy and billing compliance records,
  130  clinical and medical record audits, and other factors. Providers
  131  are not entitled to enrollment in the Medicaid provider network.
  132  The agency shall determine instances in which allowing Medicaid
  133  beneficiaries to purchase durable medical equipment and other
  134  goods is less expensive to the Medicaid program than long-term
  135  rental of the equipment or goods. The agency may establish rules
  136  to facilitate purchases in lieu of long-term rentals in order to
  137  protect against fraud and abuse in the Medicaid program as
  138  defined in s. 409.913. The agency may seek federal waivers
  139  necessary to administer these policies.
  140         (8)(a) The agency shall implement a Medicaid prescribed
  141  drug spending-control program that includes the following
  142  components:
  143         1. A Medicaid preferred drug list, which shall be a listing
  144  of cost-effective therapeutic options recommended by the
  145  Medicaid Pharmacy and Therapeutics Committee established
  146  pursuant to s. 409.91195 and adopted by the agency for each
  147  therapeutic class on the preferred drug list. At the discretion
  148  of the committee, and when feasible, the preferred drug list
  149  should include at least two products in a therapeutic class. The
  150  agency may post the preferred drug list and updates to the list
  151  on an Internet website without following the rulemaking
  152  procedures of chapter 120. Antiretroviral agents are excluded
  153  from the preferred drug list. The agency shall also limit the
  154  amount of a prescribed drug dispensed to no more than a 34-day
  155  supply unless the drug products’ smallest marketed package is
  156  greater than a 34-day supply, or the drug is determined by the
  157  agency to be a maintenance drug in which case a 100-day maximum
  158  supply may be authorized. The agency may seek any federal
  159  waivers necessary to implement these cost-control programs and
  160  to continue participation in the federal Medicaid rebate
  161  program, or alternatively to negotiate state-only manufacturer
  162  rebates. The agency may adopt rules to administer this
  163  subparagraph. The agency shall continue to provide unlimited
  164  contraceptive drugs and items. The agency must establish
  165  procedures to ensure that:
  166         a. There is a response to a request for prior consultation
  167  by telephone or other telecommunication device within 24 hours
  168  after receipt of a request for prior consultation; and
  169         b. A 72-hour supply of the drug prescribed is provided in
  170  an emergency or when the agency does not provide a response
  171  within 24 hours as required by sub-subparagraph a.
  172         2. Reimbursement to pharmacies for Medicaid prescribed
  173  drugs shall be set at the lowest of: the average wholesale price
  174  (AWP) minus 16.4 percent, the wholesaler acquisition cost (WAC)
  175  plus 1.5 percent, the federal upper limit (FUL), the state
  176  maximum allowable cost (SMAC), or the usual and customary (UAC)
  177  charge billed by the provider.
  178         3. The agency shall develop and implement a process for
  179  managing the drug therapies of Medicaid recipients who are using
  180  significant numbers of prescribed drugs each month. The
  181  management process may include, but is not limited to,
  182  comprehensive, physician-directed medical-record reviews, claims
  183  analyses, and case evaluations to determine the medical
  184  necessity and appropriateness of a patient’s treatment plan and
  185  drug therapies. The agency may contract with a private
  186  organization to provide drug-program-management services. The
  187  Medicaid drug benefit management program shall include
  188  initiatives to manage drug therapies for HIV/AIDS patients,
  189  patients using 20 or more unique prescriptions in a 180-day
  190  period, and the top 1,000 patients in annual spending. The
  191  agency shall enroll any Medicaid recipient in the drug benefit
  192  management program if he or she meets the specifications of this
  193  provision and is not enrolled in a Medicaid health maintenance
  194  organization.
  195         4. The agency may limit the size of its pharmacy network
  196  based on need, competitive bidding, price negotiations,
  197  credentialing, or similar criteria. The agency shall give
  198  special consideration to rural areas in determining the size and
  199  location of pharmacies included in the Medicaid pharmacy
  200  network. A pharmacy credentialing process may include criteria
  201  such as a pharmacy’s full-service status, location, size,
  202  patient educational programs, patient consultation, disease
  203  management services, and other characteristics. The agency may
  204  impose a moratorium on Medicaid pharmacy enrollment if it is
  205  determined that it has a sufficient number of Medicaid
  206  participating providers. The agency must allow dispensing
  207  practitioners to participate as a part of the Medicaid pharmacy
  208  network regardless of the practitioner’s proximity to any other
  209  entity that is dispensing prescription drugs under the Medicaid
  210  program. A dispensing practitioner must meet all credentialing
  211  requirements applicable to his or her practice, as determined by
  212  the agency.
  213         5. The agency shall develop and implement a program that
  214  requires Medicaid practitioners who prescribe drugs to use a
  215  counterfeit-proof prescription pad for Medicaid prescriptions.
  216  The agency shall require the use of standardized counterfeit
  217  proof prescription pads by Medicaid-participating prescribers or
  218  prescribers who write prescriptions for Medicaid recipients. The
  219  agency may implement the program in targeted geographic areas or
  220  statewide.
  221         6. The agency may enter into arrangements that require
  222  manufacturers of generic drugs prescribed to Medicaid recipients
  223  to provide rebates of at least 15.1 percent of the average
  224  manufacturer price for the manufacturer’s generic products.
  225  These arrangements shall require that if a generic-drug
  226  manufacturer pays federal rebates for Medicaid-reimbursed drugs
  227  at a level below 15.1 percent, the manufacturer must provide a
  228  supplemental rebate to the state in an amount necessary to
  229  achieve a 15.1-percent rebate level.
  230         7. The agency may establish a preferred drug list as
  231  described in this subsection, and, pursuant to the establishment
  232  of such preferred drug list, negotiate supplemental rebates from
  233  manufacturers that are in addition to those required by Title
  234  XIX of the Social Security Act and at no less than 14 percent of
  235  the average manufacturer price as defined in 42 U.S.C. s. 1936
  236  on the last day of a quarter unless the federal or supplemental
  237  rebate, or both, equals or exceeds 29 percent. There is no upper
  238  limit on the supplemental rebates the agency may negotiate. The
  239  agency may determine that specific products, brand-name or
  240  generic, are competitive at lower rebate percentages. Agreement
  241  to pay the minimum supplemental rebate percentage guarantees a
  242  manufacturer that the Medicaid Pharmaceutical and Therapeutics
  243  Committee will consider a product for inclusion on the preferred
  244  drug list. However, a pharmaceutical manufacturer is not
  245  guaranteed placement on the preferred drug list by simply paying
  246  the minimum supplemental rebate. Agency decisions will be made
  247  on the clinical efficacy of a drug and recommendations of the
  248  Medicaid Pharmaceutical and Therapeutics Committee, as well as
  249  the price of competing products minus federal and state rebates.
  250  The agency may contract with an outside agency or contractor to
  251  conduct negotiations for supplemental rebates. For the purposes
  252  of this section, the term “supplemental rebates” means cash
  253  rebates. Value-added programs as a substitution for supplemental
  254  rebates are prohibited. The agency may seek any federal waivers
  255  to implement this initiative.
  256         8. The agency shall expand home delivery of pharmacy
  257  products. The agency may amend the state plan and issue a
  258  procurement, as necessary, in order to implement this program.
  259  The procurements must include agreements with a pharmacy or
  260  pharmacies located in the state to provide mail order delivery
  261  services at no cost to the recipients who elect to receive home
  262  delivery of pharmacy products. The procurement must focus on
  263  serving recipients with chronic diseases for which pharmacy
  264  expenditures represent a significant portion of Medicaid
  265  pharmacy expenditures or which impact a significant portion of
  266  the Medicaid population. The agency may seek and implement any
  267  federal waivers necessary to implement this subparagraph.
  268         9. The agency shall limit to one dose per month any drug
  269  prescribed to treat erectile dysfunction.
  270         10.a. The agency may implement a Medicaid behavioral drug
  271  management system. The agency may contract with a vendor that
  272  has experience in operating behavioral drug management systems
  273  to implement this program. The agency may seek federal waivers
  274  to implement this program.
  275         b. The agency, in conjunction with the Department of
  276  Children and Families, may implement the Medicaid behavioral
  277  drug management system that is designed to improve the quality
  278  of care and behavioral health prescribing practices based on
  279  best practice guidelines, improve patient adherence to
  280  medication plans, reduce clinical risk, and lower prescribed
  281  drug costs and the rate of inappropriate spending on Medicaid
  282  behavioral drugs. The program may include the following
  283  elements:
  284         (I) Provide for the development and adoption of best
  285  practice guidelines for behavioral health-related drugs such as
  286  antipsychotics, antidepressants, and medications for treating
  287  bipolar disorders and other behavioral conditions; translate
  288  them into practice; review behavioral health prescribers and
  289  compare their prescribing patterns to a number of indicators
  290  that are based on national standards; and determine deviations
  291  from best practice guidelines.
  292         (II) Implement processes for providing feedback to and
  293  educating prescribers using best practice educational materials
  294  and peer-to-peer consultation.
  295         (III) Assess Medicaid beneficiaries who are outliers in
  296  their use of behavioral health drugs with regard to the numbers
  297  and types of drugs taken, drug dosages, combination drug
  298  therapies, and other indicators of improper use of behavioral
  299  health drugs.
  300         (IV) Alert prescribers to patients who fail to refill
  301  prescriptions in a timely fashion, are prescribed multiple same
  302  class behavioral health drugs, and may have other potential
  303  medication problems.
  304         (V) Track spending trends for behavioral health drugs and
  305  deviation from best practice guidelines.
  306         (VI) Use educational and technological approaches to
  307  promote best practices, educate consumers, and train prescribers
  308  in the use of practice guidelines.
  309         (VII) Disseminate electronic and published materials.
  310         (VIII) Hold statewide and regional conferences.
  311         (IX) Implement a disease management program with a model
  312  quality-based medication component for severely mentally ill
  313  individuals and emotionally disturbed children who are high
  314  users of care.
  315         11. The agency shall implement a Medicaid prescription drug
  316  management system.
  317         a. The agency may contract with a vendor that has
  318  experience in operating prescription drug management systems in
  319  order to implement this system. Any management system that is
  320  implemented in accordance with this subparagraph must rely on
  321  cooperation between physicians and pharmacists to determine
  322  appropriate practice patterns and clinical guidelines to improve
  323  the prescribing, dispensing, and use of drugs in the Medicaid
  324  program. The agency may seek federal waivers to implement this
  325  program.
  326         b. The drug management system must be designed to improve
  327  the quality of care and prescribing practices based on best
  328  practice guidelines, improve patient adherence to medication
  329  plans, reduce clinical risk, and lower prescribed drug costs and
  330  the rate of inappropriate spending on Medicaid prescription
  331  drugs. The program must:
  332         (I) Provide for the adoption of best practice guidelines
  333  for the prescribing and use of drugs in the Medicaid program,
  334  including translating best practice guidelines into practice;
  335  reviewing prescriber patterns and comparing them to indicators
  336  that are based on national standards and practice patterns of
  337  clinical peers in their community, statewide, and nationally;
  338  and determine deviations from best practice guidelines.
  339         (II) Implement processes for providing feedback to and
  340  educating prescribers using best practice educational materials
  341  and peer-to-peer consultation.
  342         (III) Assess Medicaid recipients who are outliers in their
  343  use of a single or multiple prescription drugs with regard to
  344  the numbers and types of drugs taken, drug dosages, combination
  345  drug therapies, and other indicators of improper use of
  346  prescription drugs.
  347         (IV) Alert prescribers to recipients who fail to refill
  348  prescriptions in a timely fashion, are prescribed multiple drugs
  349  that may be redundant or contraindicated, or may have other
  350  potential medication problems.
  351         11.12. The agency may contract for drug rebate
  352  administration, including, but not limited to, calculating
  353  rebate amounts, invoicing manufacturers, negotiating disputes
  354  with manufacturers, and maintaining a database of rebate
  355  collections.
  356         12.13. The agency may specify the preferred daily dosing
  357  form or strength for the purpose of promoting best practices
  358  with regard to the prescribing of certain drugs as specified in
  359  the General Appropriations Act and ensuring cost-effective
  360  prescribing practices.
  361         13.14. The agency may require prior authorization for
  362  Medicaid-covered prescribed drugs. The agency may prior
  363  authorize the use of a product:
  364         a. For an indication not approved in labeling;
  365         b. To comply with certain clinical guidelines; or
  366         c. If the product has the potential for overuse, misuse, or
  367  abuse.
  369  The agency may require the prescribing professional to provide
  370  information about the rationale and supporting medical evidence
  371  for the use of a drug. The agency shall post prior
  372  authorization, step-edit criteria and protocol, and updates to
  373  the list of drugs that are subject to prior authorization on the
  374  agency’s Internet website within 21 days after the prior
  375  authorization and step-edit criteria and protocol and updates
  376  are approved by the agency. For purposes of this subparagraph,
  377  the term “step-edit” means an automatic electronic review of
  378  certain medications subject to prior authorization.
  379         14.15. The agency, in conjunction with the Pharmaceutical
  380  and Therapeutics Committee, may require age-related prior
  381  authorizations for certain prescribed drugs. The agency may
  382  preauthorize the use of a drug for a recipient who may not meet
  383  the age requirement or may exceed the length of therapy for use
  384  of this product as recommended by the manufacturer and approved
  385  by the Food and Drug Administration. Prior authorization may
  386  require the prescribing professional to provide information
  387  about the rationale and supporting medical evidence for the use
  388  of a drug.
  389         15.16. The agency shall implement a step-therapy prior
  390  authorization approval process for medications excluded from the
  391  preferred drug list. Medications listed on the preferred drug
  392  list must be used within the previous 12 months before the
  393  alternative medications that are not listed. The step-therapy
  394  prior authorization may require the prescriber to use the
  395  medications of a similar drug class or for a similar medical
  396  indication unless contraindicated in the Food and Drug
  397  Administration labeling. The trial period between the specified
  398  steps may vary according to the medical indication. The step
  399  therapy approval process shall be developed in accordance with
  400  the committee as stated in s. 409.91195(7) and (8). A drug
  401  product may be approved without meeting the step-therapy prior
  402  authorization criteria if the prescribing physician provides the
  403  agency with additional written medical or clinical documentation
  404  that the product is medically necessary because:
  405         a. There is not a drug on the preferred drug list to treat
  406  the disease or medical condition which is an acceptable clinical
  407  alternative;
  408         b. The alternatives have been ineffective in the treatment
  409  of the beneficiary’s disease; or
  410         c. Based on historic evidence and known characteristics of
  411  the patient and the drug, the drug is likely to be ineffective,
  412  or the number of doses have been ineffective.
  414  The agency shall work with the physician to determine the best
  415  alternative for the patient. The agency may adopt rules waiving
  416  the requirements for written clinical documentation for specific
  417  drugs in limited clinical situations.
  418         16.17. The agency shall implement a return and reuse
  419  program for drugs dispensed by pharmacies to institutional
  420  recipients, which includes payment of a $5 restocking fee for
  421  the implementation and operation of the program. The return and
  422  reuse program shall be implemented electronically and in a
  423  manner that promotes efficiency. The program must permit a
  424  pharmacy to exclude drugs from the program if it is not
  425  practical or cost-effective for the drug to be included and must
  426  provide for the return to inventory of drugs that cannot be
  427  credited or returned in a cost-effective manner. The agency
  428  shall determine if the program has reduced the amount of
  429  Medicaid prescription drugs that which are destroyed on an
  430  annual basis and if there are additional ways to ensure more
  431  prescription drugs are not destroyed which could safely be
  432  reused.
  433         Section 4. Subsections (1) and (2) of section 409.979,
  434  Florida Statutes, are amended to read:
  435         409.979 Eligibility.—
  437  recipients who meet all of the following criteria are eligible
  438  to receive long-term care services and must receive long-term
  439  care services by participating in the long-term care managed
  440  care program. The recipient must be:
  441         (a) Sixty-five years of age or older, or age 18 or older
  442  and eligible for Medicaid by reason of a disability.
  443         (b) Determined by the Comprehensive Assessment Review and
  444  Evaluation for Long-Term Care Services (CARES) preadmission
  445  screening program to require nursing facility care as defined in
  446  s. 409.985(3) or, in the case of individuals diagnosed with
  447  cystic fibrosis, determined by the CARES program to require
  448  hospital-level of care.
  449         (2) ENROLLMENT OFFERS.—
  450         (a) Subject to the availability of funds, the Department of
  451  Elderly Affairs shall make offers for enrollment to eligible
  452  individuals based on a wait-list prioritization. Before making
  453  enrollment offers, the agency and the Department of Elderly
  454  Affairs shall determine that sufficient funds exist to support
  455  additional enrollment into plans.
  456         (b) Medicaid recipients enrolled in one of the following
  457  home and community-based service Medicaid waivers are eligible
  458  to participate in the long-term care managed care program when
  459  all eligibility criteria requirements established in paragraph
  460  (1) of this subsection are met and shall be transitioned into
  461  the long-term care managed care program by January 1, 2018:
  462         1. Traumatic Brain and Spinal Cord Injury Waiver.
  463         2. Adult Cystic Fibrosis Waiver.
  464         3.Project AIDS Care Waiver.
  466  The agency shall seek federal approval to terminate the
  467  Traumatic Brain and Spinal Cord Injury Waiver, the Adult Cystic
  468  Fibrosis Waiver, and the Project AIDS Care Waiver after all
  469  eligible Medicaid recipients have transitioned into the long
  470  term care managed care program.
  471         Section 5. Subsection (7) of section 393.0661, Florida
  472  Statutes, is amended to read:
  473         393.0661 Home and community-based services delivery system;
  474  comprehensive redesign.—The Legislature finds that the home and
  475  community-based services delivery system for persons with
  476  developmental disabilities and the availability of appropriated
  477  funds are two of the critical elements in making services
  478  available. Therefore, it is the intent of the Legislature that
  479  the Agency for Persons with Disabilities shall develop and
  480  implement a comprehensive redesign of the system.
  481         (7) The agency shall collect premiums or cost sharing
  482  pursuant to s. 409.906(13)(c) s. 409.906(13)(d).
  483         Section 6. Paragraph (a) of subsection (4) of section
  484  409.968, Florida Statutes, is amended to read:
  485         409.968 Managed care plan payments.—
  486         (4)(a) Subject to a specific appropriation and federal
  487  approval under s. 409.906(13)(d) s. 409.906(13)(e), the agency
  488  shall establish a payment methodology to fund managed care plans
  489  for flexible services for persons with severe mental illness and
  490  substance use disorders, including, but not limited to,
  491  temporary housing assistance. A managed care plan eligible for
  492  these payments must do all of the following:
  493         1. Participate as a specialty plan for severe mental
  494  illness or substance use disorders or participate in counties
  495  designated by the General Appropriations Act;
  496         2. Include providers of behavioral health services pursuant
  497  to chapters 394 and 397 in the managed care plan’s provider
  498  network; and
  499         3. Document a capability to provide housing assistance
  500  through agreements with housing providers, relationships with
  501  local housing coalitions, and other appropriate arrangements.
  502         Section 7. This act shall take effect July 1, 2017.