Florida Senate - 2018                                    SB 1468
       By Senator Rouson
       19-01050-18                                           20181468__
    1                        A bill to be entitled                      
    2         An act relating to alcohol and substance abuse
    3         prevention; creating s. 14.35, F.S.; creating the
    4         Office of Alcohol and Drug Control Policy within the
    5         Executive Office of the Governor; providing for
    6         appointment of the director of the office; specifying
    7         duties of the office; requiring the office to adopt
    8         rules; requiring the office to submit an annual report
    9         to the Governor and the Legislature; amending s.
   10         409.912, F.S.; requiring the Agency for Health Care
   11         Administration, in consultation with the Department of
   12         Children and Families, to seek federal approval for
   13         waivers to increase federal Medicaid funding for a
   14         specified purpose; providing an effective date.
   16  Be It Enacted by the Legislature of the State of Florida:
   18         Section 1. Section 14.35, Florida Statutes, is created to
   19  read:
   20         14.35Office of Alcohol and Drug Control Policy.—
   21         (1)The Office of Alcohol and Drug Control Policy is
   22  created within the Executive Office of the Governor. The
   23  director, who shall be appointed by and serve at the pleasure of
   24  the Governor, shall oversee the office.
   25         (2)The office is responsible for all matters relating to
   26  the research of, coordination of, and execution of programs
   27  related to alcohol and drug control.
   28         (3)The office shall:
   29         (a) Develop a strategic plan to reduce the prevalence of
   30  alcohol and substance abuse in the state.
   31         (b)Monitor data and issues related to state policies
   32  concerning youth alcohol use prevention and state substance
   33  abuse policies, the impact of such policies on state and local
   34  programs, and the flexibility of such policies to adapt to the
   35  needs of local communities and service providers.
   36         (c)Collect data related to drug crimes and overdoses to
   37  generate statistical and analytical reports containing
   38  recommendations for this state’s criminal justice system.
   39         (d)Issue policy recommendations to executive branch
   40  agencies for alcohol and substance abuse prevention and
   41  treatment to ensure efficiency in efforts undertaken by the
   42  administration.
   43         (e)Work with behavioral health managing entities to
   44  identify existing resources and programs in each community which
   45  provide alcohol and substance abuse prevention education or
   46  treatment.
   47         (f)Facilitate coordination of alcohol and substance abuse
   48  prevention education and treatment between the courts, local and
   49  state agencies, organizations, service providers, and related
   50  public or private programs concerning alcohol and substance
   51  abuse.
   52         (g)Assist behavioral health managing entities in
   53  coordinating activities to ensure the availability of training,
   54  technical assistance, and consultation to local service
   55  providers for programs funded by the state which provide
   56  services related to alcohol or substance abuse.
   57         (h)Act as a referral source of information, using existing
   58  information clearinghouse resources.
   59         (i)Search for grant opportunities to fund the office and
   60  its initiatives.
   61         (j)Be knowledgeable on alcohol and substance abuse
   62  prevention and treatment programs and initiatives in this state
   63  and in other states.
   64         (k)Review existing research on programs related to
   65  substance abuse prevention and treatment.
   66         (l)Coordinate with the Department of Education to link
   67  schools with community-based agencies and county health
   68  departments to implement early intervention programs for the
   69  prevention of alcohol and substance abuse.
   70         (m)Coordinate media campaigns to demonstrate the negative
   71  impact of substance abuse disorders and to prevent the
   72  development of such disorders in children, young people, and
   73  adults.
   74         (n)Prepare and submit legislative budget requests.
   75         (o)Adopt rules necessary to administer this section.
   76         (p)Submit a report annually to the Governor, the President
   77  of the Senate, and the Speaker of the House of Representatives
   78  on the effectiveness of state policies and coordinated state
   79  efforts related to substance abuse.
   80         Section 2. Subsection (14) is added to section 409.912,
   81  Florida Statutes, to read:
   82         409.912 Cost-effective purchasing of health care.—The
   83  agency shall purchase goods and services for Medicaid recipients
   84  in the most cost-effective manner consistent with the delivery
   85  of quality medical care. To ensure that medical services are
   86  effectively utilized, the agency may, in any case, require a
   87  confirmation or second physician’s opinion of the correct
   88  diagnosis for purposes of authorizing future services under the
   89  Medicaid program. This section does not restrict access to
   90  emergency services or poststabilization care services as defined
   91  in 42 C.F.R. s. 438.114. Such confirmation or second opinion
   92  shall be rendered in a manner approved by the agency. The agency
   93  shall maximize the use of prepaid per capita and prepaid
   94  aggregate fixed-sum basis services when appropriate and other
   95  alternative service delivery and reimbursement methodologies,
   96  including competitive bidding pursuant to s. 287.057, designed
   97  to facilitate the cost-effective purchase of a case-managed
   98  continuum of care. The agency shall also require providers to
   99  minimize the exposure of recipients to the need for acute
  100  inpatient, custodial, and other institutional care and the
  101  inappropriate or unnecessary use of high-cost services. The
  102  agency shall contract with a vendor to monitor and evaluate the
  103  clinical practice patterns of providers in order to identify
  104  trends that are outside the normal practice patterns of a
  105  provider’s professional peers or the national guidelines of a
  106  provider’s professional association. The vendor must be able to
  107  provide information and counseling to a provider whose practice
  108  patterns are outside the norms, in consultation with the agency,
  109  to improve patient care and reduce inappropriate utilization.
  110  The agency may mandate prior authorization, drug therapy
  111  management, or disease management participation for certain
  112  populations of Medicaid beneficiaries, certain drug classes, or
  113  particular drugs to prevent fraud, abuse, overuse, and possible
  114  dangerous drug interactions. The Pharmaceutical and Therapeutics
  115  Committee shall make recommendations to the agency on drugs for
  116  which prior authorization is required. The agency shall inform
  117  the Pharmaceutical and Therapeutics Committee of its decisions
  118  regarding drugs subject to prior authorization. The agency is
  119  authorized to limit the entities it contracts with or enrolls as
  120  Medicaid providers by developing a provider network through
  121  provider credentialing. The agency may competitively bid single
  122  source-provider contracts if procurement of goods or services
  123  results in demonstrated cost savings to the state without
  124  limiting access to care. The agency may limit its network based
  125  on the assessment of beneficiary access to care, provider
  126  availability, provider quality standards, time and distance
  127  standards for access to care, the cultural competence of the
  128  provider network, demographic characteristics of Medicaid
  129  beneficiaries, practice and provider-to-beneficiary standards,
  130  appointment wait times, beneficiary use of services, provider
  131  turnover, provider profiling, provider licensure history,
  132  previous program integrity investigations and findings, peer
  133  review, provider Medicaid policy and billing compliance records,
  134  clinical and medical record audits, and other factors. Providers
  135  are not entitled to enrollment in the Medicaid provider network.
  136  The agency shall determine instances in which allowing Medicaid
  137  beneficiaries to purchase durable medical equipment and other
  138  goods is less expensive to the Medicaid program than long-term
  139  rental of the equipment or goods. The agency may establish rules
  140  to facilitate purchases in lieu of long-term rentals in order to
  141  protect against fraud and abuse in the Medicaid program as
  142  defined in s. 409.913. The agency may seek federal waivers
  143  necessary to administer these policies.
  144         (14)The agency, in consultation with the department, shall
  145  seek federal approval for a waiver to increase the availability
  146  of federal Medicaid funding to provide programs that improve the
  147  quality of and access to treatment for individuals with
  148  substance abuse disorders served by the Medicaid program and to
  149  provide a more comprehensive continuum of care for individuals
  150  with substance abuse disorders, including detoxification
  151  services, residential services, medication-assisted treatment,
  152  targeted case management, and recovery support that Medicaid is
  153  unable to cover without a waiver.
  154         Section 3. This act shall take effect July 1, 2018.