Florida Senate - 2019                                     SB 504
       
       
        
       By Senator Rouson
       
       
       
       
       
       19-00883-19                                            2019504__
    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 of a
   13         waiver to increase federal Medicaid funding for
   14         specified purposes relating to substance use
   15         disorders; providing an effective date.
   16          
   17  Be It Enacted by the Legislature of the State of Florida:
   18  
   19         Section 1. Section 14.35, Florida Statutes, is created to
   20  read:
   21         14.35Office of Alcohol and Drug Control Policy.—
   22         (1)The Office of Alcohol and Drug Control Policy is
   23  created within the Executive Office of the Governor. The
   24  director, who shall be appointed by and serve at the pleasure of
   25  the Governor, shall oversee the office.
   26         (2)The office is responsible for all matters relating to
   27  the research, coordination, and execution of programs related to
   28  alcohol and drug control.
   29         (3)The office shall:
   30         (a) Develop a strategic plan to reduce the prevalence of
   31  alcohol and substance abuse in the state.
   32         (b)Monitor data and issues related to state policies
   33  concerning youth alcohol use prevention and state substance
   34  abuse policies, the impact of such policies on state and local
   35  programs, and the flexibility of such policies to adapt to the
   36  needs of local communities and service providers.
   37         (c)Collect data related to drug crimes and overdoses to
   38  generate statistical and analytical reports containing
   39  recommendations for this state’s criminal justice system.
   40         (d)Issue policy recommendations to executive branch
   41  agencies for alcohol and substance abuse prevention and
   42  treatment to ensure the administration operates efficiently.
   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 treatment or prevention
   46  education.
   47         (f)Facilitate coordination of alcohol and substance abuse
   48  treatment and prevention education among 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 this 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 about 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 use disorders and to prevent the development
   72  of such disorders in children, young people, and adults.
   73         (n)Prepare and submit legislative budget requests.
   74         (o)Adopt rules necessary to administer this section.
   75         (p)Submit a report annually to the Governor, the President
   76  of the Senate, and the Speaker of the House of Representatives
   77  on the effectiveness of state policies and coordinated state
   78  efforts related to substance abuse.
   79         Section 2. Subsection (14) is added to section 409.912,
   80  Florida Statutes, to read:
   81         409.912 Cost-effective purchasing of health care.—The
   82  agency shall purchase goods and services for Medicaid recipients
   83  in the most cost-effective manner consistent with the delivery
   84  of quality medical care. To ensure that medical services are
   85  effectively utilized, the agency may, in any case, require a
   86  confirmation or second physician’s opinion of the correct
   87  diagnosis for purposes of authorizing future services under the
   88  Medicaid program. This section does not restrict access to
   89  emergency services or poststabilization care services as defined
   90  in 42 C.F.R. s. 438.114. Such confirmation or second opinion
   91  shall be rendered in a manner approved by the agency. The agency
   92  shall maximize the use of prepaid per capita and prepaid
   93  aggregate fixed-sum basis services when appropriate and other
   94  alternative service delivery and reimbursement methodologies,
   95  including competitive bidding pursuant to s. 287.057, designed
   96  to facilitate the cost-effective purchase of a case-managed
   97  continuum of care. The agency shall also require providers to
   98  minimize the exposure of recipients to the need for acute
   99  inpatient, custodial, and other institutional care and the
  100  inappropriate or unnecessary use of high-cost services. The
  101  agency shall contract with a vendor to monitor and evaluate the
  102  clinical practice patterns of providers in order to identify
  103  trends that are outside the normal practice patterns of a
  104  provider’s professional peers or the national guidelines of a
  105  provider’s professional association. The vendor must be able to
  106  provide information and counseling to a provider whose practice
  107  patterns are outside the norms, in consultation with the agency,
  108  to improve patient care and reduce inappropriate utilization.
  109  The agency may mandate prior authorization, drug therapy
  110  management, or disease management participation for certain
  111  populations of Medicaid beneficiaries, certain drug classes, or
  112  particular drugs to prevent fraud, abuse, overuse, and possible
  113  dangerous drug interactions. The Pharmaceutical and Therapeutics
  114  Committee shall make recommendations to the agency on drugs for
  115  which prior authorization is required. The agency shall inform
  116  the Pharmaceutical and Therapeutics Committee of its decisions
  117  regarding drugs subject to prior authorization. The agency is
  118  authorized to limit the entities it contracts with or enrolls as
  119  Medicaid providers by developing a provider network through
  120  provider credentialing. The agency may competitively bid single
  121  source-provider contracts if procurement of goods or services
  122  results in demonstrated cost savings to the state without
  123  limiting access to care. The agency may limit its network based
  124  on the assessment of beneficiary access to care, provider
  125  availability, provider quality standards, time and distance
  126  standards for access to care, the cultural competence of the
  127  provider network, demographic characteristics of Medicaid
  128  beneficiaries, practice and provider-to-beneficiary standards,
  129  appointment wait times, beneficiary use of services, provider
  130  turnover, provider profiling, provider licensure history,
  131  previous program integrity investigations and findings, peer
  132  review, provider Medicaid policy and billing compliance records,
  133  clinical and medical record audits, and other factors. Providers
  134  are not entitled to enrollment in the Medicaid provider network.
  135  The agency shall determine instances in which allowing Medicaid
  136  beneficiaries to purchase durable medical equipment and other
  137  goods is less expensive to the Medicaid program than long-term
  138  rental of the equipment or goods. The agency may establish rules
  139  to facilitate purchases in lieu of long-term rentals in order to
  140  protect against fraud and abuse in the Medicaid program as
  141  defined in s. 409.913. The agency may seek federal waivers
  142  necessary to administer these policies.
  143         (14)The agency, in consultation with the department, shall
  144  seek federal approval for a waiver to increase the availability
  145  of federal Medicaid funding to provide programs that improve the
  146  quality of and access to treatment for individuals with
  147  substance use disorders served by the Medicaid program and to
  148  provide a more comprehensive continuum of care for individuals
  149  with substance use disorders, including detoxification services,
  150  residential services, medication-assisted treatment, targeted
  151  case management, and recovery support, which Medicaid is unable
  152  to cover without a waiver.
  153         Section 3. This act shall take effect July 1, 2019.