Florida Senate - 2022             CONFERENCE COMMITTEE AMENDMENT
       Bill No. SB 2526
       
       
       
       
       
       
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                              LEGISLATIVE ACTION                        
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       The Conference Committee on SB 2526 recommended the following:
       
    1         Senate Conference Committee Amendment (with title
    2  amendment)
    3  
    4         Delete everything after the enacting clause
    5  and insert:
    6         Section 1. Subsection (1) of section 17.41, Florida
    7  Statutes, is amended to read:
    8         17.41 Department of Financial Services Tobacco Settlement
    9  Clearing Trust Fund.—
   10         (1) The Department of Financial Services Tobacco Settlement
   11  Clearing Trust Fund, which shall be referred to as the “Lawton
   12  Chiles Trust Fund,” is created within that department.
   13         Section 2. Section 210.201, Florida Statutes, is amended to
   14  read:
   15         210.201 H. Lee Moffitt Cancer Center and Research Institute
   16  facilities; establishment; funding.—
   17         (1) The Board of Directors of the H. Lee Moffitt Cancer
   18  Center and Research Institute shall construct, furnish, and
   19  equip, and shall covenant to complete, the cancer research and
   20  clinical and related facilities of the H. Lee Moffitt Cancer
   21  Center and Research Institute funded with proceeds from the
   22  Cigarette Tax Collection Trust Fund pursuant to s. 210.20.
   23  Moneys transferred to the Board of Directors of the H. Lee
   24  Moffitt Cancer Center and Research Institute pursuant to s.
   25  210.20 may be used to secure financing to pay costs related to
   26  constructing, furnishing, equipping, operating, and maintaining
   27  cancer research and clinical and related facilities; furnishing,
   28  equipping, operating, and maintaining other leased or owned
   29  properties; and paying costs incurred in connection with
   30  purchasing, financing, operating, and maintaining such
   31  equipment, facilities, and properties as provided in s. 210.20.
   32  Such financing may include the issuance of tax-exempt bonds or
   33  other forms of indebtedness by a local authority, municipality,
   34  or county pursuant to parts II and III of chapter 159. Such
   35  bonds shall not constitute state bonds for purposes of s. 11,
   36  Art. VII of the State Constitution, but shall constitute bonds
   37  of a local agency,” as defined in s. 159.27(4). The cigarette
   38  tax dollars pledged to facilities pursuant to s. 210.20 may be
   39  replaced annually by the Legislature from tobacco litigation
   40  settlement proceeds.
   41         (2) Beginning in the 2022-2023 fiscal year, and annually
   42  through the 2052-2053 fiscal year, the sum of $20 million is
   43  appropriated and shall be transferred to the Board of Directors
   44  of the H. Lee Moffitt Cancer Center and Research Institute for
   45  construction and development of Moffitt’s Pasco County life
   46  sciences park. Moneys transferred to the Board of Directors of
   47  the H. Lee Moffitt Cancer Center and Research Institute pursuant
   48  to this subsection may be used to secure financing to pay costs
   49  related to the construction and development of Moffitt’s Pasco
   50  County life sciences park. Such financing may include the
   51  issuance of tax-exempt bonds or other forms of indebtedness by a
   52  local authority, municipality, or county pursuant to parts II
   53  and III of chapter 159. Such bonds shall not constitute state
   54  bonds for purposes of s. 11, Art. VII of the State Constitution,
   55  but shall constitute bonds of a local agency as defined in s.
   56  159.27(4).
   57         Section 3. Paragraph (f) is added to subsection (7) of
   58  section 381.02035, Florida Statutes, to read:
   59         381.02035 Canadian Prescription Drug Importation Program.—
   60         (7) ELIGIBLE IMPORTERS.—The following entities may import
   61  prescription drugs from an eligible Canadian supplier under the
   62  program:
   63         (f) A pharmacist or wholesaler employed by or under
   64  contract with a forensic facility, as defined in s. 916.106,
   65  that is managed by the Agency for Persons with Disabilities, for
   66  dispensing to clients treated in such facility.
   67         Section 4. Section 381.915, Florida Statutes, is amended to
   68  read:
   69         381.915 Casey DeSantis Cancer Research Florida Consortium
   70  of National Cancer Institute Centers Program.—
   71         (1) This section may be cited as the “Casey DeSantis Cancer
   72  Research Florida NCI Cancer Centers Act.”
   73         (2) The Casey DeSantis Cancer Research Florida Consortium
   74  of National Cancer Institute Centers Program is established to
   75  enhance the quality and competitiveness of cancer care in this
   76  state, further a statewide biomedical research strategy directly
   77  responsive to the health needs of Florida’s citizens, and
   78  capitalize on the potential educational opportunities available
   79  to its students. The department shall make payments to Florida
   80  based cancer centers recognized by the National Cancer Institute
   81  (NCI) at the National Institutes of Health as NCI-designated
   82  cancer centers or NCI-designated comprehensive cancer centers,
   83  and cancer centers working toward achieving NCI designation. The
   84  department shall distribute funds to participating cancer
   85  centers on a quarterly basis during each fiscal year for which
   86  an appropriation is made.
   87         (3) On or before September 15 of each year, the department
   88  shall calculate an allocation fraction to be used for
   89  distributing funds to participating cancer centers. On or before
   90  the final business day of each quarter of the state fiscal year,
   91  the department shall distribute to each participating cancer
   92  center one-fourth of that cancer center’s annual allocation
   93  calculated under subsection (6). The allocation fraction for
   94  each participating cancer center is based on the cancer center’s
   95  tier-designated weight under subsection (4) multiplied by each
   96  of the following allocation factors: number of reportable cases,
   97  peer-review costs, and biomedical education and training. As
   98  used in this section, the term:
   99         (a) “Biomedical education and training” means instruction
  100  that is offered to a student who is enrolled in a biomedical
  101  research program at an affiliated university as a medical
  102  student or a student in a master’s or doctoral degree program,
  103  or who is a resident physician trainee or postdoctoral trainee
  104  in such program. An affiliated university biomedical research
  105  program must be accredited or approved by a nationally
  106  recognized agency and offered through an institution accredited
  107  by the Commission on Colleges of the Southern Association of
  108  Colleges and Schools. Full-time equivalency for trainees shall
  109  be prorated for training received in oncologic sciences and
  110  oncologic medicine.
  111         (b) “Cancer center” means a freestanding center, a center
  112  situated within an academic institution, or a formal research
  113  based consortium under centralized leadership that has achieved
  114  NCI designation or is prepared to achieve NCI designation by
  115  July 1, 2019.
  116         (c) “Florida-based” means that a cancer center’s actual or
  117  sought designated status is or would be recognized by the NCI as
  118  primarily located in Florida and not in another state.
  119         (d) “Peer-review costs” means the total annual direct costs
  120  for peer-reviewed cancer-related research projects, consistent
  121  with reporting guidelines provided by the NCI, for the most
  122  recent annual reporting period available.
  123         (e) “Reportable cases” means cases of cancer in which a
  124  cancer center is involved in the diagnosis, evaluation of the
  125  diagnosis, evaluation of the extent of cancer spread at the time
  126  of diagnosis, or administration of all or any part of the first
  127  course of therapy for the most recent annual reporting period
  128  available. Cases relating to patients enrolled in institutional
  129  or investigator-initiated interventional clinical trials shall
  130  be weighted at 1.2 relative to other cases weighted at 1.0.
  131  Determination of institutional or investigator-initiated
  132  interventional clinical trials must be consistent with reporting
  133  guidelines provided by the NCI.
  134         (4) Tier designations and corresponding weights within the
  135  Casey DeSantis Cancer Research Florida Consortium of National
  136  Cancer Institute Centers Program are as follows:
  137         (a) Tier 1: Florida-based NCI-designated comprehensive
  138  cancer centers, which shall be weighted at 1.5.
  139         (b) Tier 2: Florida-based NCI-designated cancer centers,
  140  which shall be weighted at 1.25.
  141         (c) Tier 3: Florida-based cancer centers seeking
  142  designation as either a NCI-designated cancer center or NCI
  143  designated comprehensive cancer center, which shall be weighted
  144  at 1.0.
  145         1. A cancer center shall meet the following minimum
  146  criteria to be considered eligible for Tier 3 designation in any
  147  given fiscal year:
  148         a. Conducting cancer-related basic scientific research and
  149  cancer-related population scientific research;
  150         b. Offering and providing the full range of diagnostic and
  151  treatment services on site, as determined by the Commission on
  152  Cancer of the American College of Surgeons;
  153         c. Hosting or conducting cancer-related interventional
  154  clinical trials that are registered with the NCI’s Clinical
  155  Trials Reporting Program;
  156         d. Offering degree-granting programs or affiliating with
  157  universities through degree-granting programs accredited or
  158  approved by a nationally recognized agency and offered through
  159  the center or through the center in conjunction with another
  160  institution accredited by the Commission on Colleges of the
  161  Southern Association of Colleges and Schools;
  162         e. Providing training to clinical trainees, medical
  163  trainees accredited by the Accreditation Council for Graduate
  164  Medical Education or the American Osteopathic Association, and
  165  postdoctoral fellows recently awarded a doctorate degree; and
  166         f. Having more than $5 million in annual direct costs
  167  associated with their total NCI peer-reviewed grant funding.
  168         2. The General Appropriations Act or accompanying
  169  legislation may limit the number of cancer centers which shall
  170  receive Tier 3 designations or provide additional criteria for
  171  such designation.
  172         3. A cancer center’s participation in Tier 3 may not extend
  173  beyond June 30, 2024.
  174         4. A cancer center that qualifies as a designated Tier 3
  175  center under the criteria provided in subparagraph 1. by July 1,
  176  2014, is authorized to pursue NCI designation as a cancer center
  177  or a comprehensive cancer center until June 30, 2024.
  178         (5) The department shall use the following formula to
  179  calculate a participating cancer center’s allocation fraction:
  180  
  181       CAF=[0.4x(CRC÷TCRC)]+[0.3x(CPC÷TCPC)]+[0.3x(CBE÷TCBE)]      
  182  
  183         Where:
  184         CAF=A cancer center’s allocation fraction.
  185         CRC=A cancer center’s tier-weighted reportable cases.
  186         TCRC=The total tier-weighted reportable cases for all
  187  cancer centers.
  188         CPC=A cancer center’s tier-weighted peer-review costs.
  189         TCPC=The total tier-weighted peer-review costs for all
  190  cancer centers.
  191         CBE=A cancer center’s tier-weighted biomedical education
  192  and training.
  193         TCBE=The total tier-weighted biomedical education and
  194  training for all cancer centers.
  195  
  196         (6) A cancer center’s annual allocation shall be calculated
  197  by multiplying the funds appropriated for the Casey DeSantis
  198  Cancer Research Florida Consortium of National Cancer Institute
  199  Centers Program in the General Appropriations Act by that cancer
  200  center’s allocation fraction. If the calculation results in an
  201  annual allocation that is less than $16 million, that cancer
  202  center’s annual allocation shall be increased to a sum equaling
  203  $16 million, with the additional funds being provided
  204  proportionally from the annual allocations calculated for the
  205  other participating cancer centers.
  206         (7) Beginning July 1, 2017, and every 3 years thereafter,
  207  the department, in conjunction with participating cancer
  208  centers, shall submit a report to the Cancer Control and
  209  Research Advisory Council on specific metrics relating to cancer
  210  mortality and external funding for cancer-related research in
  211  the state. If a cancer center does not endorse this report or
  212  produce an equivalent independent report, the cancer center
  213  shall be suspended from the program for 1 year. The report must
  214  include:
  215         (a) An analysis of trending age-adjusted cancer mortality
  216  rates in the state, which must include, at a minimum, overall
  217  age-adjusted mortality rates for cancer statewide and age
  218  adjusted mortality rates by age group, geographic region, and
  219  type of cancer, which must include, at a minimum:
  220         1. Lung cancer.
  221         2. Pancreatic cancer.
  222         3. Sarcoma.
  223         4. Melanoma.
  224         5. Leukemia and myelodysplastic syndromes.
  225         6. Brain cancer.
  226         (b) Identification of trends in overall federal funding,
  227  broken down by institutional source, for cancer-related research
  228  in the state.
  229         (c) A list and narrative description of collaborative
  230  grants and interinstitutional collaboration among participating
  231  cancer centers, a comparison of collaborative grants in
  232  proportion to the grant totals for each cancer center, a
  233  catalogue of retreats and progress seed grants using state
  234  funds, and targets for collaboration in the future and reports
  235  on progress regarding such targets where appropriate.
  236         (8) This section is subject to annual appropriation by the
  237  Legislature.
  238         (9) The department may adopt rules to administer this
  239  section.
  240         Section 5. Paragraph (i) of subsection (5) of section
  241  394.9082, Florida Statutes, is amended, and paragraphs (k) and
  242  (l) are added to subsection (4) of that section, to read:
  243         394.9082 Behavioral health managing entities.—
  244         (4) CONTRACT WITH MANAGING ENTITIES.—
  245         (k) The department’s contracts with managing entities must
  246  be made available in a publicly accessible format on the
  247  department’s website.
  248         (l) Every 2 years, the department shall conduct a
  249  comprehensive, multiyear review of the revenues, expenditures,
  250  and financial positions of managing entities covering the most
  251  recent 2 consecutive fiscal years. The review must include a
  252  comprehensive system-of-care analysis. The department shall
  253  submit the review to the Governor, the President of the Senate,
  254  and the Speaker of the House of Representatives by November 1 of
  255  every other year, beginning in 2023.
  256         (5) MANAGING ENTITY DUTIES.—A managing entity shall:
  257         (i) Develop a comprehensive provider network of qualified
  258  providers to deliver behavioral health services. The managing
  259  entity is not required to competitively procure network
  260  providers but shall publicize opportunities to join the provider
  261  network and evaluate providers in the network to determine if
  262  they may remain in the network. A managing entity must provide
  263  notice to a provider before the provider is removed from the
  264  network. The managing entity shall publish these processes on
  265  its website. The managing entity shall ensure continuity of care
  266  for clients if a provider ceases to provide a service or leaves
  267  the network.
  268         Section 6. Present subsections (4) through (11) of section
  269  409.814, Florida Statutes, are redesignated as subsections (5)
  270  through (12), respectively, a new subsection (4) is added to
  271  that section, and present subsections (5), (6), and (10) are
  272  amended, to read:
  273         409.814 Eligibility.—A child who has not reached 19 years
  274  of age whose family income is equal to or below 200 percent of
  275  the federal poverty level is eligible for the Florida Kidcare
  276  program as provided in this section. If an enrolled individual
  277  is determined to be ineligible for coverage, he or she must be
  278  immediately disenrolled from the respective Florida Kidcare
  279  program component.
  280         (4) A Title XXI-funded child who reaches 19 years of age is
  281  eligible for continued Title XXI-funded coverage for the
  282  duration of a pregnancy and the postpartum period consisting of
  283  the 12-month period beginning on the last day of a pregnancy, if
  284  such pregnancy or postpartum period begins prior to the child
  285  reaching 19 years of age, and if the child is ineligible for
  286  Medicaid.
  287         (6)(5) A child who is otherwise eligible for the Florida
  288  Kidcare program and who has a preexisting condition that
  289  prevents coverage under another insurance plan as described in
  290  paragraph (5)(a)(4)(a) which would have disqualified the child
  291  for the Florida Kidcare program if the child were able to enroll
  292  in the plan is eligible for Florida Kidcare coverage when
  293  enrollment is possible.
  294         (7)(6) A child whose family income is above 200 percent of
  295  the federal poverty level or a child who is excluded under the
  296  provisions of subsection (5)(4) may participate in the Florida
  297  Kidcare program as provided in s. 409.8132 or, if the child is
  298  ineligible for Medikids by reason of age, in the Florida Healthy
  299  Kids program, subject to the following:
  300         (a) The family is not eligible for premium assistance
  301  payments and must pay the full cost of the premium, including
  302  any administrative costs.
  303         (b) The board of directors of the Florida Healthy Kids
  304  Corporation may offer a reduced benefit package to these
  305  children in order to limit program costs for such families.
  306         (11)(10) Subject to paragraph (5)(a)(4)(a), the Florida
  307  Kidcare program shall withhold benefits from an enrollee if the
  308  program obtains evidence that the enrollee is no longer
  309  eligible, submitted incorrect or fraudulent information in order
  310  to establish eligibility, or failed to provide verification of
  311  eligibility. The applicant or enrollee shall be notified that
  312  because of such evidence program benefits will be withheld
  313  unless the applicant or enrollee contacts a designated
  314  representative of the program by a specified date, which must be
  315  within 10 working days after the date of notice, to discuss and
  316  resolve the matter. The program shall make every effort to
  317  resolve the matter within a timeframe that will not cause
  318  benefits to be withheld from an eligible enrollee.
  319         Section 7. Subsection (2) of section 409.908, Florida
  320  Statutes, is amended to read:
  321         409.908 Reimbursement of Medicaid providers.—Subject to
  322  specific appropriations, the agency shall reimburse Medicaid
  323  providers, in accordance with state and federal law, according
  324  to methodologies set forth in the rules of the agency and in
  325  policy manuals and handbooks incorporated by reference therein.
  326  These methodologies may include fee schedules, reimbursement
  327  methods based on cost reporting, negotiated fees, competitive
  328  bidding pursuant to s. 287.057, and other mechanisms the agency
  329  considers efficient and effective for purchasing services or
  330  goods on behalf of recipients. If a provider is reimbursed based
  331  on cost reporting and submits a cost report late and that cost
  332  report would have been used to set a lower reimbursement rate
  333  for a rate semester, then the provider’s rate for that semester
  334  shall be retroactively calculated using the new cost report, and
  335  full payment at the recalculated rate shall be effected
  336  retroactively. Medicare-granted extensions for filing cost
  337  reports, if applicable, shall also apply to Medicaid cost
  338  reports. Payment for Medicaid compensable services made on
  339  behalf of Medicaid-eligible persons is subject to the
  340  availability of moneys and any limitations or directions
  341  provided for in the General Appropriations Act or chapter 216.
  342  Further, nothing in this section shall be construed to prevent
  343  or limit the agency from adjusting fees, reimbursement rates,
  344  lengths of stay, number of visits, or number of services, or
  345  making any other adjustments necessary to comply with the
  346  availability of moneys and any limitations or directions
  347  provided for in the General Appropriations Act, provided the
  348  adjustment is consistent with legislative intent.
  349         (2)(a)1. Reimbursement to nursing homes licensed under part
  350  II of chapter 400 and state-owned-and-operated intermediate care
  351  facilities for the developmentally disabled licensed under part
  352  VIII of chapter 400 must be made prospectively.
  353         2. Unless otherwise limited or directed in the General
  354  Appropriations Act, reimbursement to hospitals licensed under
  355  part I of chapter 395 for the provision of swing-bed nursing
  356  home services must be made on the basis of the average statewide
  357  nursing home payment, and reimbursement to a hospital licensed
  358  under part I of chapter 395 for the provision of skilled nursing
  359  services must be made on the basis of the average nursing home
  360  payment for those services in the county in which the hospital
  361  is located. When a hospital is located in a county that does not
  362  have any community nursing homes, reimbursement shall be
  363  determined by averaging the nursing home payments in counties
  364  that surround the county in which the hospital is located.
  365  Reimbursement to hospitals, including Medicaid payment of
  366  Medicare copayments, for skilled nursing services shall be
  367  limited to 30 days, unless a prior authorization has been
  368  obtained from the agency. Medicaid reimbursement may be extended
  369  by the agency beyond 30 days, and approval must be based upon
  370  verification by the patient’s physician that the patient
  371  requires short-term rehabilitative and recuperative services
  372  only, in which case an extension of no more than 15 days may be
  373  approved. Reimbursement to a hospital licensed under part I of
  374  chapter 395 for the temporary provision of skilled nursing
  375  services to nursing home residents who have been displaced as
  376  the result of a natural disaster or other emergency may not
  377  exceed the average county nursing home payment for those
  378  services in the county in which the hospital is located and is
  379  limited to the period of time which the agency considers
  380  necessary for continued placement of the nursing home residents
  381  in the hospital.
  382         (b) Subject to any limitations or directions in the General
  383  Appropriations Act, the agency shall establish and implement a
  384  state Title XIX Long-Term Care Reimbursement Plan for nursing
  385  home care in order to provide care and services in conformance
  386  with the applicable state and federal laws, rules, regulations,
  387  and quality and safety standards and to ensure that individuals
  388  eligible for medical assistance have reasonable geographic
  389  access to such care.
  390         1. The agency shall amend the long-term care reimbursement
  391  plan and cost reporting system to create direct care and
  392  indirect care subcomponents of the patient care component of the
  393  per diem rate. These two subcomponents together shall equal the
  394  patient care component of the per diem rate. Separate prices
  395  shall be calculated for each patient care subcomponent,
  396  initially based on the September 2016 rate setting cost reports
  397  and subsequently based on the most recently audited cost report
  398  used during a rebasing year. The direct care subcomponent of the
  399  per diem rate for any providers still being reimbursed on a cost
  400  basis shall be limited by the cost-based class ceiling, and the
  401  indirect care subcomponent may be limited by the lower of the
  402  cost-based class ceiling, the target rate class ceiling, or the
  403  individual provider target. The ceilings and targets apply only
  404  to providers being reimbursed on a cost-based system. Effective
  405  October 1, 2018, a prospective payment methodology shall be
  406  implemented for rate setting purposes with the following
  407  parameters:
  408         a. Peer Groups, including:
  409         (I) North-SMMC Regions 1-9, less Palm Beach and Okeechobee
  410  Counties; and
  411         (II) South-SMMC Regions 10-11, plus Palm Beach and
  412  Okeechobee Counties.
  413         b. Percentage of Median Costs based on the cost reports
  414  used for September 2016 rate setting:
  415         (I) Direct Care Costs........................100 percent.
  416         (II) Indirect Care Costs......................92 percent.
  417         (III) Operating Costs.........................86 percent.
  418         c. Floors:
  419         (I) Direct Care Component.....................95 percent.
  420         (II) Indirect Care Component................92.5 percent.
  421         (III) Operating Component...........................None.
  422         d. Pass-through Payments..................Real Estate and
  423  ...............................................Personal Property
  424  ...................................Taxes and Property Insurance.
  425         e. Quality Incentive Program Payment
  426  Pool......................................6 percent of September
  427  .......................................2016 non-property related
  428  ................................payments of included facilities.
  429         f. Quality Score Threshold to Quality for Quality Incentive
  430  Payment..................20th percentile of included facilities.
  431         g. Fair Rental Value System Payment Parameters:
  432         (I) Building Value per Square Foot based on 2018 RS Means.
  433         (II) Land Valuation...10 percent of Gross Building value.
  434         (III) Facility Square Footage......Actual Square Footage.
  435         (IV) Moveable Equipment Allowance.........$8,000 per bed.
  436         (V) Obsolescence Factor......................1.5 percent.
  437         (VI) Fair Rental Rate of Return................8 percent.
  438         (VII) Minimum Occupancy.......................90 percent.
  439         (VIII) Maximum Facility Age.....................40 years.
  440         (IX) Minimum Square Footage per Bed..................350.
  441         (X) Maximum Square Footage for Bed...................500.
  442         (XI) Minimum Cost of a renovation/replacements$500 per bed.
  443         h. Ventilator Supplemental payment of $200 per Medicaid day
  444  of 40,000 ventilator Medicaid days per fiscal year.
  445         2. The direct care subcomponent shall include salaries and
  446  benefits of direct care staff providing nursing services
  447  including registered nurses, licensed practical nurses, and
  448  certified nursing assistants who deliver care directly to
  449  residents in the nursing home facility, allowable therapy costs,
  450  and dietary costs. This excludes nursing administration, staff
  451  development, the staffing coordinator, and the administrative
  452  portion of the minimum data set and care plan coordinators. The
  453  direct care subcomponent also includes medically necessary
  454  dental care, vision care, hearing care, and podiatric care.
  455         3. All other patient care costs shall be included in the
  456  indirect care cost subcomponent of the patient care per diem
  457  rate, including complex medical equipment, medical supplies, and
  458  other allowable ancillary costs. Costs may not be allocated
  459  directly or indirectly to the direct care subcomponent from a
  460  home office or management company.
  461         4. On July 1 of each year, the agency shall report to the
  462  Legislature direct and indirect care costs, including average
  463  direct and indirect care costs per resident per facility and
  464  direct care and indirect care salaries and benefits per category
  465  of staff member per facility.
  466         5. Every fourth year, the agency shall rebase nursing home
  467  prospective payment rates to reflect changes in cost based on
  468  the most recently audited cost report for each participating
  469  provider.
  470         6. A direct care supplemental payment may be made to
  471  providers whose direct care hours per patient day are above the
  472  80th percentile and who provide Medicaid services to a larger
  473  percentage of Medicaid patients than the state average.
  474         7. For the period beginning on October 1, 2018, and ending
  475  on September 30, 2021, the agency shall reimburse providers the
  476  greater of their September 2016 cost-based rate or their
  477  prospective payment rate. Effective October 1, 2021, the agency
  478  shall reimburse providers the greater of 95 percent of their
  479  cost-based rate or their rebased prospective payment rate, using
  480  the most recently audited cost report for each facility. This
  481  subparagraph shall expire September 30, 2023.
  482         8. Pediatric, Florida Department of Veterans Affairs, and
  483  government-owned facilities are exempt from the pricing model
  484  established in this subsection and shall remain on a cost-based
  485  prospective payment system. Effective October 1, 2018, the
  486  agency shall set rates for all facilities remaining on a cost
  487  based prospective payment system using each facility’s most
  488  recently audited cost report, eliminating retroactive
  489  settlements.
  490  
  491  It is the intent of the Legislature that the reimbursement plan
  492  achieve the goal of providing access to health care for nursing
  493  home residents who require large amounts of care while
  494  encouraging diversion services as an alternative to nursing home
  495  care for residents who can be served within the community. The
  496  agency shall base the establishment of any maximum rate of
  497  payment, whether overall or component, on the available moneys
  498  as provided for in the General Appropriations Act. The agency
  499  may base the maximum rate of payment on the results of
  500  scientifically valid analysis and conclusions derived from
  501  objective statistical data pertinent to the particular maximum
  502  rate of payment. The agency shall base the rates of payments in
  503  accordance with the minimum wage requirements as provided in the
  504  General Appropriations Act.
  505         Section 8. Paragraph (a) of subsection (7) of section
  506  20.435, Florida Statutes, is amended to read:
  507         20.435 Department of Health; trust funds.—The following
  508  trust funds shall be administered by the Department of Health:
  509         (7) Biomedical Research Trust Fund.
  510         (a) Funds to be credited to the trust fund shall consist of
  511  funds appropriated by the Legislature. Funds shall be used for
  512  the purposes of the James and Esther King Biomedical Research
  513  Program, the Casey DeSantis Cancer Research Florida Consortium
  514  of National Cancer Institute Centers Program, and the William G.
  515  “Bill” Bankhead, Jr., and David Coley Cancer Research Program as
  516  specified in ss. 215.5602, 288.955, 381.915, and 381.922. The
  517  trust fund is exempt from the service charges imposed by s.
  518  215.20.
  519         Section 9. Paragraph (c) of subsection (2) of section
  520  210.20, Florida Statutes, is amended to read:
  521         210.20 Employees and assistants; distribution of funds.—
  522         (2) As collections are received by the division from such
  523  cigarette taxes, it shall pay the same into a trust fund in the
  524  State Treasury designated “Cigarette Tax Collection Trust Fund”
  525  which shall be paid and distributed as follows:
  526         (c) Beginning July 1, 2017, and continuing through June 30,
  527  2033, the division shall from month to month certify to the
  528  Chief Financial Officer the amount derived from the cigarette
  529  tax imposed by s. 210.02, less the service charges provided for
  530  in s. 215.20 and less 0.9 percent of the amount derived from the
  531  cigarette tax imposed by s. 210.02, which shall be deposited
  532  into the Alcoholic Beverage and Tobacco Trust Fund, specifying
  533  an amount equal to 1 percent of the net collections, not to
  534  exceed $3 million annually, and that amount shall be deposited
  535  into the Biomedical Research Trust Fund in the Department of
  536  Health. These funds are appropriated annually from the
  537  Biomedical Research Trust Fund for the advancement of cures for
  538  cancers afflicting pediatric populations through basic or
  539  applied research, including, but not limited to, clinical trials
  540  and nontoxic drug discovery. These funds are not included in the
  541  calculation for the distribution of funds pursuant to s.
  542  381.915; however, these funds shall be distributed to cancer
  543  centers participating in the Casey DeSantis Cancer Research
  544  Florida Consortium of National Cancer Institute Centers Program
  545  in the same proportion as is allocated to each cancer center in
  546  accordance with s. 381.915 and are in addition to any funds
  547  distributed pursuant to that section.
  548         Section 10. Subsection (3) of section 409.816, Florida
  549  Statutes, is amended to read:
  550         409.816 Limitations on premiums and cost sharing.—The
  551  following limitations on premiums and cost sharing are
  552  established for the program.
  553         (3) Enrollees in families with a family income above 150
  554  percent of the federal poverty level who are not receiving
  555  coverage under the Medicaid program or who are not eligible
  556  under s. 409.814(7) s. 409.814(6) may be required to pay
  557  enrollment fees, premiums, copayments, deductibles, coinsurance,
  558  or similar charges on a sliding scale related to income, except
  559  that the total annual aggregate cost sharing with respect to all
  560  children in a family may not exceed 5 percent of the family’s
  561  income. However, copayments, deductibles, coinsurance, or
  562  similar charges may not be imposed for preventive services,
  563  including well-baby and well-child care, age-appropriate
  564  immunizations, and routine hearing and vision screenings.
  565         Section 11. This act shall take effect July 1, 2022.
  566  
  567  ================= T I T L E  A M E N D M E N T ================
  568  And the title is amended as follows:
  569         Delete everything before the enacting clause
  570  and insert:
  571                        A bill to be entitled                      
  572         An act relating to health; amending s. 17.41, F.S.;
  573         providing that the Department of Financial Services
  574         Tobacco Settlement Clearing Trust Fund shall be
  575         referred to as the “Lawton Chiles Trust Fund”;
  576         amending s. 210.201, F.S.; providing an appropriation
  577         to the Board of Directors of the H. Lee Moffitt Cancer
  578         Center and Research Institute for a specified purpose;
  579         authorizing such appropriation to be used to secure
  580         certain financing; providing construction; amending s.
  581         381.02035, F.S.; authorizing pharmacists and
  582         wholesalers employed by or under contract with
  583         forensic facilities managed by the Agency for Persons
  584         with Disabilities to import prescription drugs under
  585         the Canadian Prescription Drug Importation Program for
  586         dispensing to clients in such facilities; amending s.
  587         381.915, F.S.; renaming the Florida Consortium of
  588         National Cancer Institute Centers Program as the
  589         “Casey DeSantis Cancer Research Program”; revising a
  590         short title; amending s. 394.9082, F.S.; requiring
  591         that the Department of Children and Families’
  592         contracts with managing entities be made available on
  593         the department’s website; requiring the department to
  594         conduct a specified review of managing entities every
  595         2 years; requiring the department to submit the review
  596         to the Governor and the Legislature by a specified
  597         date; requiring managing entities to provide notice to
  598         providers before removing the provider from the
  599         provider network; amending s. 409.814, F.S.; providing
  600         for continued Title XXI-funded coverage for certain
  601         enrollees beyond 19 years of age under certain
  602         circumstances; providing for eligibility; amending s.
  603         409.908, F.S.; requiring the agency to base its rate
  604         of payments for nursing home care in its Title XIX
  605         Long-Term Care Reimbursement Plan in accordance with
  606         specified minimum wage requirements; amending ss.
  607         20.435, 210.20, and 409.816, F.S.; conforming
  608         provisions to changes made by the act; providing an
  609         effective date.