CODING: Words stricken are deletions; words underlined are additions.House Bill 1405
Florida House of Representatives - 1997 HB 1405
By Representative Bloom
1 A bill to be entitled
2 An act relating to reimbursement for health
3 care services; amending ss. 409.906, 409.908,
4 F.S.; authorizing the Agency for Health Care
5 Administration to pay for certain services
6 provided by a registered nurse first assistant;
7 providing an effective date.
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9 Be It Enacted by the Legislature of the State of Florida:
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11 Section 1. Present subsections (20) and (21) of
12 section 409.906, Florida Statutes, 1996 Supplement, are
13 renumbered as subsections (21) and (22), respectively, and a
14 new subsection (20) is added to that section to read:
15 409.906 Optional Medicaid services.--Subject to
16 specific appropriations, the agency may make payments for
17 services which are optional to the state under Title XIX of
18 the Social Security Act and are furnished by Medicaid
19 providers to recipients who are determined to be eligible on
20 the dates on which the services were provided. Any optional
21 service that is provided shall be provided only when medically
22 necessary and in accordance with state and federal law.
23 Nothing in this section shall be construed to prevent or limit
24 the agency from adjusting fees, reimbursement rates, lengths
25 of stay, number of visits, or number of services, or making
26 any other adjustments necessary to comply with the
27 availability of moneys and any limitations or directions
28 provided for in the General Appropriations Act or chapter 216.
29 Optional services may include:
30 (20) REGISTERED NURSE FIRST ASSISTANT SERVICES.--The
31 agency may pay for all services provided to a recipient by a
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CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1997 HB 1405
252-346-97
1 registered nurse first assistant as described in s. 464.027.
2 Reimbursement for such services may not be less than 80
3 percent of the reimbursement that would be paid to a physician
4 providing the same services.
5 Section 2. Present paragraphs (q), (r), and (s) of
6 subsection (3) of section 409.908, Florida Statutes, 1996
7 Supplement, are redesignated as paragraphs (r), (s), and (t),
8 respectively, and a new paragraph (q) is added to that
9 subsection to read:
10 409.908 Reimbursement of Medicaid providers.--Subject
11 to specific appropriations, the agency shall reimburse
12 Medicaid providers, in accordance with state and federal law,
13 according to methodologies set forth in the rules of the
14 agency and in policy manuals and handbooks incorporated by
15 reference therein. These methodologies may include fee
16 schedules, reimbursement methods based on cost reporting,
17 negotiated fees, competitive bidding pursuant to s. 287.057,
18 and other mechanisms the agency considers efficient and
19 effective for purchasing services or goods on behalf of
20 recipients. Payment for Medicaid compensable services made on
21 behalf of Medicaid eligible persons is subject to the
22 availability of moneys and any limitations or directions
23 provided for in the General Appropriations Act or chapter 216.
24 Further, nothing in this section shall be construed to prevent
25 or limit the agency from adjusting fees, reimbursement rates,
26 lengths of stay, number of visits, or number of services, or
27 making any other adjustments necessary to comply with the
28 availability of moneys and any limitations or directions
29 provided for in the General Appropriations Act, provided the
30 adjustment is consistent with legislative intent.
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CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 1997 HB 1405
252-346-97
1 (3) Subject to any limitations or directions provided
2 for in the General Appropriations Act, the following Medicaid
3 services and goods may be reimbursed on a fee-for-service
4 basis. For each allowable service or goods furnished in
5 accordance with Medicaid rules, policy manuals, handbooks, and
6 state and federal law, the payment shall be the amount billed
7 by the provider, the provider's usual and customary charge, or
8 the maximum allowable fee established by the agency, whichever
9 amount is less, with the exception of those services or goods
10 for which the agency makes payment using a methodology based
11 on capitation rates, average costs, or negotiated fees.
12 (q) Registered nurse first assistant services.
13 Section 3. This act shall take effect July 1, 1997.
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16 SENATE SUMMARY
17 Authorizes the Agency for Health Care Administration to
pay for optional Medicaid services provided by a
18 registered nurse first assistant at no less than 80
percent of the rate that would be paid a physician for
19 the same services. Authorizes the agency to reimburse
registered nurse first assistants on a fee-for-service
20 basis for services provided under Medicaid.
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