CODING: Words stricken are deletions; words underlined are additions.
House Bill 1465e1




                                          HB 1465, First Engrossed



  1                      A bill to be entitled

  2         An act relating to social and economic

  3         assistance; amending s. 409.908, F.S.; deleting

  4         a provision relating to the reimbursement for

  5         midwives who provide services to Medicaid

  6         recipients; directing the Agency for Health

  7         Care Administration to adopt certain rules;

  8         providing an effective date.

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10  Be It Enacted by the Legislature of the State of Florida:

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12         Section 1.  Paragraph (d) of subsection (12) of section

13  409.908, Florida Statutes, 1996 Supplement, is amended to

14  read:

15         409.908  Reimbursement of Medicaid providers.--Subject

16  to specific appropriations, the agency shall reimburse

17  Medicaid providers, in accordance with state and federal law,

18  according to methodologies set forth in the rules of the

19  agency and in policy manuals and handbooks incorporated by

20  reference therein.  These methodologies may include fee

21  schedules, reimbursement methods based on cost reporting,

22  negotiated fees, competitive bidding pursuant to s. 287.057,

23  and other mechanisms the agency considers efficient and

24  effective for purchasing services or goods on behalf of

25  recipients.  Payment for Medicaid compensable services made on

26  behalf of Medicaid eligible persons is subject to the

27  availability of moneys and any limitations or directions

28  provided for in the General Appropriations Act or chapter 216.

29  Further, nothing in this section shall be construed to prevent

30  or limit the agency from adjusting fees, reimbursement rates,

31  lengths of stay, number of visits, or number of services, or


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CODING: Words stricken are deletions; words underlined are additions.






                                          HB 1465, First Engrossed



  1  making any other adjustments necessary to comply with the

  2  availability of moneys and any limitations or directions

  3  provided for in the General Appropriations Act, provided the

  4  adjustment is consistent with legislative intent.

  5         (12)

  6         (d)  Notwithstanding paragraph (b), reimbursement fees

  7  to physicians for providing total obstetrical services to

  8  Medicaid recipients, which include prenatal, delivery, and

  9  postpartum care, shall be at least $1,500 per delivery for a

10  pregnant woman with low medical risk and at least $2,000 per

11  delivery for a pregnant woman with high medical risk. However,

12  reimbursement to physicians working in Regional Perinatal

13  Intensive Care Centers designated pursuant to chapter 383, for

14  services to certain pregnant Medicaid recipients with a high

15  medical risk, may be made according to obstetrical care and

16  neonatal care groupings and rates established by the agency.

17  Nurse midwives licensed under chapter 464 or midwives licensed

18  under chapter 467 shall be reimbursed at no less than 80

19  percent of the low medical risk fee. However, midwives

20  licensed under chapter 467 shall not receive Medicaid

21  reimbursement for home deliveries conducted for Medicaid

22  recipients, but shall be reimbursed for prenatal and

23  postpartal care provided to such recipients. The agency shall

24  by rule determine, for the purpose of this paragraph, what

25  constitutes a high or low medical risk pregnant woman and

26  shall not pay more based solely on the fact that a caesarean

27  section was performed, rather than a vaginal delivery. The

28  agency shall by rule determine a prorated payment for

29  obstetrical services in cases where only part of the total

30  prenatal, delivery, or postpartum care was performed.

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                                          HB 1465, First Engrossed



  1         The Agency for Health Care Administration shall adopt

  2  rules within chapter 467, F.S., for appropriate insurance

  3  coverage by such licensees.  Prior to the issuance and renewal

  4  of an active license, or reactivation of an inactive license

  5  for midwives licensed under chapter 467, F.S., such licensees

  6  shall submit proof of coverage with each application.

  7         Section 2.  This act shall take effect July 1, 1997.

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