Senate Bill 2324

    Florida Senate - 1998                                  SB 2324

    By Senator Rossin





    35-981A-98

  1                      A bill to be entitled

  2         An act relating to the Long-Term-Care Community

  3         Diversion Pilot Project; amending s. 430.705,

  4         F.S.; allowing participants to choose

  5         long-term-care service providers affiliated

  6         with an individuals's religious denomination or

  7         faith group under certain circumstances;

  8         providing an effective date.

  9

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

11

12         Section 1.  Subsection (3) of section 430.705, Florida

13  Statutes, is amended to read:

14         430.705  Implementation of the long-term care community

15  diversion pilot projects.--

16         (3)  The department shall provide to prospective

17  participants a choice of participating in a community

18  diversion pilot project or any other appropriate placement

19  available.  To the extent possible, individuals shall be

20  allowed to choose their care providers. Individuals may also

21  choose providers that are affiliated with their religious

22  faith or denomination. Before a prospective participant

23  enrolls in a managed care plan, the department shall provide

24  him or her with a list of participating providers which

25  identifies any affiliation with a religious faith or

26  denomination of a provider, in the same type size as the

27  provider's name. If a mandated managed long-term-care system

28  is implemented to serve Medicaid-eligible long-term-care

29  recipients or individuals who are eligible for Medicaid and

30  Medicare, the participants may, before receiving

31  long-term-care services, designate their religious faith or

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






    Florida Senate - 1998                                  SB 2324
    35-981A-98




  1  denominations and request that they receive services from a

  2  provider affiliated with their designation, subject to the

  3  following conditions:

  4         (a)  A service provider affiliated with their

  5  designated religious faith or denomination is located in the

  6  geographic area served by the managed care organization;

  7         (b)  The managed care organization has a provider in

  8  its network to meet the individual's request, or, if not, the

  9  organization must provide the service through an affiliated

10  out-of-network provider if one is available that is able to

11  provide the level of care and services the participant needs,

12  that agrees to be reimbursed at a rate that is no less than

13  the contract rate for similar providers for the same services

14  and supplies, and that meets the guidelines established by the

15  organization for quality of care, credentialing, and

16  utilization required of similar providers under contract.

17         (c)  If a managed care organization denies a

18  participant's request for long-term-care services from a

19  provider affiliated with the designated religious faith or

20  denomination, the organization must provide a written

21  explanation of the denial to the participant within 3 days. A

22  participant may appeal the denial under s. 641.511, or other

23  applicable grievance procedures.

24         Section 2.  This act shall take effect upon becoming a

25  law.

26

27            *****************************************

28                          SENATE SUMMARY

29    Provides that Medicaid beneficiaries who receive
      long-term health care may select religiously affiliated
30    long-term-care facilities.

31

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