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



                                                   HOUSE AMENDMENT

                                                Bill No. CS/HB 365

    Amendment No.     (for drafter's use only)

                            CHAMBER ACTION
              Senate                               House
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  5                                           ORIGINAL STAMP BELOW

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11  Representative(s) Cosgrove offered the following:

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13         Amendment (with title amendment) 

14  Remove from the bill:  Everything after the enacting clause

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16  and insert in lieu thereof:

17         Section 1.  Section 641.76, Florida Statutes, is

18  created to read:

19         641.76  Task Force on Direct Access.--

20         (1)  There is hereby created the Task Force on Direct

21  Access, to be composed of the following persons:  the chair of

22  the Committee on Health Care Services of the House of

23  Representatives, the chair of the Committee on Health Care of

24  the Senate, a representative of the health maintenance

25  organization industry to be appointed by the Florida

26  Association of Health Maintenance Organizations, the director

27  of the Agency for Health Care Administration or a designee,

28  the Insurance Commissioner or a designee, and a physician

29  appointed by the Secretary of Health.

30         (2)  The Task Force shall study the appropriateness of

31  allowing managed care entity subscribers direct access to any

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    File original & 9 copies    04/24/97
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                                                   HOUSE AMENDMENT

                                                Bill No. CS/HB 365

    Amendment No.     (for drafter's use only)





  1  specialist provider and evaluate the following:

  2         (a)  The adequacy of specialized treatment and care

  3  received by subscribers of exclusive provider organizations

  4  licensed under s. 627.6472 and health maintenance

  5  organizations licensed under part I.

  6         (b)  The ability of subscribers to health maintenance

  7  organizations and exclusive provider organizations to obtain

  8  referrals or authorizations for medically necessary specialty

  9  care and treatment.

10         (c)  The effectiveness of the primary care physician in

11  preventing illness, detecting disease and serious illness, and

12  authorizing appropriate specialty care.

13         (d)  The health outcomes of subscribers to health

14  maintenance organizations and exclusive provider organizations

15  compared with subscribers of traditional indemnity insurers or

16  fee-for-service insurers.

17         (3)  A chair of the group shall be elected from among

18  the members and the task force shall meet at the call of the

19  chair. Task force members shall be responsible for their own

20  travel and per diem expenses, and staff shall be provided by

21  the committee staff of the legislative members on the task

22  force.

23         (4)  The task force shall report its findings and

24  recommendations to the Speaker of the House of Representatives

25  and the Minority Leader of the House of Representatives and

26  the President of the Senate and the Minority Leader of the

27  Senate by January 31, 1997.

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

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    File original & 9 copies    04/24/97
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                                                   HOUSE AMENDMENT

                                                Bill No. CS/HB 365

    Amendment No.     (for drafter's use only)





  1  ================ T I T L E   A M E N D M E N T ===============

  2  And the title is amended as follows:

  3  remove from the title of the bill:  the entire title

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  5  and insert in lieu thereof:

  6                  A bill to be entitled

  7         An act relating to managed care; creating s.

  8         641.76, F.S.; creating the Task Force on Direct

  9         Access to review the appropriateness of direct

10         access by managed care subscribers to

11         specialist providers; specifying membership of

12         the task force; specifying areas to be

13         reviewed; requiring a report; providing an

14         effective date.

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    File original & 9 copies    04/24/97
    hbd0005                     04:48 pm         00365-0119-385479