Senate Bill 1134

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    Florida Senate - 1999                                  SB 1134

    By Senator Kirkpatrick





    5-629-99

  1                      A bill to be entitled

  2         An act relating to Medicaid managed health

  3         care; amending s. 409.912, F.S.; authorizing

  4         the Agency for Health Care Administration to

  5         award additional contracts for providing

  6         comprehensive behavioral health care services

  7         to certain Medicaid recipients; defining the

  8         term "comprehensive behavioral health care

  9         services"; providing a deadline for

10         implementing this act; providing an effective

11         date.

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

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15         Section 1.  Paragraph (b) of subsection (3) of section

16  409.912, Florida Statutes, 1998 Supplement, is amended to

17  read:

18         409.912  Cost-effective purchasing of health care.--The

19  agency shall purchase goods and services for Medicaid

20  recipients in the most cost-effective manner consistent with

21  the delivery of quality medical care.  The agency shall

22  maximize the use of prepaid per capita and prepaid aggregate

23  fixed-sum basis services when appropriate and other

24  alternative service delivery and reimbursement methodologies,

25  including competitive bidding pursuant to s. 287.057, designed

26  to facilitate the cost-effective purchase of a case-managed

27  continuum of care. The agency shall also require providers to

28  minimize the exposure of recipients to the need for acute

29  inpatient, custodial, and other institutional care and the

30  inappropriate or unnecessary use of high-cost services.

31         (3)  The agency may contract with:

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    Florida Senate - 1999                                  SB 1134
    5-629-99




  1         (b)  An entity that is providing comprehensive

  2  behavioral inpatient and outpatient mental health care

  3  services to certain Medicaid recipients in Hillsborough,

  4  Highlands, Hardee, Manatee, and Polk Counties, through a

  5  capitated, prepaid arrangement pursuant to the federal waiver

  6  provided for by s. 409.905(5). Such an entity must become

  7  licensed under chapter 624, chapter 636, or chapter 641 and

  8  must possess the clinical systems and operational competence

  9  to manage risk and provide comprehensive behavioral health

10  care to Medicaid recipients by December 31, 1998, and is

11  exempt from the provisions of part I of chapter 641 until

12  then.  As used in this subsection, the term "comprehensive

13  behavioral health care services" means all covered services of

14  psychiatric and substance abuse inpatient, psychiatric

15  outpatient, and community mental health and mental health

16  targeted case management for adults and children which

17  services are available to Medicaid recipients. Beginning

18  October 1, 1999, the agency shall use competitive bidding to

19  award additional capitated, prepaid contracts for

20  comprehensive behavioral health care services. An entity

21  cannot submit a proposal for such a contract unless it is

22  licensed under chapter 624, chapter 636, or chapter 641 and

23  possesses the clinical systems and operational competence to

24  manage risk and provide comprehensive behavioral health care

25  services to Medicaid recipients. However, if the entity

26  assumes risk, the Department of Insurance shall develop

27  appropriate regulatory requirements by rule under the

28  insurance code before the entity becomes operational.

29         Section 2.  This act shall take effect October 1, 1999.

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    Florida Senate - 1999                                  SB 1134
    5-629-99




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  2                          SENATE SUMMARY

  3    Authorizes the Agency for Health Care Administration to
      award additional contracts for providing comprehensive
  4    behavioral health care services to certain Medicaid
      recipients in specified counties. Defines the term
  5    "comprehensive behavioral health care services." Requires
      that the act be implemented within 12 months after its
  6    effective date.

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