Senate Bill 2022

    Florida Senate - 1999                                  SB 2022

    By Senator Lee





    23-1339-99

  1                      A bill to be entitled

  2         An act relating to health care costs; amending

  3         s. 409.912, F.S.; authorizing the Agency for

  4         Health Care Administration to contract with

  5         additional providers in a demonstration project

  6         to test Medicaid direct contracting; providing

  7         an effective date.

  8

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

10

11         Section 1.  Paragraph (d) of subsection (3) of section

12  409.912, Florida Statutes, 1998 Supplement, is amended to

13  read:

14         409.912  Cost-effective purchasing of health care.--The

15  agency shall purchase goods and services for Medicaid

16  recipients in the most cost-effective manner consistent with

17  the delivery of quality medical care.  The agency shall

18  maximize the use of prepaid per capita and prepaid aggregate

19  fixed-sum basis services when appropriate and other

20  alternative service delivery and reimbursement methodologies,

21  including competitive bidding pursuant to s. 287.057, designed

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

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

24  minimize the exposure of recipients to the need for acute

25  inpatient, custodial, and other institutional care and the

26  inappropriate or unnecessary use of high-cost services.

27         (3)  The agency may contract with:

28         (d)  No more than eight four provider service networks

29  for demonstration projects to test Medicaid direct

30  contracting. One demonstration project must be located in

31  Orange County.  The demonstration projects may be reimbursed

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






    Florida Senate - 1999                                  SB 2022
    23-1339-99




  1  on a fee-for-service or prepaid basis.  A provider service

  2  network that which is reimbursed by the agency on a prepaid

  3  basis shall be exempt from parts I and III of chapter 641, but

  4  must meet appropriate financial reserve, quality assurance,

  5  and patient rights requirements as established by the agency.

  6  The agency shall award contracts on a competitive bid basis

  7  and shall select bidders based upon price and quality of care.

  8  Medicaid recipients assigned to a demonstration project shall

  9  be chosen equally from those who would otherwise have been

10  assigned to prepaid plans and MediPass.  The agency is

11  authorized to seek federal Medicaid waivers as necessary to

12  implement the provisions of this section.  A demonstration

13  project awarded pursuant to this paragraph shall be for 2

14  years from the date of implementation.

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

16  law.

17

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19                          SENATE SUMMARY

20    Increases to eight the number of provider service
      networks with which the Agency for Health Care
21    Administration may contract in a demonstration project to
      test Medicaid direct contracting.
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