House Bill 2227

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    Florida House of Representatives - 1999                HB 2227

        By the Committee on Health & Human Services Appropriations
    and Representative Sanderson





  1                      A bill to be entitled

  2         An act relating to health care; amending s.

  3         409.912, F.S., relating to purchase of goods

  4         and services for Medicaid recipients; requiring

  5         the Agency for Health Care Administration to

  6         develop certain programs and initiatives

  7         relating to the prescribing, use, and

  8         dispensing of drugs; providing for an advisory

  9         panel on prescription practice patterns;

10         providing an effective date.

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

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14         Section 1.  Subsection (13) of section 409.912, Florida

15  Statutes, 1998 Supplement, is amended to read:

16         409.912  Cost-effective purchasing of health care.--The

17  agency shall purchase goods and services for Medicaid

18  recipients in the most cost-effective manner consistent with

19  the delivery of quality medical care.  The agency shall

20  maximize the use of prepaid per capita and prepaid aggregate

21  fixed-sum basis services when appropriate and other

22  alternative service delivery and reimbursement methodologies,

23  including competitive bidding pursuant to s. 287.057, designed

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

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

26  minimize the exposure of recipients to the need for acute

27  inpatient, custodial, and other institutional care and the

28  inappropriate or unnecessary use of high-cost services.

29         (13)(a)  The agency shall identify health care

30  utilization and price patterns within the Medicaid program

31  which are not cost-effective or medically appropriate and

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    Florida House of Representatives - 1999                HB 2227

    611-117A-99






  1  assess the effectiveness of new or alternate methods of

  2  providing and monitoring service, and may implement such

  3  methods as it considers appropriate. Such methods may include

  4  disease management initiatives, an integrated and systematic

  5  approach for managing the health care needs of recipients who

  6  are at risk of or diagnosed with a specific disease by using

  7  best practices, prevention strategies, clinical-practice

  8  improvement, clinical interventions and protocols, outcomes

  9  research, information technology, and other tools and

10  resources to reduce overall costs and improve measurable

11  outcomes.

12         (b)  The responsibility of the agency under this

13  subsection shall include the development of capabilities to

14  identify actual and optimal practice patterns; patient and

15  provider educational initiatives; methods for determining

16  patient compliance with prescribed treatments; fraud, waste,

17  and abuse prevention and detection programs; and beneficiary

18  case management programs.

19         1.  The practice pattern identification program shall

20  evaluate practitioner prescribing patterns based on national

21  and regional practice guidelines, comparing practitioners to

22  their peer groups. The agency and its Drug Utilization Review

23  Board shall consult with a panel of practicing health care

24  professionals appointed by the director of the agency,

25  consisting of six physicians licensed under chapter 458,

26  chapter 459, or chapter 461, two pharmacists licensed under

27  chapter 465, and one dentist licensed under chapter 466 who is

28  an oral and maxillofacial surgeon. The advisory panel shall be

29  responsible for evaluating treatment guidelines and

30  recommending ways to incorporate their use in the practice

31  pattern identification program. Practitioners who are

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    Florida House of Representatives - 1999                HB 2227

    611-117A-99






  1  prescribing inappropriately or inefficiently, as determined by

  2  the agency, may have their prescribing of certain drugs

  3  subject to prior authorization.

  4         2.  The agency shall also develop educational

  5  interventions designed to promote the proper use of

  6  medications by providers and beneficiaries.

  7         3.  The agency shall implement a pharmacy fraud, waste,

  8  and abuse initiative that may include a surety bond or letter

  9  of credit requirement for participating pharmacies, enhanced

10  provider auditing practices, the use of additional fraud and

11  abuse software, recipient management programs for

12  beneficiaries inappropriately using their benefits, and other

13  steps that will eliminate provider and recipient fraud, waste,

14  and abuse. The initiative shall address enforcement efforts to

15  reduce the number and use of counterfeit prescriptions.

16         4.  The agency may apply for any federal waivers needed

17  to implement this paragraph.

18         Section 2.  This act shall take effect July 1, 1999.

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21                          HOUSE SUMMARY

22
      Amends provisions relating to the purchase of goods and
23    services for Medicaid recipients, to require the Agency
      for Health Care Administration to develop certain
24    programs and initiatives relating to the prescribing,
      use, and dispensing of drugs. Provides for appointment
25    and duties of an advisory panel on prescription practice
      patterns. See bill for details.
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