Senate Bill 1046
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2000 SB 1046
By Senators Silver and Kirkpatrick
317-501A-00
1 A bill to be entitled
2 An act relating to Medicaid managed behavioral
3 health care; amending s. 409.912, F.S.;
4 authorizing the Agency for Health Care
5 Administration to contract for prepaid
6 behavioral health care services for Medicaid
7 recipients in specified counties; providing
8 requirements for the agency in developing
9 procurement procedures; defining the term
10 "comprehensive behavioral health care
11 services"; providing deadlines for entering
12 such contracts; deleting provisions requiring
13 the Department of Insurance to develop certain
14 requirements for entities that provide mental
15 health care services; providing an effective
16 date.
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18 Be It Enacted by the Legislature of the State of Florida:
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20 Section 1. Paragraph (b) of subsection (3) of section
21 409.912, Florida Statutes, is amended to read:
22 409.912 Cost-effective purchasing of health care.--The
23 agency shall purchase goods and services for Medicaid
24 recipients in the most cost-effective manner consistent with
25 the delivery of quality medical care. The agency shall
26 maximize the use of prepaid per capita and prepaid aggregate
27 fixed-sum basis services when appropriate and other
28 alternative service delivery and reimbursement methodologies,
29 including competitive bidding pursuant to s. 287.057, designed
30 to facilitate the cost-effective purchase of a case-managed
31 continuum of care. The agency shall also require providers to
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Florida Senate - 2000 SB 1046
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1 minimize the exposure of recipients to the need for acute
2 inpatient, custodial, and other institutional care and the
3 inappropriate or unnecessary use of high-cost services.
4 (3) The agency may contract with:
5 (b) An entity that is providing comprehensive
6 behavioral inpatient and outpatient mental health care
7 services to certain Medicaid recipients in Hillsborough,
8 Highlands, Hardee, Manatee, and Polk Counties, through a
9 capitated, prepaid arrangement pursuant to the federal waiver
10 provided for by s. 409.905(5). Such an entity must be become
11 licensed under chapter 624, chapter 636, or chapter 641 and
12 must possess the clinical systems and operational competence
13 to manage risk and provide comprehensive health care to
14 Medicaid recipients. As used in this paragraph, the term
15 "comprehensive behavioral health care services" means covered
16 mental health and substance abuse treatment services that are
17 available to Medicaid recipients. Any contract awarded under
18 this paragraph must be competitively procured. The agency must
19 ensure that Medicaid recipients have available the choice of
20 at least two managed care plans for their behavioral health
21 care services. The agency may reimburse for
22 substance-abuse-treatment services on a fee-for-service basis
23 until the agency finds that adequate funds are available for
24 capitated, prepaid arrangements.
25 1. By January 1, 2001, the agency shall modify the
26 contracts with the entities providing comprehensive inpatient
27 and outpatient mental health care services to Medicaid
28 recipients in Hillsborough, Highlands, Hardee, Manatee, and
29 Polk Counties, to include substance-abuse-treatment services.
30 2. By December 31, 2001, the agency shall contract
31 with entities providing comprehensive behavioral health care
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Florida Senate - 2000 SB 1046
317-501A-00
1 services to Medicaid recipients through capitated, prepaid
2 arrangements in Broward, Charlotte, Collier, DeSoto, Escambia,
3 Glades, Hendry, Lee, Okaloosa, Pasco, Pinellas, Santa Rosa,
4 Sarasota, and Walton Counties. by December 31, 1998, and is
5 exempt from the provisions of part I of chapter 641 until
6 then. However, if the entity assumes risk, the Department of
7 Insurance shall develop appropriate regulatory requirements by
8 rule under the insurance code before the entity becomes
9 operational.
10 Section 2. This act shall take effect July 1, 2000.
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13 SENATE SUMMARY
14 Authorizes the Agency for Health Care Administration to
contract for prepaid behavioral health care services for
15 Medicaid recipients in specified counties in accordance
with specified deadlines.
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