Senate Bill 1046c1

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



    Florida Senate - 2000                           CS for SB 1046

    By the Committee on Health, Aging and Long-Term Care; and
    Senators Silver and Kirkpatrick




    317-1874-00

  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; authorizing the Agency

16         for Health Care Administration to contract for

17         mental health and substance abuse treatment

18         services for Medicaid recipients through an

19         administrative services organization agreement;

20         providing requirements for procurement and

21         availability of such services; providing an

22         effective date.

23

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

25

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

27  409.912, Florida Statutes, is amended, and paragraph (e) is

28  added to that subsection, to read:

29         409.912  Cost-effective purchasing of health care.--The

30  agency shall purchase goods and services for Medicaid

31  recipients in the most cost-effective manner consistent with

                                  1

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






    Florida Senate - 2000                           CS for SB 1046
    317-1874-00




  1  the delivery of quality medical care.  The agency shall

  2  maximize the use of prepaid per capita and prepaid aggregate

  3  fixed-sum basis services when appropriate and other

  4  alternative service delivery and reimbursement methodologies,

  5  including competitive bidding pursuant to s. 287.057, designed

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

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

  8  minimize the exposure of recipients to the need for acute

  9  inpatient, custodial, and other institutional care and the

10  inappropriate or unnecessary use of high-cost services.

11         (3)  The agency may contract with:

12         (b)  An entity that is providing comprehensive

13  behavioral inpatient and outpatient mental health care

14  services to certain Medicaid recipients in Hillsborough,

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

16  capitated, prepaid arrangement pursuant to the federal waiver

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

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

19  must possess the clinical systems and operational competence

20  to manage risk and provide comprehensive behavioral health

21  care to Medicaid recipients. As used in this paragraph, the

22  term "comprehensive behavioral health care services" means

23  covered mental health and substance abuse treatment services

24  that are available to Medicaid recipients. Any contract

25  awarded under this paragraph must be competitively procured.

26  The agency must ensure that Medicaid recipients have available

27  the choice of at least two managed care plans for their

28  behavioral health care services. The agency may reimburse for

29  substance-abuse-treatment services on a fee-for-service basis

30  until the agency finds that adequate funds are available for

31  capitated, prepaid arrangements.

                                  2

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






    Florida Senate - 2000                           CS for SB 1046
    317-1874-00




  1         1.  By January 1, 2001, the agency shall modify the

  2  contracts with the entities providing comprehensive inpatient

  3  and outpatient mental health care services to Medicaid

  4  recipients in Hillsborough, Highlands, Hardee, Manatee, and

  5  Polk Counties, to include substance-abuse-treatment services.

  6         2.  By December 31, 2001, the agency shall contract

  7  with entities providing comprehensive behavioral health care

  8  services to Medicaid recipients through capitated, prepaid

  9  arrangements in Broward, Charlotte, Collier, DeSoto, Escambia,

10  Glades, Hendry, Lee, Okaloosa, Pasco, Pinellas, Santa Rosa,

11  Sarasota, and Walton Counties. by December 31, 1998, and is

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

13  then. However, if the entity assumes risk, the Department of

14  Insurance shall develop appropriate regulatory requirements by

15  rule under the insurance code before the entity becomes

16  operational.

17         (e)  An entity that provides comprehensive behavioral

18  health care services to certain Medicaid recipients through an

19  administrative services organization agreement. Such an entity

20  must possess the clinical systems and operational competence

21  to provide comprehensive health care to Medicaid recipients.

22  As used in this paragraph, the term "comprehensive behavioral

23  health care services" means covered mental health and

24  substance abuse treatment services that are available to

25  Medicaid recipients. Any contract awarded under this paragraph

26  must be competitively procured. The agency must ensure that

27  Medicaid recipients have available the choice of at least two

28  managed care plans for their behavioral health care services.

29         Section 2.  This act shall take effect July 1, 2000.

30

31

                                  3

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






    Florida Senate - 2000                           CS for SB 1046
    317-1874-00




  1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
  2                         Senate Bill 1046

  3

  4  The Committee Substitute allows the agency to contract with an
    entity which provides comprehensive behavioral health care
  5  services to certain Medicaid recipients through an
    administrative services organization agreement. Such an entity
  6  must possess clinical systems and operational competence to
    provide comprehensive health care to Medicaid recipients.
  7

  8

  9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

                                  4