House Bill 1129er

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    2000 Legislature                   CS/HB 1129, Third Engrossed



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  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; authorizing the agency

10         to contract for the provision of certain

11         services in Alachua County and authorizing it

12         to make certain determinations regarding

13         Sarasota County; prohibiting the inclusion of

14         certain children in such services; requiring

15         the agency to require certain providers to

16         prevent the displacement of certain indigent

17         care patients; providing for certain

18         traditional mental health providers to be

19         offered a contract to participate in such

20         prepaid services plans; defining the term

21         "comprehensive behavioral health care

22         services"; providing deadlines for entering

23         such contracts; deleting provisions requiring

24         the Department of Insurance to develop certain

25         requirements for entities that provide mental

26         health care services; authorizing the Agency

27         for Health Care Administration to contract for

28         mental health and substance abuse treatment

29         services for Medicaid recipients through an

30         administrative services organization agreement;

31         providing requirements for procurement and


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    ENROLLED

    2000 Legislature                   CS/HB 1129, Third Engrossed



  1         availability of such services; providing an

  2         effective date.

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

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

  7  409.912, Florida Statutes, is amended, and paragraph (e) is

  8  added to that subsection, to read:

  9         409.912  Cost-effective purchasing of health care.--The

10  agency shall purchase goods and services for Medicaid

11  recipients in the most cost-effective manner consistent with

12  the delivery of quality medical care.  The agency shall

13  maximize the use of prepaid per capita and prepaid aggregate

14  fixed-sum basis services when appropriate and other

15  alternative service delivery and reimbursement methodologies,

16  including competitive bidding pursuant to s. 287.057, designed

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

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

19  minimize the exposure of recipients to the need for acute

20  inpatient, custodial, and other institutional care and the

21  inappropriate or unnecessary use of high-cost services.

22         (3)  The agency may contract with:

23         (b)  An entity that is providing comprehensive

24  behavioral inpatient and outpatient mental health care

25  services to certain Medicaid recipients in Hillsborough,

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

27  capitated, prepaid arrangement pursuant to the federal waiver

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

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

30  must possess the clinical systems and operational competence

31  to manage risk and provide comprehensive behavioral health


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    2000 Legislature                   CS/HB 1129, Third Engrossed



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

  2  term "comprehensive behavioral health care services" means

  3  covered mental health and substance abuse treatment services

  4  that are available to Medicaid recipients. The Secretary of

  5  the Department of Children and Families shall approve

  6  provisions of procurements related to children in the

  7  department's care or custody prior to enrolling such children

  8  in a prepaid behavioral health plan. Any contract awarded

  9  under this paragraph must be competitively procured. In

10  developing the behavioral health care prepaid plan procurement

11  document, the agency shall ensure that the procurement

12  document requires the contractor to develop and implement a

13  plan to ensure compliance with s. 394.4574 related to services

14  provided to residents of licensed assisted living facilities

15  that hold a limited mental health license. The agency must

16  ensure that Medicaid recipients have available the choice of

17  at least two managed care plans for their behavioral health

18  care services. The agency may reimburse for

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

20  until the agency finds that adequate funds are available for

21  capitated, prepaid arrangements.

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

23  contracts with the entities providing comprehensive inpatient

24  and outpatient mental health care services to Medicaid

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

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

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

28  with entities providing comprehensive behavioral health care

29  services to Medicaid recipients through capitated, prepaid

30  arrangements in Charlotte, Collier, DeSoto, Escambia, Glades,

31  Hendry, Lee, Okaloosa, Pasco, Pinellas, Santa Rosa, Sarasota,


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    2000 Legislature                   CS/HB 1129, Third Engrossed



  1  and Walton Counties. The agency may contract with entities

  2  providing comprehensive behavioral health care services to

  3  Medicaid recipients through capitated, prepaid arrangements in

  4  Alachua County. The agency may determine if Sarasota County

  5  shall be included as a separate catchment area or included in

  6  any other agency geographic area.

  7         3.  Children residing in a Department of Juvenile

  8  Justice residential program approved as a Medicaid behavioral

  9  health overlay services provider shall not be included in a

10  behavioral health care prepaid health plan pursuant to this

11  paragraph.

12         4.  In converting to a prepaid system of delivery, the

13  agency shall in its procurement document require an entity

14  providing comprehensive behavioral health care services to

15  prevent the displacement of indigent care patients by

16  enrollees in the Medicaid prepaid health plan providing

17  behavioral health care services from facilities receiving

18  state funding to provide indigent behavioral health care, to

19  facilities licensed under chapter 395 which do not receive

20  state funding for indigent behavioral health care, or

21  reimburse the unsubsidized facility for the cost of behavioral

22  health care provided to the displaced indigent care patient.

23         5.  Traditional community mental health providers under

24  contract with the Department of Children and Families pursuant

25  to Part IV of chapter 394 and inpatient mental health

26  providers licensed pursuant to chapter 395, must be offered an

27  opportunity to accept or decline a contract to participate in

28  any provider network for prepaid behavioral health services.

29  by December 31, 1998, and is exempt from the provisions of

30  part I of chapter 641 until then. However, if the entity

31  assumes risk, the Department of Insurance shall develop


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    ENROLLED

    2000 Legislature                   CS/HB 1129, Third Engrossed



  1  appropriate regulatory requirements by rule under the

  2  insurance code before the entity becomes operational.

  3         (e)  An entity that provides comprehensive behavioral

  4  health care services to certain Medicaid recipients through an

  5  administrative services organization agreement. Such an entity

  6  must possess the clinical systems and operational competence

  7  to provide comprehensive health care to Medicaid recipients.

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

  9  health care services" means covered mental health and

10  substance abuse treatment services that are available to

11  Medicaid recipients. Any contract awarded under this paragraph

12  must be competitively procured. The agency must ensure that

13  Medicaid recipients have available the choice of at least two

14  managed care plans for their behavioral health care services.

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

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