Senate Bill 1766

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    Florida Senate - 2000                                  SB 1766

    By Senator McKay





    26-1039-00                                              See HB

  1                      A bill to be entitled

  2         An act relating to obsolete, expired, or

  3         repealed provisions of law; repealing various

  4         provisions of law that have become obsolete,

  5         have had their effect, have served their

  6         purpose, or have been impliedly repealed or

  7         superseded; repealing s. 154.013, F.S.,

  8         relating to county primary health care panels;

  9         amending s. 154.011, F.S.; deleting a

10         cross-reference, to conform; repealing s.

11         154.12(2), F.S., relating to the legal status

12         of county public health trusts with respect to

13         a repealed provision of law relating to the

14         filing of caveats; repealing s. 154.3105, F.S.,

15         relating to a work group to develop rules for

16         the Health Care Responsibility Act; amending

17         ss. 154.308 and 154.309, F.S.; deleting

18         cross-references, to conform; repealing s.

19         381.0408, F.S., relating to the Public Health

20         Partnership Council on Stroke; repealing s.

21         408.0014, F.S., the Florida Health Access

22         Corporation Act; amending ss. 20.42 and

23         409.9117, F.S.; deleting references, to

24         conform; repealing s. 408.004, F.S., relating

25         to the Florida Health Plan; repealing ss.

26         408.002, 408.005, and 408.006, F.S., relating

27         to legislative findings and intent and to

28         development goals and strategies, to conform;

29         amending ss. 408.061, 408.15, 408.301, and

30         408.704, F.S.; deleting references, to conform;

31         repealing s. 408.01, F.S., relating to the

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    Florida Senate - 2000                                  SB 1766
    26-1039-00                                              See HB




  1         voluntary private health insurance coverage and

  2         insurance cost containment program; repealing

  3         s. 408.02(9), F.S., relating to a demonstration

  4         project on the effectiveness of practice

  5         parameters with respect to the costs of

  6         defensive medicine and professional liability

  7         insurance; repealing s. 408.062(1)(g), F.S.,

  8         relating to development of an alternative

  9         uniform system of financial reporting of gross

10         revenues per adjusted admission; amending s.

11         408.7071, F.S.; deleting provisions relating to

12         development of a standardized claim form for

13         insurers and health care providers licensed in

14         this state and to the committee appointed for

15         such purpose; repealing s. 409.908(12)(c) and

16         (22), F.S., relating to a report on the effect

17         of the resource-based relative value scale fee

18         schedule on utilization of Medicaid services

19         and to implementation of changes in the

20         Medicaid reimbursement methodology for

21         facilities formerly known as ICF/DD facilities;

22         repealing s. 514.081, F.S., relating to a

23         saving clause applicable to provisions

24         governing construction, modification, and

25         operation of public swimming pools and bathing

26         facilities; amending s. 636.045, F.S.; deleting

27         obsolete provisions relating to minimum surplus

28         requirements for prepaid limited health service

29         organizations; repealing s. 859.03, F.S.,

30         relating to wrapping and labeling requirements

31         applicable to the sale of morphine; repealing

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    Florida Senate - 2000                                  SB 1766
    26-1039-00                                              See HB




  1         s. 859.05, F.S., relating to a prohibition on

  2         the sale or other disposition of narcotics

  3         except by prescription; repealing s. 35, ch.

  4         93-129, Laws of Florida, relating to a work

  5         group on rural health care; repealing s. 19,

  6         ch. 96-403, Laws of Florida, relating to a task

  7         force on the organization and structure of

  8         state health programs; repealing s. 3, ch.

  9         98-21, Laws of Florida, relating to a rural

10         hospital redefinition study group; repealing s.

11         1, ch. 98-305, Laws of Florida, relating to the

12         Prostate Cancer Task Force; repealing s. 4, ch.

13         99-214, Laws of Florida, relating to a school

14         nurse training study group; repealing s. 6, ch.

15         99-393, Laws of Florida, relating to an

16         advisory group on submission and payment of

17         health claims; repealing s. 192, ch. 99-397,

18         Laws of Florida, relating to the task force on

19         the funding of the Public Medical Assistance

20         Trust Fund; amending ch. 99-226, Laws of

21         Florida, relating to the Medicaid Formulary

22         study panel; providing an effective date.

23

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

25

26         Section 1.  Section 154.013, Florida Statutes, is

27  repealed.

28         Section 2.  Subsection (1) of section 154.011, Florida

29  Statutes, is amended to read:

30         154.011  Primary care services.--

31

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    Florida Senate - 2000                                  SB 1766
    26-1039-00                                              See HB




  1         (1)  It is the intent of the Legislature that all 67

  2  counties offer primary care services through contracts, as

  3  required by s. 154.01(3), for Medicaid recipients and other

  4  qualified low-income persons.  Therefore, beginning July 1,

  5  1987, the Department of Health is directed, to the extent that

  6  funds are appropriated, to develop a plan to implement a

  7  program in cooperation with each county.  The department shall

  8  coordinate with the county's primary care panel, as created by

  9  s. 154.013, or with the county's governing body if no primary

10  care panel is appointed.  Such primary care programs shall be

11  phased-in and made operational as additional resources are

12  appropriated, and shall be subject to the following:

13         (a)  The department shall enter into contracts with the

14  county governing body for the purpose of expanding primary

15  care coverage.  The county governing body shall have the

16  option of organizing the primary care programs through county

17  health departments or through county public hospitals owned

18  and operated directly by the county.  The department shall, as

19  its first priority, maximize the number of counties

20  participating in the primary care programs under this section,

21  but shall establish priorities for funding based on need and

22  the willingness of counties to participate.  The department

23  shall select counties for programs through a formal

24  request-for-proposal process that requires compliance with

25  program standards for cost-effective quality care and seeks to

26  maximize access throughout the county.

27         (b)  Each county's primary care program may utilize any

28  or all of the following options of providing services:

29  offering services directly through the county health

30  departments; contracting with individual or group

31  practitioners for all or part of the service; or developing

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    Florida Senate - 2000                                  SB 1766
    26-1039-00                                              See HB




  1  service delivery models which are organized through the county

  2  health departments but which utilize other service or delivery

  3  systems available, such as federal primary care programs or

  4  prepaid health plans.  In addition, counties shall have the

  5  option of pooling resources and joining with neighboring

  6  counties in order to fulfill the intent of this section.

  7         (c)  Each primary care program shall conform to the

  8  requirements and specifications of the department, and shall

  9  at a minimum:

10         1.  Adopt a minimum eligibility standard of at least

11  100 percent of the federal nonfarm poverty level.

12         2.  Provide a comprehensive mix of preventive and

13  illness care services.

14         3.  Be family oriented and be easily accessible

15  regardless of income, physical status, or geographical

16  location.

17         4.  Ensure 24-hour telephone access and offer evening

18  and weekend clinic services.

19         5.  Offer continuity of care over time.

20         6.  Make maximum use of existing providers and closely

21  coordinate its services and funding with existing federal

22  primary care programs, especially in rural counties, to ensure

23  efficient use of resources.

24         7.  Have a sliding fee schedule based on income for

25  eligible persons above 100 percent of the federal nonfarm

26  poverty level.

27         8.  Include quality assurance provisions and procedures

28  for evaluation.

29         9.  Provide early periodic screening diagnostic and

30  treatment services for Medicaid-eligible children.

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    Florida Senate - 2000                                  SB 1766
    26-1039-00                                              See HB




  1         10.  Fully utilize and coordinate with rural hospitals

  2  for outpatient services, including contracting for services

  3  when advisable in terms of cost-effectiveness and feasibility.

  4         Section 3.  Subsection (2) of section 154.12, Florida

  5  Statutes, is repealed.

  6         Section 4.  Section 154.3105, Florida Statutes, is

  7  repealed.

  8         Section 5.  Subsection (1) of section 154.308, Florida

  9  Statutes, is amended to read:

10         154.308  Determination of patient's eligibility;

11  spend-down program.--

12         (1)  The agency, pursuant to s. 154.3105, shall adopt

13  rules which provide statewide eligibility determination

14  procedures, forms, and criteria which shall be used by all

15  counties for determining whether a person financially

16  qualifies as indigent for the purposes of this part.

17         (a)  The criteria used to determine eligibility must be

18  uniform statewide and include, at a minimum, which assets, if

19  any, may be included in the determination, which verification

20  of income shall be required, which categories of persons shall

21  be eligible, and any other criteria which may be determined as

22  necessary.

23         (b)  The methodology for determining financial

24  eligibility must be uniform statewide such that any county or

25  the state could determine whether a person is a qualified

26  indigent.

27         Section 6.  Subsection (1) of section 154.309, Florida

28  Statutes, is amended to read:

29         154.309  Certification of county of residence.--

30         (1)  The agency, pursuant to s. 154.3105, shall adopt

31  rules for certification determination procedures which provide

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    Florida Senate - 2000                                  SB 1766
    26-1039-00                                              See HB




  1  criteria to be used for determining a qualified indigent's

  2  county of residence.  Such criteria must include, at a

  3  minimum, how and to what extent residency shall be verified

  4  and how a hospital shall be notified of a patient's

  5  certification or the inability to certify a patient.

  6         Section 7.  Section 381.0408, Florida Statutes, is

  7  repealed.

  8         Section 8.  Section 408.0014, Florida Statutes, is

  9  repealed.

10         Section 9.  Paragraphs (b) and (c) of subsection (2) of

11  section 20.42, Florida Statutes, are amended to read:

12         20.42  Agency for Health Care Administration.--There is

13  created the Agency for Health Care Administration within the

14  Department of Business and Professional Regulation. The agency

15  shall be a separate budget entity, and the director of the

16  agency shall be the agency head for all purposes. The agency

17  shall not be subject to control, supervision, or direction by

18  the Department of Business and Professional Regulation in any

19  manner, including, but not limited to, personnel, purchasing,

20  transactions involving real or personal property, and

21  budgetary matters.

22         (2)  ORGANIZATION OF THE AGENCY.--The agency shall be

23  organized as follows:

24         (b)  The Division of Health Policy and Cost Control,

25  which shall be responsible for health policy, the State Center

26  for Health Statistics, the development of The Florida Health

27  Plan, certificate of need, state and local health planning

28  under s. 408.033, and research and analysis.

29         (c)  The Division of State Health Purchasing shall be

30  responsible for the Medicaid program. The division shall also

31  administer the contracts with the Florida Health Access

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    Florida Senate - 2000                                  SB 1766
    26-1039-00                                              See HB




  1  Corporation program and the Florida Health Care Purchasing

  2  Cooperative and the Florida Healthy Kids Corporation.

  3         Section 10.  Paragraph (h) of subsection (2) of section

  4  409.9117, Florida Statutes, is amended to read:

  5         409.9117  Primary care disproportionate share

  6  program.--

  7         (2)  In the establishment and funding of this program,

  8  the agency shall use the following criteria in addition to

  9  those specified in s. 409.911, payments may not be made to a

10  hospital unless the hospital agrees to:

11         (h)  Work with the Florida Healthy Kids Corporation,

12  the Florida Health Care Purchasing Cooperative, the Florida

13  Health Access Corporation, and business health coalitions, as

14  appropriate, to develop a feasibility study and plan to

15  provide a low-cost comprehensive health insurance plan to

16  persons who reside within the area and who do not have access

17  to such a plan.

18

19  Any hospital that fails to comply with any of the provisions

20  of this subsection, or any other contractual condition, may

21  not receive payments under this section until full compliance

22  is achieved.

23         Section 11.  Sections 408.002, 408.004, 408.005, and

24  408.006, Florida Statutes, are repealed.

25         Section 12.  Paragraph (a) of subsection (4) of section

26  408.061, Florida Statutes, is amended to read:

27         408.061  Data collection; uniform systems of financial

28  reporting; information relating to physician charges;

29  confidentiality of patient records; immunity.--

30         (4)(a)  Within 120 days after the end of its fiscal

31  year, each health care facility shall file with the agency, on

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    Florida Senate - 2000                                  SB 1766
    26-1039-00                                              See HB




  1  forms adopted by the agency and based on the uniform system of

  2  financial reporting, its actual financial experience for that

  3  fiscal year, including expenditures, revenues, and statistical

  4  measures.  Such data may be based on internal financial

  5  reports which are certified to be complete and accurate by the

  6  provider.  However, hospitals' actual financial experience

  7  shall be their audited actual experience. Nursing homes that

  8  do not participate in the Medicare or Medicaid programs shall

  9  also submit audited actual experience. Every nursing home

10  shall submit to the agency, in a format designated by the

11  agency, a statistical profile of the nursing home residents.

12  The agency, in conjunction with the Department of Elderly

13  Affairs and the Department of Health, shall review these

14  statistical profiles and develop recommendations for the types

15  of residents who might more appropriately be placed in their

16  homes or other noninstitutional settings. The agency shall

17  include its findings in the final Florida Health Plan which

18  must be submitted to the Legislature by December 31, 1993.

19  Included in the findings shall be outcome data and cost

20  differential data as part of patient profiles.

21         Section 13.  Subsections (6) and (7) of section 408.15,

22  Florida Statutes, are amended to read:

23         408.15  Powers of the agency.--In addition to the

24  powers granted to the agency elsewhere in this chapter, the

25  agency is authorized to:

26         (6)  Apply for and receive and accept grants, gifts,

27  and other payments, including property and services, from any

28  governmental or other public and private entity or person and

29  make arrangements as to the use of same, including undertaking

30  special studies and other projects related to The Florida

31

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    Florida Senate - 2000                                  SB 1766
    26-1039-00                                              See HB




  1  Health Plan. Funds obtained under this subsection may be used

  2  as matching funds for public or private grants.

  3         (7)  Seek federal statutory changes and any waivers of

  4  federal laws or regulations that will aid in implementing The

  5  Florida Health Plan and related health care reforms.  This may

  6  include seeking amendments to:

  7         (a)  The Employee Retirement and Income Security Act of

  8  1974 to permit greater state regulation of employer insurance

  9  plans.

10         (b)  The Medicaid program to permit alternative

11  organizational alignments, elimination of all program

12  eligibility requirements except income, and a moratorium on

13  further federal mandates.

14         (c)  The Medicare program to seek state administration

15  of benefits, provider payments, or case management of

16  beneficiaries.

17         (d)  Federal tax laws to permit a 100-percent tax

18  deduction for all private health insurance plans, including

19  those of self-employed persons and unincorporated employers,

20  and reform of the flexible sharing account requirements to

21  maximize pretax health care expenditures.

22         (e)  Other federal programs to permit full

23  implementation of The Florida Health Plan and related state

24  health care reforms.

25         Section 14.  Section 408.301, Florida Statutes, is

26  amended to read:

27         408.301  Legislative findings.--The Legislature has

28  found that access to quality, affordable, health care for all

29  Floridians is an important goal for the state.  The

30  Legislature has charged the Agency for Health Care

31  Administration with the responsibility of developing the

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    Florida Senate - 2000                                  SB 1766
    26-1039-00                                              See HB




  1  Florida Health Plan for assuring access to health care for all

  2  Floridians. At the same time, The Legislature recognizes that

  3  there are Floridians with special health care and social needs

  4  which require particular attention. The people served by the

  5  Department of Children and Family Services and the Department

  6  of Health are examples of citizens with special needs.  The

  7  Legislature further recognizes that the Medicaid program is an

  8  intricate part of the service delivery system for the special

  9  needs citizens served by or through the Department of Children

10  and Family Services and the Department of Health.  The Agency

11  for Health Care Administration is not a service provider and

12  does not develop or direct programs for the special needs

13  citizens served by or through the Department of Children and

14  Family Services and the Department of Health. Therefore, it is

15  the intent of the Legislature that the Agency for Health Care

16  Administration work closely with the Department of Children

17  and Family Services and the Department of Health in developing

18  plans for assuring access to all Floridians in order to assure

19  that the needs of special citizens are met.

20         Section 15.  Paragraph (b) of subsection (5) of section

21  408.704, Florida Statutes, is amended to read:

22         408.704  Agency duties and responsibilities related to

23  community health purchasing alliances.--The agency shall

24  assist in developing a statewide system of community health

25  purchasing alliances.  To this end, the agency is responsible

26  for:

27         (5)  Establishing a data system for accountable health

28  partnerships.

29         (b)  The advisory data committee shall issue a report

30  and recommendations on each of the following subjects as each

31  is completed.  A final report covering all subjects must be

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    Florida Senate - 2000                                  SB 1766
    26-1039-00                                              See HB




  1  included in the final Florida Health Plan to be submitted to

  2  the Legislature on December 31, 1993.  The report shall

  3  include recommendations regarding:

  4         1.  Types of data to be collected.  Careful

  5  consideration shall be given to other data collection projects

  6  and standards for electronic data interchanges already in

  7  process in this state and nationally, to evaluating and

  8  recommending the feasibility and cost-effectiveness of various

  9  data collection activities, and to ensuring that data

10  reporting is necessary to support the evaluation of providers

11  with respect to cost containment, access, quality, control of

12  expensive technologies, and customer satisfaction analysis.

13  Data elements to be collected from providers include prices,

14  utilization, patient outcomes, quality, and patient

15  satisfaction.  The completion of this task is the first

16  priority of the advisory data committee. The agency shall

17  begin implementing these data collection activities

18  immediately upon receipt of the recommendations, but no later

19  than January 1, 1994.  The data shall be submitted by

20  hospitals, other licensed health care facilities, pharmacists,

21  and group practices as defined in s. 455.654(3)(f).

22         2.  A standard data set, a standard cost-effective

23  format for collecting the data, and a standard methodology for

24  reporting the data to the agency, or its designee, and to the

25  alliances.  The reporting mechanisms must be designed to

26  minimize the administrative burden and cost to health care

27  providers and carriers.  A methodology shall be developed for

28  aggregating data in a standardized format for making

29  comparisons between accountable health partnerships which

30  takes advantage of national models and activities.

31

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    Florida Senate - 2000                                  SB 1766
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  1         3.  Methods by which the agency should collect,

  2  process, analyze, and distribute the data.

  3         4.  Standards for data interpretation.  The advisory

  4  data committee shall actively solicit broad input from the

  5  provider community, carriers, the business community, and the

  6  general public.

  7         5.  Structuring the data collection process to:

  8         a.  Incorporate safeguards to ensure that the health

  9  care services utilization data collected is reviewed by

10  experienced, practicing physicians licensed to practice

11  medicine in this state;

12         b.  Require that carrier customer satisfaction data

13  conclusions are validated by the agency;

14         c.  Protect the confidentiality of medical information

15  to protect the patient's identity and to protect the privacy

16  of individual physicians and patients.  Proprietary data

17  submitted by insurers, providers, and purchasers are

18  confidential pursuant to s. 408.061; and

19         d.  Afford all interested professional medical and

20  hospital associations and carriers a minimum of 60 days to

21  review and comment before data is released to the public.

22         6.  Developing a data collection implementation

23  schedule, based on the data collection capabilities of

24  carriers and providers.

25         Section 16.  Section 408.01, Florida Statutes, is

26  repealed.

27         Section 17.  Subsection (9) of section 408.02, Florida

28  Statutes, is repealed.

29         Section 18.  Paragraph (g) of subsection (1) of section

30  408.062, Florida Statutes, is repealed.

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    Florida Senate - 2000                                  SB 1766
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  1         Section 19.  Section 408.7071, Florida Statutes, is

  2  amended to read:

  3         408.7071  Standardized claim form.--

  4         (1)  The Agency for Health Care Administration shall

  5  develop a standardized claim claims form to be used by

  6  insurers and health care providers licensed in this state.

  7         (2)  In order to develop the standardized claim form,

  8  the agency shall appoint a 15-person committee.  The committee

  9  shall consist of:

10         (a)  The director of the Agency for Health Care

11  Administration, or the director's designee.

12         (b)  The Insurance Commissioner, or the commissioner's

13  designee.

14         (c)  Two representatives of hospitals.

15         (d)  Five representatives of physicians: two licensed

16  under chapter 458, one licensed under chapter 459, one

17  licensed under chapter 460, and one licensed under chapter

18  461.

19         (e)  Two representatives of health insurers.

20         (f)  Two representatives of health maintenance

21  organizations.

22         (g)  Two representatives of consumers.

23         (3)  The committee shall issue a draft of the

24  standardized claims form to the Agency for Health Care

25  Administration by October 1, 1993.  The agency may return the

26  form to the committee for modification on a schedule that

27  allows the agency to include the standardized claim form in

28  the final Florida Health Plan, which must be submitted to the

29  Legislature by December 1, 1993.

30

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    Florida Senate - 2000                                  SB 1766
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  1         Section 20.  Paragraph (c) of subsection (12) and

  2  subsection (22) of section 409.908, Florida Statutes, are

  3  repealed.

  4         Section 21.  Section 514.081, Florida Statutes, is

  5  repealed.

  6         Section 22.  Section 636.045, Florida Statutes, is

  7  amended to read:

  8         636.045  Minimum surplus requirements.--

  9         (1)  Except as provided in subsection (2), Each prepaid

10  limited health service organization must at all times maintain

11  a minimum surplus in an amount which is the greater of

12  $150,000 or 10 percent of total liabilities. Any prepaid

13  limited health service organization which had a valid

14  certificate of authority issued pursuant to part I, part II,

15  or part III of chapter 637, or chapter 638, before October 1,

16  1993, must maintain the surplus required on September 30,

17  1993, until the following dates, and then shall increase its

18  surplus as follows:

19

20  Date                                                    Amount

21  January 1, 1994.................................The greater of

22                                           $100,000 or 6 percent

23                                           of total liabilities,

24                                           whichever is greater.

25  January 1, 1995.................................The greater of

26                                           $125,000 or 8 percent

27                                           of total liabilities,

28                                           whichever is greater.

29  January 1, 1996.................................The greater of

30                                          $150,000 or 10 percent

31                                           of total liabilities,

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  1                                           whichever is greater.

  2

  3         (2)  The department may not issue a certificate of

  4  authority on or after October 1, 1993, unless the prepaid

  5  limited health service organization has a minimum surplus in

  6  an amount of $150,000 or 10 percent of liabilities, whichever

  7  is the greater amount.

  8         Section 23.  Section 859.03, Florida Statutes, is

  9  repealed.

10         Section 24.  Section 859.05, Florida Statutes, is

11  repealed.

12         Section 25.  Section 35 of chapter 93-129, Laws of

13  Florida, is repealed.

14         Section 26.  Section 19 of chapter 96-403, Laws of

15  Florida, is repealed.

16         Section 27.  Section 3 of chapter 98-21, Laws of

17  Florida, is repealed.

18         Section 28.  Section 1 of chapter 98-305, Laws of

19  Florida, is repealed.

20         Section 29.  Section 4 of chapter 99-214, Laws of

21  Florida, is repealed.

22         Section 30.  Section 6 of chapter 99-393, Laws of

23  Florida, is repealed.

24         Section 31.  Section 192 of chapter 99-397, Laws of

25  Florida, is repealed.

26         Section 32.  The proviso language following Specific

27  Appropriation 224 of chapter 99-226, Laws of Florida, is

28  amended to read:

29

30  224  SALARIES AND BENEFITS      POSITIONS    884

31        FROM GENERAL REVENUE FUND........  12,856,783

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    Florida Senate - 2000                                  SB 1766
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  1        FROM ADMINISTRATIVE TRUST FUND........        22,992,867

  2        FROM GRANTS AND DONATIONS TRUST FUND........     187,973

  3

  4         From the funds in Specific Appropriation 224,

  5         the Agency for Health Care Administration in

  6         conjunction with the Department of Children and

  7         Families shall conduct a feasibility study

  8         related to the development and implementation

  9         of a system to automate patient applications

10         for nursing home care under the Medicaid

11         program.

12

13         The Agency for Health Care Administration and

14         the Department of Children and Families shall

15         evaluate the potential cost effectiveness of

16         conducting the demonstration project, document

17         potential savings to the state and provide a

18         written report to the chairmen of the Senate

19         Budget Committee and the House Fiscal

20         Responsibility Council and to the Governor no

21         later than February 1, 2000.

22

23         From the funds in Specific Appropriation 224

24         and 225B the agency shall provide support for

25         the Medicaid Formulary study panel.

26

27         The Medicaid Formulary study panel is created

28         and shall consist of the following nine

29         members: three members appointed by the

30         Governor to include the Director of the Agency

31         for Health Care Administration; three members

                                  17

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






    Florida Senate - 2000                                  SB 1766
    26-1039-00                                              See HB




  1         appointed by the Speaker of the House of

  2         Representatives to include a Member of the

  3         House of Representatives; and three members

  4         appointed by the President of the Senate, to

  5         include a Member of the Senate. The Governor

  6         shall appoint a chairperson of the panel from

  7         among the panel membership. The panel shall be

  8         placed for administrative purposes within the

  9         Agency for Health Care Administration. Staff

10         support for the panel shall be provided by the

11         Agency for Health Care Administration.

12

13         The panel shall prepare recommendations on the

14         advisability, feasibility and cost

15         effectiveness of implementing an appropriate

16         formulary for the Medicaid program. Included

17         within the recommendations shall be proposals

18         which will ensure quality of care, enhance

19         patient safety, support appropriate

20         utilization, and maximize cost efficiency. In

21         addition, the panel shall when making their

22         recommendations, include studying the pros and

23         cons of an Open Formulary versus a Restricted

24         Formulary, and the impact a formulary will have

25         on the overall Medicaid program.

26

27         In addition, the panel must prepare a plan

28         which must include, but is not limited to, the

29         following specific components: recommended time

30         lines for implementation; an appropriate

31         communication plan to providers and Medicaid

                                  18

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






    Florida Senate - 2000                                  SB 1766
    26-1039-00                                              See HB




  1         beneficiaries; a plan to obtain all required

  2         waivers from the federal government;

  3         identification of cost savings through a

  4         combination of changes in prescription drug

  5         utilization, enhanced patient compliance, and

  6         reduced purchasing costs; development of

  7         appropriate clinical protocols and guidelines;

  8         identification of administrative resources to

  9         support the program; multi-year projections for

10         benchmarks for additional cost savings; and an

11         ongoing evaluation plan that includes cost and

12         quality measures. However, the agency shall not

13         implement a formulary without specific

14         legislative authorization.

15

16         Travel and per diem costs of panel members

17         shall be the responsibility of the appointing

18         agency.

19

20         The panel shall present its report to the

21         Governor, the Speaker of the House of

22         Representatives, and the President of the

23         Senate by no later than January 15, 2000.

24         Section 33.  This act shall take effect upon becoming a

25  law.

26

27

28

29

30

31

                                  19

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






    Florida Senate - 2000                                  SB 1766
    26-1039-00                                              See HB




  1            *****************************************

  2                       LEGISLATIVE SUMMARY

  3
      Repeals various provisions of law that have become
  4    obsolete, have had their effect, have served their
      purpose, or have been impliedly repealed or superseded.
  5    Repeals or deletes provisions relating to county primary
      health care panels; the legal status of county public
  6    health trusts with respect to a repealed provision of law
      relating to the filing of caveats; a work group to
  7    develop rules for the Health Care Responsibility Act; the
      Public Health Partnership Council on Stroke; the Florida
  8    Health Access Corporation Act; the Florida Health Plan;
      the voluntary private health insurance coverage and
  9    insurance cost containment program; a demonstration
      project on the effectiveness of practice parameters with
10    respect to the costs of defensive medicine and
      professional liability insurance; development of an
11    alternative uniform system of financial reporting of
      gross revenues per adjusted admission; development of a
12    standardized claim form for insurers and health care
      providers licensed in this state and to the committee
13    appointed for such purpose; a report on the effect of the
      resource-based relative value scale fee schedule on
14    utilization of Medicaid services; implementation of
      changes in the Medicaid reimbursement methodology for
15    facilities formerly known as ICF/DD facilities; a saving
      clause applicable to provisions governing construction,
16    modification, and operation of public swimming pools and
      bathing facilities; minimum surplus requirements for
17    prepaid limited health service organizations; wrapping
      and labeling requirements applicable to the sale of
18    morphine; a prohibition on the sale or other disposition
      of narcotics except by prescription; a work group on
19    rural health care; a task force on the organization and
      structure of state health programs; a rural hospital
20    redefinition study group; the Prostate Cancer Task Force;
      a school nurse training study group; an advisory group on
21    submission and payment of health claims; and the Medicaid
      Formulary study panel.
22

23

24

25

26

27

28

29

30

31

                                  20