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





                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1905

    Amendment No. 1 (for drafter's use only)

                            CHAMBER ACTION
              Senate                               House
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 4                                                                

 5                                           ORIGINAL STAMP BELOW

 6

 7

 8

 9

10                                                                

11  The Committee on Health Care Services offered the following:

12

13         Amendment (with title amendment) 

14  Remove from the bill:  Everything after the enacting clause

15

16  and insert in lieu thereof:

17         Section 1.  Section 381.0403, Florida Statutes, is

18  amended to read:

19         381.0403  The Community Hospital Education Act.--

20         (1)  SHORT TITLE.--This section shall be known and

21  cited as "The Community Hospital Education Act."

22         (2)  LEGISLATIVE INTENT.--

23         (a)  It is the intent of the Legislature that health

24  care services for the citizens of this state be upgraded and

25  that a program for continuing these services be maintained

26  through a plan for community medical education.  The program

27  is intended to provide additional outpatient and inpatient

28  services, a continuing supply of highly trained physicians,

29  and graduate medical education.

30         (b)  The Legislature further acknowledges the critical

31  need for increased numbers of primary care family physicians

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1905

    Amendment No. 1 (for drafter's use only)





 1  to provide the necessary current and projected health and

 2  medical services.  In order to meet both present and

 3  anticipated needs, the Legislature supports an expansion in

 4  the number of family practice residency positions.  The

 5  Legislature intends that the funding for graduate education in

 6  family practice be maintained and that funding for all primary

 7  care specialties be provided at a minimum of $10,000 per

 8  resident per year.  Should funding for this act remain

 9  constant or be reduced, it is intended that all programs

10  funded by this act be maintained or reduced proportionately.

11         (3)  PROGRAM FOR COMMUNITY HOSPITAL EDUCATION; STATE

12  AND LOCAL PLANNING.--

13         (a)  There is established under the Board of Regents a

14  program for statewide graduate medical education.  It is

15  intended that continuing graduate medical education programs

16  for interns and residents be established on a statewide basis.

17  The program shall provide financial support for primary care

18  specialty interns and residents based on policies recommended

19  and approved by the Community Hospital Education Council,

20  herein established, and the Board of Regents. Only those

21  programs with at least 3 residents or interns in each year of

22  the training program are qualified to apply for financial

23  support. Programs with fewer than 3 residents or interns per

24  training year are qualified to apply for financial support,

25  but only if the appropriate accrediting entity for the

26  particular specialty has approved the program for fewer

27  positions. When feasible and to the extent allowed through the

28  General Appropriations Act, state funds shall be used to

29  generate federal matching funds under Medicaid, or other

30  federal programs, and the resulting combined state and federal

31  funds shall be allocated to participating hospitals for the

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1905

    Amendment No. 1 (for drafter's use only)





 1  support of graduate medical education, and for administrative

 2  costs associated with the production of the annual report as

 3  specified in section 5 of this act.

 4         (b)  For the purposes of this section, primary care

 5  specialties include emergency medicine, family practice,

 6  internal medicine, pediatrics, psychiatry,

 7  obstetrics/gynecology, and combined pediatrics and internal

 8  medicine, and other primary care specialties as may be

 9  included by the council and Board of Regents.

10         (c)(b)  Medical institutions throughout the state may

11  apply to the Community Hospital Education Council for

12  grants-in-aid for financial support of their approved

13  programs.  Recommendations for funding of approved programs

14  shall be forwarded to the Board of Regents.

15         (d)(c)  The program shall provide a plan for community

16  clinical teaching and training with the cooperation of the

17  medical profession, hospitals, and clinics.  The plan shall

18  also include formal teaching opportunities for intern and

19  resident training.  In addition, the plan shall establish an

20  off-campus medical faculty with university faculty review to

21  be located throughout the state in local communities.

22         (4)  PROGRAM FOR GRADUATE MEDICAL EDUCATION

23  INNOVATIONS.--

24         (a)  There is established under the Board of Regents a

25  program for fostering graduate medical education innovations.

26  Funds appropriated annually by the Legislature for this

27  purpose shall be distributed to participating hospitals or

28  consortia of participating hospitals and Florida medical

29  schools on a competitive grant or formula basis to achieve

30  state health care workforce policy objectives, including but

31  not limited to:

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1905

    Amendment No. 1 (for drafter's use only)





 1         1.  Increasing the number of residents in primary care

 2  and other high demand specialties or fellowships;

 3         2.  Enhancing retention of primary care physicians in

 4  Florida practice;

 5         3.  Promoting practice in medically under-served areas

 6  of the state; 

 7         4.  Encouraging racial and ethnic diversity within the

 8  state's physician workforce; and

 9         5.  Encouraging increased production of geriatricians.

10         (b)  Participating hospitals or consortia of

11  participating hospitals and Florida medical schools may apply

12  to the Community Hospital Education Council for funding under

13  this innovations program. Innovations program funding shall

14  provide funding based on policies recommended and approved by

15  the Community Hospital Education Council and the Board of

16  Regents.

17         (c)  Participating hospitals or consortia of

18  participating hospitals and Florida medical schools awarded an

19  innovations grant shall provide the Community Hospital

20  Education Council and Board of Regents with an annual report

21  on their project.

22         (5)(4)  FAMILY PRACTICE RESIDENCIES.--In addition to

23  the programs established in subsection (3), the Community

24  Hospital Education Council and the Board of Regents shall

25  establish an ongoing statewide program of family practice

26  residencies.  The administration of this program shall be in

27  the manner described in this section.

28         (6)(5)  COUNCIL AND DIRECTOR.--

29         (a)  There is established the Community Hospital

30  Education Council, hereinafter referred to as the council,

31  which shall consist of eleven members, as follows:

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1905

    Amendment No. 1 (for drafter's use only)





 1         1.  Seven members must be program directors of

 2  accredited graduate medical education programs or practicing

 3  physicians who have faculty appointments in accredited

 4  graduate medical education programs.  Six of these members

 5  must be board certified or board eligible in family practice,

 6  internal medicine, pediatrics, emergency medicine,

 7  obstetrics-gynecology, and psychiatry, respectively, and

 8  licensed pursuant to chapter 458. No more than one of these

 9  members may be appointed from any one specialty.  One member

10  must be licensed pursuant to chapter 459.

11         2.  One member must be a representative of the

12  administration of a hospital with an approved community

13  hospital medical education program;

14         3.  One member must be the dean of a medical school in

15  this state; and

16         4.  Two members must be consumer representatives.

17

18  All of the members shall be appointed by the Governor for

19  terms of 4 years each.

20         (b)  Council membership shall cease when a member's

21  representative status no longer exists.  Members of similar

22  representative status shall be appointed to replace retiring

23  or resigning members of the council.

24         (c)  The Chancellor of the State University System

25  shall designate an administrator to serve as staff director.

26  The council shall elect a chair from among its membership.

27  Such other personnel as may be necessary to carry out the

28  program shall be employed as authorized by the Board of

29  Regents.

30         (7)(6)  BOARD OF REGENTS; STANDARDS.--

31         (a)  The Board of Regents, with recommendations from

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1905

    Amendment No. 1 (for drafter's use only)





 1  the council, shall establish standards and policies for the

 2  use and expenditure of graduate medical education funds

 3  appropriated pursuant to subsection (8) (7) for a program of

 4  community hospital education.  The board shall establish

 5  requirements for hospitals to be qualified for participation

 6  in the program which shall include, but not be limited to:

 7         1.  Submission of an educational plan and a training

 8  schedule.

 9         2.  A determination by the council to ascertain that

10  each portion of the program of the hospital provides a high

11  degree of academic excellence and is accredited by the

12  Accreditation Council for Graduate Medical Education of the

13  American Medical Association or is accredited by the American

14  Osteopathic Association.

15         3.  Supervision of the educational program of the

16  hospital by a physician who is not the hospital administrator.

17         (b)  The Board of Regents shall periodically review the

18  educational program provided by a participating hospital to

19  assure that the program includes a reasonable amount of both

20  formal and practical training and that the formal sessions are

21  presented as scheduled in the plan submitted by each hospital.

22         (c)  In years that funds are transferred to the Agency

23  for Health Care Administration, the Board of Regents shall

24  certify to the Agency for Health Care Administration on a

25  quarterly basis the number of primary care specialty residents

26  and interns at each of the participating hospitals for which

27  the Community Hospital Education Council and the board

28  recommends funding.

29         (8)(7)  MATCHING FUNDS.--State funds shall be used to

30  match funds from any local governmental or hospital source.

31  The state shall provide up to 50 percent of the funds, and the

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1905

    Amendment No. 1 (for drafter's use only)





 1  community hospital medical education program shall provide the

 2  remainder.  However, except for fixed capital outlay, the

 3  provisions of this subsection shall not apply to any program

 4  authorized under the provisions of subsection (5)(4) for the

 5  first 3 years after such program is in operation.

 6         Section 2.  Subsection (44) of section 408.07, Florida

 7  Statutes, is amended to read:

 8         408.07  Definitions.--As used in this chapter, with the

 9  exception of ss. 408.031-408.045, the term:

10         (44)  "Teaching hospital" means any Florida hospital

11  officially formally affiliated with an accredited Florida

12  medical school which exhibits activity in the area of graduate

13  medical education as reflected by at least seven different

14  graduate medical education programs accredited by the

15  Accreditation Council for Graduate Medical Education resident

16  physician specialties and the presence of 100 or more

17  full-time equivalent resident physicians. The Director of the

18  Agency for Health Care Administration shall be responsible for

19  determining which hospitals meet this definition.

20         Section 3.  Subsection (6) of section 409.905, Florida

21  Statutes, is amended to read:

22         409.905  Mandatory Medicaid services.--The agency may

23  make payments for the following services, which are required

24  of the state by Title XIX of the Social Security Act,

25  furnished by Medicaid providers to recipients who are

26  determined to be eligible on the dates on which the services

27  were provided.  Any service under this section shall be

28  provided only when medically necessary and in accordance with

29  state and federal law. Nothing in this section shall be

30  construed to prevent or limit the agency from adjusting fees,

31  reimbursement rates, lengths of stay, number of visits, number

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1905

    Amendment No. 1 (for drafter's use only)





 1  of services, or any other adjustments necessary to comply with

 2  the availability of moneys and any limitations or directions

 3  provided for in the General Appropriations Act or chapter 216.

 4         (6)  HOSPITAL OUTPATIENT SERVICES.--The agency shall

 5  pay for preventive, diagnostic, therapeutic, or palliative

 6  care and other services provided to a recipient in the

 7  outpatient portion of a hospital licensed under part I of

 8  chapter 395, and provided under the direction of a licensed

 9  physician or licensed dentist, except that payment for such

10  care and services is limited to $1,500 $1,000 per state fiscal

11  year per recipient, unless an exception has been made by the

12  agency, and with the exception of a Medicaid recipient under

13  age 21, in which case the only limitation is medical

14  necessity.

15         Section 4.  Subsection (1) of section 409.908, Florida

16  Statutes, is amended to read:

17         409.908  Reimbursement of Medicaid providers.--Subject

18  to specific appropriations, the agency shall reimburse

19  Medicaid providers, in accordance with state and federal law,

20  according to methodologies set forth in the rules of the

21  agency and in policy manuals and handbooks incorporated by

22  reference therein.  These methodologies may include fee

23  schedules, reimbursement methods based on cost reporting,

24  negotiated fees, competitive bidding pursuant to s. 287.057,

25  and other mechanisms the agency considers efficient and

26  effective for purchasing services or goods on behalf of

27  recipients.  Payment for Medicaid compensable services made on

28  behalf of Medicaid eligible persons is subject to the

29  availability of moneys and any limitations or directions

30  provided for in the General Appropriations Act or chapter 216.

31  Further, nothing in this section shall be construed to prevent

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1905

    Amendment No. 1 (for drafter's use only)





 1  or limit the agency from adjusting fees, reimbursement rates,

 2  lengths of stay, number of visits, or number of services, or

 3  making any other adjustments necessary to comply with the

 4  availability of moneys and any limitations or directions

 5  provided for in the General Appropriations Act, provided the

 6  adjustment is consistent with legislative intent.

 7         (1)  Reimbursement to hospitals licensed under part I

 8  of chapter 395 must be made prospectively or on the basis of

 9  negotiation.

10         (a)  Reimbursement for inpatient care is limited as

11  provided for in s. 409.905(5), except for:.

12         1.  The raising of rate reimbursement caps, subject to

13  certification from the Board of Regents that the hospital has

14  complied with s. 381.0403, excluding rural hospitals.

15         2.  Recognition of the costs of graduate medical

16  education.

17         3.  Other methodologies recognized in the General

18  Appropriations Act.

19

20  The agency is authorized to receive funds from state entities,

21  including, but limited to, the Board of Regents, local

22  governments, and other local political subdivisions, for the

23  purpose of making special exception payments, including

24  federal matching funds, through the Medicaid inpatient

25  reimbursement methodologies. Funds received from state

26  entities or local governments for this purpose shall be

27  separately accounted for and shall not be commingled with

28  other state or local funds in any manner. Notwithstanding this

29  section and s. 409.915, counties are exempt from contributing

30  toward the cost of the special exception reimbursement for

31  hospitals serving a disproportionate share of low-income

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1905

    Amendment No. 1 (for drafter's use only)





 1  persons and providing graduate medical education.

 2         (b)  Reimbursement for hospital outpatient care is

 3  limited to $1,500 $1,000 per state fiscal year per recipient,

 4  except for:

 5         1.  Such care provided to a Medicaid recipient under

 6  age 21, in which case the only limitation is medical

 7  necessity.;

 8         2.  Renal dialysis services.; and

 9         3.  Other exceptions made by the agency.

10

11  The agency is authorized to receive funds from state entities,

12  including, but not limited to, the Board of Regents, local

13  governments, and other local political subdivisions, for the

14  purpose of making payments, including federal matching funds,

15  through the Medicaid outpatient reimbursement methodologies.

16  Funds received from state entities and local governments for

17  this purpose shall be separately accounted for and shall not

18  be commingled with other state or local funds in any manner.

19         (c)(b)  Hospitals that provide services to a

20  disproportionate share of low-income Medicaid recipients, or

21  that participate in the regional perinatal intensive care

22  center program under chapter 383, or that participate in the

23  statutory teaching hospital disproportionate share program, or

24  that participate in the extraordinary disproportionate share

25  program, may receive additional reimbursement. The total

26  amount of payment for disproportionate share hospitals shall

27  be fixed by the General Appropriations Act. The computation of

28  these payments must be made in compliance with all federal

29  regulations and the methodologies described in ss. 409.911,

30  409.9112, and 409.9113.

31         (d)(c)  The agency is authorized to limit inflationary

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1905

    Amendment No. 1 (for drafter's use only)





 1  increases for outpatient hospital services as directed by the

 2  General Appropriations Act.

 3         Section 5.  The Board of Regents, the Executive Office

 4  of the Governor, the Department of Health, and the Agency for

 5  Health Care Administration shall collaborate to establish a

 6  committee that shall produce an annual report on graduate

 7  medical education. To the maximum extent feasible, the

 8  committee shall have the same membership as the Graduate

 9  Medical Education Study Committee, established by proviso

10  accompanying Item #191 of the fiscal year 1999-2000 General

11  Appropriations Act. The report shall be provided to the

12  Governor, President of Senate, and Speaker of the House of

13  Representatives by January 15 of each year. Committee members

14  shall serve without compensation. From the funds provided in

15  section 381.0403(3), Florida Statutes, the committee is

16  authorized to expend a maximum of $75,000 per year to provide

17  for administrative costs and contractual services. The report

18  shall address the following topics:

19         (1)  The role of residents and medical faculty in the

20  provision of health care.

21         (2)  The relationship of graduate medical education to

22  the state's physician workforce.

23         (3)  The costs of training medical residents for

24  hospitals, medical schools, teaching hospitals, including all

25  hospital-medical affiliations, practice plans at all of the

26  medical schools, and municipalities.

27         (4)  The availability and adequacy of all sources of

28  revenue to support graduate medical education and recommend

29  alternative sources of funding for graduate medical education.

30         (5)  The use of state and federal appropriated funds

31  for graduate medical education by hospitals receiving such

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1905

    Amendment No. 1 (for drafter's use only)





 1  funds.

 2         Section 6.  This act shall take effect July 1, 2000.

 3

 4

 5  ================ T I T L E   A M E N D M E N T ===============

 6  And the title is amended as follows:

 7         On page 1, lines 2-29,

 8  remove from the title of the bill:  all of said lines

 9

10  and insert in lieu thereof:

11         An act relating to health care; amending s.

12         381.0403, F.S.; placing an emphasis on primary

13         care physicians rather than family physicians;

14         modifying the provisions relating to the

15         funding of graduate medical education; defining

16         primary care specialties; establishing a

17         program for graduate medical education

18         innovations; creating a process regarding the

19         release of funds; amending s. 408.07, F.S.;

20         modifying the definition of "teaching

21         hospital"; amending s. 409.905, F.S.;

22         increasing the Medicaid reimbursement

23         limitation for certain hospital outpatient

24         services; amending s. 409.908, F.S.; providing

25         exceptions to Medicaid reimbursement

26         limitations for certain hospital inpatient

27         care; authorizing the agency to receive certain

28         funds for such exceptional reimbursements;

29         providing an exemption from county contribution

30         requirements; increasing the Medicaid

31         reimbursement limitation for certain hospital

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 1905

    Amendment No. 1 (for drafter's use only)





 1         outpatient care; authorizing the agency to

 2         receive certain funds for such outpatient care;

 3         removing authority for additional reimbursement

 4         for hospitals participating in the

 5         extraordinary disproportionate share program;

 6         providing an exemption from county contribution

 7         requirements;  requiring an annual report

 8         addressing specific topics; providing a

 9         committee for report purposes; providing a

10         report due date; providing an effective date.

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