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





                                                   HOUSE AMENDMENT

                                                  Bill No. HB 2167

    Amendment No.     (for drafter's use only)

                            CHAMBER ACTION
              Senate                               House
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 4                                                                

 5                                           ORIGINAL STAMP BELOW

 6

 7

 8

 9

10                                                                

11  Representative(s) Posey and Boyd offered the following:

12

13         Amendment (with title amendment) 

14         On page 17, line 16,

15

16  insert:

17         Section 11.  Paragraph (g) of subsection (3) of section

18  110.123, Florida Statutes, is amended to read:

19         110.123  State group insurance program.--

20         (3)  STATE GROUP INSURANCE PROGRAM.--

21         (g)1.  A person eligible to participate in the state

22  group insurance program may be authorized by rules adopted by

23  the department, in lieu of participating in the state group

24  health insurance plan, to exercise an option to elect

25  membership in a health maintenance organization plan which is

26  under contract with the state in accordance with criteria

27  established by this section and by said rules.  The offer of

28  optional membership in a health maintenance organization plan

29  permitted by this paragraph may be limited or conditioned by

30  rule as may be necessary to meet the requirements of state and

31  federal laws.

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 2167

    Amendment No.     (for drafter's use only)





 1         2.  The department shall contract with health

 2  maintenance organizations seeking to participate in the state

 3  group insurance program through a request for proposal or

 4  other procurement process, as developed by the Department of

 5  Management Services and determined to be appropriate.

 6         a.  The department shall establish a schedule of

 7  minimum benefits for health maintenance organization coverage,

 8  and that schedule shall include: physician services; inpatient

 9  and outpatient hospital services; emergency medical services,

10  including out-of-area emergency coverage; diagnostic

11  laboratory and diagnostic and therapeutic radiologic services;

12  mental health, alcohol, and chemical dependency treatment

13  services meeting the minimum requirements of state and federal

14  law; skilled nursing facilities and services; prescription

15  drugs; and other benefits as may be required by the

16  department.  Additional services may be provided subject to

17  the contract between the department and the HMO.

18         b.  The department may establish uniform deductibles,

19  copayments, or coinsurance schedules for all participating HMO

20  plans.

21         c.  The department may require detailed information

22  from each health maintenance organization participating in the

23  procurement process, including information pertaining to

24  organizational status, experience in providing prepaid health

25  benefits, accessibility of services, financial stability of

26  the plan, quality of management services, accreditation

27  status, quality of medical services, network access and

28  adequacy, performance measurement, ability to meet the

29  department's reporting requirements, and the actuarial basis

30  of the proposed rates and other data determined by the

31  director to be necessary for the evaluation and selection of

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 2167

    Amendment No.     (for drafter's use only)





 1  health maintenance organization plans and negotiation of

 2  appropriate rates for these plans.  Upon receipt of proposals

 3  by health maintenance organization plans and the evaluation of

 4  those proposals, the department may enter into negotiations

 5  with all of the plans or a subset of the plans, as the

 6  department determines appropriate. Nothing shall preclude the

 7  department from negotiating regional or statewide contracts

 8  with health maintenance organization plans when this is

 9  cost-effective and when the department determines that the

10  plan offers high value to enrollees.

11         d.  The department may limit the number of HMOs that it

12  contracts with in each service area based on the nature of the

13  bids the department receives, the number of state employees in

14  the service area, or any unique geographical characteristics

15  of the service area. The department shall establish by rule

16  service areas throughout the state.

17         e.  All persons participating in the state group

18  insurance program who are required to contribute towards a

19  total state group health premium shall be subject to the same

20  dollar contribution regardless of whether the enrollee enrolls

21  in the state group health insurance plan or in an HMO plan.

22         3.  The division is authorized to negotiate and to

23  contract with specialty psychiatric hospitals for mental

24  health benefits, on a regional basis, for alcohol, drug abuse,

25  and mental and nervous disorders. The division may establish,

26  subject to the approval of the Legislature pursuant to

27  subsection (5), any such regional plan upon completion of an

28  actuarial study to determine any impact on plan benefits and

29  premiums.

30         4.  In addition to contracting pursuant to subparagraph

31  2., the department shall enter into contract with any HMO to

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 2167

    Amendment No.     (for drafter's use only)





 1  participate in the state group insurance program which:

 2         a.  Serves greater than 5,000 recipients on a prepaid

 3  basis under the Medicaid program;

 4         b.  Does not currently meet the 25 percent

 5  non-Medicare/non-Medicaid enrollment composition requirement

 6  established by the Department of Health excluding participants

 7  enrolled in the state group insurance program;

 8         c.  Meets the minimum benefit package and copayments

 9  and deductibles contained in sub-subparagraphs 2.a. and b.;

10         d.  Is willing to participate in the state group

11  insurance program at a cost of premiums that is not greater

12  than 95 percent of the cost of HMO premiums accepted by the

13  department in each service area; and

14         e.  Meets the minimum surplus requirements of s.

15  641.225.

16

17  The department is authorized to contract with HMOs that meet

18  the requirements of sub-subparagraphs a. through d. prior to

19  the open enrollment period for state employees.  The

20  department is not required to renew the contract with the HMOs

21  as set forth in this paragraph more than twice. Thereafter,

22  the HMOs shall be eligible to participate in the state group

23  insurance program only through the request for proposal

24  process described in subparagraph 2.

25         5.  All enrollees in the state group health insurance

26  plan or any health maintenance organization plan shall have

27  the option of changing to any other health plan which is

28  offered by the state within any open enrollment period

29  designated by the department. Open enrollment shall be held at

30  least once each calendar year.

31         6.  When a contract between a treating provider and the

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 2167

    Amendment No.     (for drafter's use only)





 1  state-contracted health maintenance organization is terminated

 2  for any reason other than for cause, each party shall allow

 3  any enrollee for whom treatment was active to continue

 4  coverage and care when medically necessary, through completion

 5  of treatment of a condition for which the enrollee was

 6  receiving care at the time of the termination, until the

 7  enrollee selects another treating provider, or until the next

 8  open enrollment period offered, whichever is longer, but no

 9  longer than 6 months after termination of the contract. Each

10  party to the terminated contract shall allow an enrollee who

11  has initiated a course of prenatal care, regardless of the

12  trimester in which care was initiated, to continue care and

13  coverage until completion of postpartum care. This does not

14  prevent a provider from refusing to continue to provide care

15  to an enrollee who is abusive, noncompliant, or in arrears in

16  payments for services provided. For care continued under this

17  subparagraph, the program and the provider shall continue to

18  be bound by the terms of the terminated contract. Changes made

19  within 30 days before termination of a contract are effective

20  only if agreed to by both parties.

21         7.  Any HMO participating in the state group insurance

22  program shall submit health care utilization and cost data to

23  the department, in such form and in such manner as the

24  division shall require, as a condition of participating in the

25  program.  The department shall enter into negotiations with

26  its contracting HMOs to determine the nature and scope of the

27  data submission and the final requirements, format, penalties

28  associated with noncompliance, and timetables for submission.

29  These determinations shall be adopted by rule.

30         8.  The department may establish and direct, with

31  respect to collective bargaining issues, a comprehensive

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 2167

    Amendment No.     (for drafter's use only)





 1  package of insurance benefits that may include supplemental

 2  health and life coverage, dental care, long-term care, vision

 3  care, and other benefits it determines necessary to enable

 4  state employees to select from among benefit options that best

 5  suit their individual and family needs.

 6         a.  Based upon a desired benefit package, the

 7  department shall issue a request for proposal for health

 8  insurance providers interested in participating in the state

 9  group insurance program, and the division shall issue a

10  request for proposal for insurance providers interested in

11  participating in the non-health-related components of the

12  state group insurance program. Upon receipt of all proposals,

13  the department may enter into contract negotiations with

14  insurance providers submitting bids or negotiate a specially

15  designed benefit package. Insurance providers offering or

16  providing supplemental coverage as of May 30, 1991, which

17  qualify for pretax benefit treatment pursuant to s. 125 of the

18  Internal Revenue Code of 1986, with 5,500 or more state

19  employees currently enrolled may be included by the department

20  in the supplemental insurance benefit plan established by the

21  department without participating in a request for proposal,

22  submitting bids, negotiating contracts, or negotiating a

23  specially designed benefit package. These contracts shall

24  provide state employees with the most cost-effective and

25  comprehensive coverage available; however, no state or agency

26  funds shall be contributed toward the cost of any part of the

27  premium of such supplemental benefit plans. With respect to

28  dental coverage, the division shall include in any

29  solicitation or contract for any state group dental program

30  made after July 1, 2001, a comprehensive indemnity dental plan

31  option which offers enrollees a completely unrestricted choice

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                                                   HOUSE AMENDMENT

                                                  Bill No. HB 2167

    Amendment No.     (for drafter's use only)





 1  of dentists. If a dental plan is endorsed, or in some manner

 2  recognized as the preferred product, such plan shall include a

 3  comprehensive indemnity dental plan option which provides

 4  enrollees with a completely unrestricted choice of dentists.

 5         b.  Pursuant to the applicable provisions of s.

 6  110.161, and s. 125 of the Internal Revenue Code of 1986, the

 7  department shall enroll in the pretax benefit program those

 8  state employees who voluntarily elect coverage in any of the

 9  supplemental insurance benefit plans as provided by

10  sub-subparagraph a.

11         c.  Nothing herein contained shall be construed to

12  prohibit insurance providers from continuing to provide or

13  offer supplemental benefit coverage to state employees as

14  provided under existing agency plans.

15         Section 12.  This act shall take effect July 1, 2001.

16

17

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

19  And the title is amended as follows:

20         On page 2, line 15, after the semicolon

21  remove from the title of the bill:

22

23  and insert in lieu thereof:

24         amending s. 110.123, F.S.; requiring

25         solicitations or contracts or a state group

26         dental program to include a comprehensive

27         indemnity dental plan option providing

28         enrollees an unrestricted access to dentists;

29

30

31

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