CODING: Words stricken are deletions; words underlined are additions.
SENATE AMENDMENT
Bill No. CS for SB 420
Amendment No.
CHAMBER ACTION
Senate House
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11 Senator Saunders moved the following amendment:
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13 Senate Amendment (with title amendment)
14 On page 3, line 5,
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16 insert:
17 Section 1. Subsection (2) of section 395.701, Florida
18 Statutes, is amended to read:
19 395.701 Annual assessments on net operating revenues
20 to fund public medical assistance; administrative fines for
21 failure to pay assessments when due; exemption.--
22 (2)(a) There is imposed upon each hospital an
23 assessment in an amount equal to 1.5 percent of the annual net
24 operating revenue for inpatient services for each hospital,
25 such revenue to be determined by the agency, based on the
26 actual experience of the hospital as reported to the agency.
27 Within 6 months after the end of each hospital fiscal year,
28 the agency shall certify the amount of the assessment for each
29 hospital. The assessment shall be payable to and collected by
30 the agency in equal quarterly amounts, on or before the first
31 day of each calendar quarter, beginning with the first full
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1 calendar quarter that occurs after the agency certifies the
2 amount of the assessment for each hospital. All moneys
3 collected pursuant to this paragraph subsection shall be
4 deposited into the Public Medical Assistance Trust Fund.
5 (b) There is imposed upon each hospital an assessment
6 in an amount equal to 1.0 percent of the annual net operating
7 revenue for outpatient services for each hospital, such
8 revenue to be determined by the agency, based on the actual
9 experience of the hospital as reported to the agency. Within 6
10 months after the end of each hospital fiscal year, the agency
11 shall certify the amount of the assessment for each hospital.
12 The assessment shall be payable to and collected by the agency
13 in equal quarterly amounts, on or before the first day of each
14 calendar quarter, beginning with the first full calendar
15 quarter that occurs after the agency certifies the amount of
16 the assessment for each hospital. All moneys collected
17 pursuant to this paragraph shall be deposited into the Public
18 Medical Assistance Trust Fund.
19 Section 2. Paragraph (a) of subsection (2) of section
20 395.7015, Florida Statutes, is amended to read:
21 395.7015 Annual assessment on health care entities.--
22 (2) There is imposed an annual assessment against
23 certain health care entities as described in this section:
24 (a) The assessment shall be equal to 1.0 1.5 percent
25 of the annual net operating revenues of health care entities.
26 The assessment shall be payable to and collected by the
27 agency. Assessments shall be based on annual net operating
28 revenues for the entity's most recently completed fiscal year
29 as provided in subsection (3).
30 Section 3. Paragraph (c) of subsection (2) of section
31 408.904, Florida Statutes, is amended to read:
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1 408.904 Benefits.--
2 (2) Covered health services include:
3 (c) Hospital outpatient services. Those services
4 provided to a member in the outpatient portion of a hospital
5 licensed under part I of chapter 395, up to a limit of $1,500
6 $1,000 per calendar year per member, that are preventive,
7 diagnostic, therapeutic, or palliative.
8 Section 4. Subsection (6) of section 409.905, Florida
9 Statutes, is amended to read:
10 409.905 Mandatory Medicaid services.--The agency may
11 make payments for the following services, which are required
12 of the state by Title XIX of the Social Security Act,
13 furnished by Medicaid providers to recipients who are
14 determined to be eligible on the dates on which the services
15 were provided. Any service under this section shall be
16 provided only when medically necessary and in accordance with
17 state and federal law. Nothing in this section shall be
18 construed to prevent or limit the agency from adjusting fees,
19 reimbursement rates, lengths of stay, number of visits, number
20 of services, or any other adjustments necessary to comply with
21 the availability of moneys and any limitations or directions
22 provided for in the General Appropriations Act or chapter 216.
23 (6) HOSPITAL OUTPATIENT SERVICES.--The agency shall
24 pay for preventive, diagnostic, therapeutic, or palliative
25 care and other services provided to a recipient in the
26 outpatient portion of a hospital licensed under part I of
27 chapter 395, and provided under the direction of a licensed
28 physician or licensed dentist, except that payment for such
29 care and services is limited to $1,500 $1,000 per state fiscal
30 year per recipient, unless an exception has been made by the
31 agency, and with the exception of a Medicaid recipient under
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1 age 21, in which case the only limitation is medical
2 necessity.
3 Section 5. Paragraph (a) of subsection (1) of section
4 409.908, Florida Statutes, is amended to read:
5 409.908 Reimbursement of Medicaid providers.--Subject
6 to specific appropriations, the agency shall reimburse
7 Medicaid providers, in accordance with state and federal law,
8 according to methodologies set forth in the rules of the
9 agency and in policy manuals and handbooks incorporated by
10 reference therein. These methodologies may include fee
11 schedules, reimbursement methods based on cost reporting,
12 negotiated fees, competitive bidding pursuant to s. 287.057,
13 and other mechanisms the agency considers efficient and
14 effective for purchasing services or goods on behalf of
15 recipients. Payment for Medicaid compensable services made on
16 behalf of Medicaid eligible persons is subject to the
17 availability of moneys and any limitations or directions
18 provided for in the General Appropriations Act or chapter 216.
19 Further, nothing in this section shall be construed to prevent
20 or limit the agency from adjusting fees, reimbursement rates,
21 lengths of stay, number of visits, or number of services, or
22 making any other adjustments necessary to comply with the
23 availability of moneys and any limitations or directions
24 provided for in the General Appropriations Act, provided the
25 adjustment is consistent with legislative intent.
26 (1) Reimbursement to hospitals licensed under part I
27 of chapter 395 must be made prospectively or on the basis of
28 negotiation.
29 (a) Reimbursement for inpatient care is limited as
30 provided for in s. 409.905(5). Reimbursement for hospital
31 outpatient care is limited to $1,500 $1,000 per state fiscal
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1 year per recipient, except for:
2 1. Such care provided to a Medicaid recipient under
3 age 21, in which case the only limitation is medical
4 necessity;
5 2. Renal dialysis services; and
6 3. Other exceptions made by the agency.
7 Section 6. Paragraph (e) is added to subsection (3) of
8 section 409.912, Florida Statutes, 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 (e) An entity in Pasco County or Pinellas County which
24 provides in-home physician services to Medicaid recipients
25 having degenerative neurological diseases in order to test the
26 cost-effectiveness of enhanced home-based medical care. The
27 entity providing the services shall be reimbursed on a
28 fee-for-service basis at a rate not less than comparable
29 Medicare reimbursement rates. The agency may apply for waivers
30 of federal regulations necessary to implement such program.
31 This paragraph expires July 1, 2002.
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1 Section 7. The Department of Health's Volunteer Health
2 Care Provider Program, or its successor program, shall
3 coordinate with the Agency for Health Care Administration, the
4 Florida Board of Medicine, the Florida Board of Osteopathic
5 Medicine, the Florida Medical Association, the Florida
6 Osteopathic Medical Association, the Florida Hospital
7 Association, Community Hospitals and Health Systems, and the
8 Florida League of Hospitals to conduct a survey and produce
9 for the Legislature by December 31 of each calendar year a
10 report relative to uncompensated care and the Florida Medicaid
11 program. The report shall include: the dollar amount of
12 uncompensated care for which the physician receives no
13 reimbursement provided by physicians licensed pursuant to
14 chapter 458, Florida Statutes, or chapter 459, Florida
15 Statutes, by medical specialty and by county; the dollar
16 amount of uncompensated care for which the hospital receives
17 no reimbursement provided by Florida hospitals licensed under
18 chapter 395, Florida Statutes, by medical specialty and by
19 county; and the number of Medicaid physicians in the state by
20 medical specialty and county and the average number of
21 encounters per physician. The results of the Medicaid provider
22 survey shall be compared with the projected need for Medicaid
23 services by specialty and county, as determined by the
24 department. The report that is to be filed on December 31,
25 2000, shall also include the following information: a
26 comparison of Florida Medicaid reimbursement rates with
27 Medicaid reimbursement rates for other states; a comparison of
28 Florida Medicaid reimbursement rates with Medicare
29 reimbursement rates; a comparison of Florida Medicaid
30 reimbursement rates with fee-for-service rates; and a
31 historical report on Florida Medicaid reimbursement rates.
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Amendment No.
1 Section 8. The Legislature shall appropriate each
2 fiscal year from the General Revenue Fund to the Public
3 Medical Assistance Trust Fund an amount sufficient to replace
4 the funds lost due to the reduction by this act of the
5 assessment on other health care entities under section
6 395.7015, Florida Statutes, and the reduction by this act in
7 the assessment on hospitals under section 395.701, Florida
8 Statutes, and to maintain federal approval of the reduced
9 amount of funds deposited into the Public Medical Assistance
10 Trust Fund under section 395.701, Florida Statutes, as state
11 matching funds for the state's Medicaid program.
12 Section 9. The sum of $28.3 million is appropriated
13 from the General Revenue Fund to the Agency for Health Care
14 Administration for the purpose of implementing this act.
15 However, such appropriation shall be reduced by an amount
16 equal to any similar appropriation for the same purpose which
17 is contained in other legislation adopted during the 2000
18 legislative session and which becomes a law.
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20 (Redesignate subsequent sections.)
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24 And the title is amended as follows:
25 On page 1, line 2, delete that line
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27 and insert:
28 An act relating to health care; amending s.
29 395.701, F.S.; reducing the annual assessment
30 on hospitals for outpatient services; amending
31 s. 395.7015, F.S.; reducing the annual
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Amendment No.
1 assessment against certain health care
2 entities; amending s. 408.904, F.S.; increasing
3 benefits for certain persons who receive
4 hospital outpatient services; amending s.
5 408.905, F.S.; increasing benefits furnished by
6 Medicaid providers to recipients of hospital
7 outpatient services; amending s. 905.908, F.S.;
8 increasing reimbursement to hospitals for
9 outpatient care; amending s. 409.912, F.S.;
10 providing for a contract with and reimbursement
11 of an entity in Pasco County or Pinellas County
12 which provides in-home physician services to
13 Medicaid recipients with degenerative
14 neurological diseases; providing for future
15 repeal; requiring certain health care providers
16 to conduct an annual survey and produce an
17 annual report on uncompensated care; providing
18 appropriations;
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