CODING: Words stricken are deletions; words underlined are additions.
HOUSE AMENDMENT
Bill No. HB 931
Amendment No. 1 (for drafter's use only)
CHAMBER ACTION
Senate House
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5 ORIGINAL STAMP BELOW
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11 The Committee on Finance & Taxation offered the following:
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13 Amendment (with title amendment)
14 Remove from the bill: Everything after the enacting clause
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16 and insert in lieu thereof:
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 for inpatient services to fund public medical assistance;
21 administrative fines for failure to pay assessments when due;
22 exemption.--
23 (2)(a) There is imposed upon each hospital an
24 assessment in an amount equal to 1.5 percent of the annual net
25 operating revenue for inpatient services for each hospital,
26 such revenue to be determined by the agency, based on the
27 actual experience of the hospital as reported to the agency.
28 Within 6 months after the end of each hospital fiscal year,
29 the agency shall certify the amount of the assessment for each
30 hospital. The assessment shall be payable to and collected by
31 the agency in equal quarterly amounts, on or before the first
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HOUSE AMENDMENT
Bill No. HB 931
Amendment No. 1 (for drafter's use only)
1 day of each calendar quarter, beginning with the first full
2 calendar quarter that occurs after the agency certifies the
3 amount of the assessment for each hospital. All moneys
4 collected pursuant to this subsection shall be deposited into
5 the Public Medical Assistance Trust Fund.
6 (b) There is imposed upon each hospital an assessment
7 in an amount equal to 1.0 percent of the annual net operating
8 revenue for outpatient services for each hospital, such
9 revenue to be determined by the agency, based on the actual
10 experience of the hospital as reported to the agency. Within 6
11 months after the end of each hospital fiscal year, the agency
12 shall certify the amount of the assessment for each hospital.
13 The assessment shall be payable to and collected by the agency
14 in equal quarterly amounts, on or before the first day of each
15 calendar quarter, beginning with the first full calendar
16 quarter that occurs after the agency certifies the amount of
17 the assessment for each hospital. All moneys collected
18 pursuant to this subsection shall be deposited into the Public
19 Medical Assistance Trust Fund.
20 Section 2. Paragraph (a) of subsection (2) of section
21 395.7015, Florida Statutes, is amended to read:
22 395.7015 Annual assessment on health care entities.--
23 (2) There is imposed an annual assessment against
24 certain health care entities as described in this section:
25 (a) The assessment shall be equal to 1.0 1.5 percent
26 of the annual net operating revenues of health care entities.
27 The assessment shall be payable to and collected by the
28 agency. Assessments shall be based on annual net operating
29 revenues for the entity's most recently completed fiscal year
30 as provided in subsection (3).
31 Section 3. Paragraph (c) of subsection 2 of section
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HOUSE AMENDMENT
Bill No. HB 931
Amendment No. 1 (for drafter's use only)
1 408.904, Florida Statutes, is amended to read:
2 408.904 Benefits.--
3 (2) Covered health services include:
4 (c) Hospital outpatient services. Those services
5 provided to a member in the outpatient portion of a hospital
6 licensed under part I of chapter 395, up to a limit of $1,500
7 $1,000 per calendar year per member, that are preventive,
8 diagnostic, therapeutic, or palliative.
9 Section 4. Subsection (6) of section 409.905, Florida
10 Statutes, is amended to read:
11 409.905 Mandatory Medicaid services.--The agency may
12 make payments for the following services, which are required
13 of the state by Title XIX of the Social Security Act,
14 furnished by Medicaid providers to recipients who are
15 determined to be eligible on the dates on which the services
16 were provided. Any service under this section shall be
17 provided only when medically necessary and in accordance with
18 state and federal law. Nothing in this section shall be
19 construed to prevent or limit the agency from adjusting fees,
20 reimbursement rates, lengths of stay, number of visits, number
21 of services, or any other adjustments necessary to comply with
22 the availability of moneys and any limitations or directions
23 provided for in the General Appropriations Act or chapter 216.
24 (6) HOSPITAL OUTPATIENT SERVICES.--The agency shall
25 pay for preventive, diagnostic, therapeutic, or palliative
26 care and other services provided to a recipient in the
27 outpatient portion of a hospital licensed under part I of
28 chapter 395, and provided under the direction of a licensed
29 physician or licensed dentist, except that payment for such
30 care and services is limited to $1,500 $1,000 per state fiscal
31 year per recipient, unless an exception has been made by the
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HOUSE AMENDMENT
Bill No. HB 931
Amendment No. 1 (for drafter's use only)
1 agency, and with the exception of a Medicaid recipient under
2 age 21, in which case the only limitation is medical
3 necessity.
4 Section 5. Paragraph (a) of subsection (1) of section
5 409.908, Florida Statutes, is amended to read:
6 409.908 Reimbursement of Medicaid providers.--Subject
7 to specific appropriations, the agency shall reimburse
8 Medicaid providers, in accordance with state and federal law,
9 according to methodologies set forth in the rules of the
10 agency and in policy manuals and handbooks incorporated by
11 reference therein. These methodologies may include fee
12 schedules, reimbursement methods based on cost reporting,
13 negotiated fees, competitive bidding pursuant to s. 287.057,
14 and other mechanisms the agency considers efficient and
15 effective for purchasing services or goods on behalf of
16 recipients. Payment for Medicaid compensable services made on
17 behalf of Medicaid eligible persons is subject to the
18 availability of moneys and any limitations or directions
19 provided for in the General Appropriations Act or chapter 216.
20 Further, nothing in this section shall be construed to prevent
21 or limit the agency from adjusting fees, reimbursement rates,
22 lengths of stay, number of visits, or number of services, or
23 making any other adjustments necessary to comply with the
24 availability of moneys and any limitations or directions
25 provided for in the General Appropriations Act, provided the
26 adjustment is consistent with legislative intent.
27 (1) Reimbursement to hospitals licensed under part I
28 of chapter 395 must be made prospectively or on the basis of
29 negotiation.
30 (a) Reimbursement for inpatient care is limited as
31 provided for in s. 409.905(5). Reimbursement for hospital
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HOUSE AMENDMENT
Bill No. HB 931
Amendment No. 1 (for drafter's use only)
1 outpatient care is limited to $1,500 $1,000 per state fiscal
2 year per recipient, except for:
3 1. Such care provided to a Medicaid recipient under
4 age 21, in which case the only limitation is medical
5 necessity;
6 2. Renal dialysis services; and
7 3. Other exceptions made by the agency.
8 Section 6. Paragraph (e) is added to subsection (3) of
9 section 409.912, Florida Statutes, to read:
10 409.912 Cost-effective purchasing of health care.--The
11 agency shall purchase goods and services for Medicaid
12 recipients in the most cost-effective manner consistent with
13 the delivery of quality medical care. The agency shall
14 maximize the use of prepaid per capita and prepaid aggregate
15 fixed-sum basis services when appropriate and other
16 alternative service delivery and reimbursement methodologies,
17 including competitive bidding pursuant to s. 287.057, designed
18 to facilitate the cost-effective purchase of a case-managed
19 continuum of care. The agency shall also require providers to
20 minimize the exposure of recipients to the need for acute
21 inpatient, custodial, and other institutional care and the
22 inappropriate or unnecessary use of high-cost services.
23 (3) The agency may contract with:
24 (e) An entity in Pasco County or Pinellas County that
25 provides in-home physician services to Medicaid recipients
26 with degenerative neurological diseases in order to test the
27 cost-effectiveness of enhanced home-based medical care. The
28 entity providing the services shall be reimbursed on a
29 fee-for-service basis at a rate not less than comparable
30 Medicare reimbursement rates. The agency may apply for waivers
31 of federal regulations necessary to implement such program.
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HOUSE AMENDMENT
Bill No. HB 931
Amendment No. 1 (for drafter's use only)
1 This paragraph shall be repealed on July 1, 2002.
2 Section 7. The Legislature shall appropriate each
3 fiscal year from the General Revenue Fund to the Public
4 Medical Assistance Trust Fund an amount sufficient to replace
5 the funds lost due to the reduction by this act of the
6 assessment on other health care entities under s. 395.7015,
7 Florida Statutes, and the reduction by this act in the
8 assessment on hospitals under s. 395.701, Florida Statutes,
9 and to maintain federal approval of the reduced amount of
10 funds deposited into the Public Medical Assistance Trust Fund
11 under s. 395.701, Florida Statutes, as state match for the
12 state's Medicaid program.
13 Section 8. There is hereby appropriated $28.3 million
14 to the Agency for Health Care Administration to implement this
15 act, provided however, that no portion of this appropriation
16 shall be effective that duplicates a similar appropriation for
17 the same purpose contained in other legislation from the 2000
18 session that becomes law.
19 Section 9. This act shall take effect July 1, 2000,
20 except that the amendments to ss. 395.701 and 395.7015,
21 Florida Statutes, by this act shall take effect only upon the
22 Agency for Health Care Administration receiving written
23 confirmation from the federal Health Care Financing
24 Administration that the changes contained in such amendments
25 will not adversely affect the use of the remaining assessments
26 as state match for the state's Medicaid program.
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29 ================ T I T L E A M E N D M E N T ===============
30 And the title is amended as follows:
31 On page 1, lines 6 through 18,
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HOUSE AMENDMENT
Bill No. HB 931
Amendment No. 1 (for drafter's use only)
1 remove from the title of the bill: all of said lines
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3 and insert in lieu thereof:
4 amending s. 395.7015, F.S.; reducing the annual
5 assessment on certain health care entities; amending ss.
6 408.904, 409.905, and 409.908, F.S.; increasing benefits for
7 hospital out patient services under the MedAccess and Medicaid
8 programs; amending s. 409.912, F.S.; providing for a contract
9 with reimbursement of an entity in Pasco or Pinellas County
10 that provides in-home physician services to Medicaid
11 recipients with degenerative neurological diseases; providing
12 for future repeal; providing appropriations; providing
13 effective dates.
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