Senate Bill sb1178e1

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    CS for CS for SB 1178                    First Engrossed (ntc)



  1                      A bill to be entitled

  2         An act relating to minority health care;

  3         creating s. 381.736, F.S.; providing for the

  4         Department of Health to monitor and report on

  5         Florida's status regarding the Healthy People

  6         2010 goals and objectives currently tracked by

  7         the department; requiring an annual report to

  8         the Legislature; requiring the department to

  9         work with various groups to educate health care

10         professionals on racial and ethnic issues in

11         health, to recruit and train health care

12         professionals from minority backgrounds, and to

13         promote certain research; amending s. 409.901,

14         F.S.; defining the term "minority physician

15         network"; amending s. 409.912, F.S.; requiring

16         the Agency for Health Care Administration to

17         contract for a Medicaid minority physician

18         network; providing guidelines for the operation

19         of the network; defining the term

20         "cost-effective"; requiring the agency to

21         conduct actuarially sound audits; providing an

22         effective date.

23  

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

25  

26         Section 1.  Section 381.736, Florida Statutes, is

27  created to read:

28         381.736  Florida Healthy People 2010 Program.--

29         (1)  The Department of Health shall, using existing

30  resources, monitor and report Florida's status on the Healthy

31  People 2010 goals and objectives currently tracked and


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    CS for CS for SB 1178                    First Engrossed (ntc)



 1  available to the department. The federal Healthy People 2010

 2  goals and objectives are designed to measure and help to

 3  improve the health of all Americans by advancing the following

 4  goals:

 5         (a)  Increase the quality and years of healthy life.

 6         (b)  Eliminate health disparities among different

 7  segments of the population.

 8         (2)  The department shall report to the Legislature by

 9  December 31 of each year on the status of disparities in

10  health among minorities and nonminorities, using health

11  indicators currently available that are consistent with those

12  identified by the federal Healthy People 2010 goals and

13  objectives.

14         (3)  To reduce negative health consequences that result

15  from ignoring racial and ethnic cultures, the department shall

16  work with minority physician networks to develop programs to

17  educate health care professionals about the importance of

18  culture in health status. These programs shall include, but

19  need not be limited to:

20         (a)  The education of health care providers about the

21  prevalence of specific health conditions among certain

22  minority groups.

23         (b)  The training of clinicians to be sensitive to

24  cultural diversity among patients and to recognize that

25  inherent biases can lead to disparate treatments.

26         (c)  The creation of initiatives that educate

27  private-sector health care and managed care organizations

28  about the importance of cross-cultural training of health care

29  professionals and the effect of such training on the

30  professional-patient relationship.

31  


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    CS for CS for SB 1178                    First Engrossed (ntc)



 1         (d)  The fostering of increased use of interpreter

 2  services in health care settings.

 3         (4)  The department shall work with and promote the

 4  establishment of public and private partnerships with

 5  charitable organizations, hospitals, and minority physician

 6  networks to increase the proportion of health care

 7  professionals from minority backgrounds.

 8         (5)  The department shall promote research on methods

 9  by which to reduce disparities in health care at colleges and

10  universities that have historically large minority

11  enrollments, including centers of excellence in this state

12  identified by the National Center on Minority Health and

13  Health Disparities, by working with those colleges and

14  universities and with community representatives to encourage

15  local minority students to pursue professions in health care.

16         Section 2.  Subsections (23), (24), (25), and (26) of

17  section 409.901, Florida Statutes, are renumbered as

18  subsections (24), (25), (26), and (27), respectively, and a

19  new subsection (23) is added to that section, to read:

20         409.901  Definitions; ss. 409.901-409.920.--As used in

21  ss. 409.901-409.920, except as otherwise specifically

22  provided, the term:

23         (23)  "Minority physician network" means a network of

24  primary care physicians with experience managing Medicaid or

25  Medicare recipients that is predominantly owned by minorities

26  as defined in s. 288.703, which may have a collaborative

27  partnership with a public college or university and a

28  tax-exempt charitable corporation.

29         Section 3.  Subsection (45) is added to section

30  409.912, Florida Statutes, to read:

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    CS for CS for SB 1178                    First Engrossed (ntc)



 1         409.912  Cost-effective purchasing of health care.--The

 2  agency shall purchase goods and services for Medicaid

 3  recipients in the most cost-effective manner consistent with

 4  the delivery of quality medical care. The agency shall

 5  maximize the use of prepaid per capita and prepaid aggregate

 6  fixed-sum basis services when appropriate and other

 7  alternative service delivery and reimbursement methodologies,

 8  including competitive bidding pursuant to s. 287.057, designed

 9  to facilitate the cost-effective purchase of a case-managed

10  continuum of care. The agency shall also require providers to

11  minimize the exposure of recipients to the need for acute

12  inpatient, custodial, and other institutional care and the

13  inappropriate or unnecessary use of high-cost services. The

14  agency may establish prior authorization requirements for

15  certain populations of Medicaid beneficiaries, certain drug

16  classes, or particular drugs to prevent fraud, abuse, overuse,

17  and possible dangerous drug interactions. The Pharmaceutical

18  and Therapeutics Committee shall make recommendations to the

19  agency on drugs for which prior authorization is required. The

20  agency shall inform the Pharmaceutical and Therapeutics

21  Committee of its decisions regarding drugs subject to prior

22  authorization.

23         (45)  The agency shall contract with an established

24  minority physician network that provides services to

25  historically underserved minority patients. The network must

26  provide cost-effective Medicaid services, comply with the

27  requirements to be a MediPass provider, and provide its

28  primary care physicians with access to data and other

29  management tools necessary to assist them in ensuring the

30  appropriate use of services, including inpatient hospital

31  services and pharmaceuticals.


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    CS for CS for SB 1178                    First Engrossed (ntc)



 1         (a)  The agency shall provide for the development and

 2  expansion of minority physician networks in each service area

 3  to provide services to Medicaid recipients who are eligible to

 4  participate under federal law and rules.

 5         (b)  The agency shall reimburse the minority physician

 6  network as a fee-for-service provider, including the case

 7  management fee for primary care, or as a capitated rate

 8  provider for Medicaid services. Any savings shall be shared

 9  with the minority physician network pursuant to the contract.

10         (c)  For purposes of this subsection, the term

11  "cost-effective" means that a network's per-member, per-month

12  costs to the state, including, but not limited to,

13  fee-for-service costs, administrative costs, and

14  case-management fees, must be no greater than the state's

15  costs associated with contracts for Medicaid services

16  established under subsection (3), which shall be actuarially

17  adjusted for case mix, model, and service area. The agency

18  shall conduct actuarially sound audits adjusted for case mix

19  and model in order to ensure such cost-effectiveness and shall

20  publish the audit results on its Internet website and submit

21  the audit results annually to the Governor, the President of

22  the Senate, and the Speaker of the House of Representatives no

23  later than December 31. Contracts established pursuant to this

24  subsection which are not cost-effective may not be renewed.

25         (d)  The agency may apply for any federal waivers

26  needed to implement this paragraph.

27         Section 4.  This act shall take effect July 1, 2004.

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