| 1 | Representative Green offered the following: |
| 2 |
|
| 3 | Amendment (with directory and title amendments) |
| 4 | Between lines 580 and 581 insert: |
| 5 | (4) Subject to any limitations or directions provided for |
| 6 | in the General Appropriations Act, alternative health plans, |
| 7 | health maintenance organizations, and prepaid health plans shall |
| 8 | be reimbursed a fixed, prepaid amount negotiated, or |
| 9 | competitively bid pursuant to s. 287.057, by the agency and |
| 10 | prospectively paid to the provider monthly for each Medicaid |
| 11 | recipient enrolled. The amount may not exceed the average amount |
| 12 | the agency determines it would have paid, based on claims |
| 13 | experience, for recipients in the same or similar category of |
| 14 | eligibility. The agency shall calculate capitation rates on a |
| 15 | regional basis and, beginning September 1, 1995, shall include |
| 16 | age-band differentials in such calculations. Effective July 1, |
| 17 | 2001, the cost of exempting statutory teaching hospitals, |
| 18 | specialty hospitals, and community hospital education program |
| 19 | hospitals from reimbursement ceilings and the cost of special |
| 20 | Medicaid payments shall not be included in premiums paid to |
| 21 | health maintenance organizations or prepaid health care plans. |
| 22 | Each rate semester, the agency shall calculate and publish a |
| 23 | Medicaid hospital rate schedule that does not reflect either |
| 24 | special Medicaid payments or the elimination of rate |
| 25 | reimbursement ceilings, to be used by hospitals and Medicaid |
| 26 | health maintenance organizations, in order to determine the |
| 27 | Medicaid rate referred to in ss. 409.912(17), 409.9128(5), and |
| 28 | 641.513(6). |
| 29 |
|
| 30 | =========== D I R E C T O R Y A M E N D M E N T ========== |
| 31 | Remove lines 551 and 552 and insert: |
| 32 | Section 7. Subsections (4) and (19) of section 409.908, |
| 33 | Florida Statutes, are amended to read: |
| 34 |
|
| 35 | ================ T I T L E A M E N D M E N T ============= |
| 36 | Remove line 20 and insert: |
| 37 | s. 409.908, F.S.; deleting certain guidelines relating to |
| 38 | reimbursement of Medicaid providers; mandating the payment |
| 39 | method of county |