Senate Bill sb0194

    Florida Senate - 2004                                   SB 194

    By Senator Wasserman Schultz





    34-130-04

  1                      A bill to be entitled

  2         An act relating to developmental disabilities;

  3         amending s. 409.912, F.S.; requiring the Agency

  4         for Health Care Administration to develop a

  5         model waiver program for children with

  6         specified disorders; providing for

  7         implementation subject to the availability of

  8         funds; providing an effective date.

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

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12         Section 1.  Subsection (45) is added to section

13  409.912, Florida Statutes, to read:

14         409.912  Cost-effective purchasing of health care.--The

15  agency shall purchase goods and services for Medicaid

16  recipients in the most cost-effective manner consistent with

17  the delivery of quality medical care. The agency shall

18  maximize the use of prepaid per capita and prepaid aggregate

19  fixed-sum basis services when appropriate and other

20  alternative service delivery and reimbursement methodologies,

21  including competitive bidding pursuant to s. 287.057, designed

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

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

24  minimize the exposure of recipients to the need for acute

25  inpatient, custodial, and other institutional care and the

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

27  agency may establish prior authorization requirements for

28  certain populations of Medicaid beneficiaries, certain drug

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

30  and possible dangerous drug interactions. The Pharmaceutical

31  and Therapeutics Committee shall make recommendations to the

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






    Florida Senate - 2004                                   SB 194
    34-130-04




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

 2  agency shall inform the Pharmaceutical and Therapeutics

 3  Committee of its decisions regarding drugs subject to prior

 4  authorization.

 5         (45)  The agency shall work with the Department of

 6  Children and Family Services to develop a model home and

 7  community-based waiver program to serve children who are

 8  diagnosed with familial dysautonomia or Riley-Day syndrome

 9  caused by a mutation of the IKBKAP gene on chromosome 9. The

10  agency shall seek a federal waiver and implement the approved

11  waiver program subject to the availability of funds and any

12  limitations provided in the General Appropriations Act. The

13  agency may adopt rules to administer this waiver program.

14         Section 2.  This act shall take effect July 1, 2004.

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17                          SENATE SUMMARY

18    Requires the Agency for Health Care Administration to
      develop a model waiver program for children with
19    specified disorders.  Provides for implementation subject
      to availability of funds.
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CODING: Words stricken are deletions; words underlined are additions.