HB 0027 2004
1	A bill to be entitled
2	An act relating to developmental disabilities; amending s.
3	409.912, F.S.; requiring the Agency for Health Care
4	Administration to develop a model waiver program for
5	children with specified disorders; providing for
6	implementation subject to the availability of funds;
7	providing an effective date.
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9	Be It Enacted by the Legislature of the State of Florida:
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11	Section 1. Subsection (45) is added to section 409.912,
12	Florida Statutes, to read:
13	409.912 Cost-effective purchasing of health care.--The
14	agency shall purchase goods and services for Medicaid recipients
15	in the most cost-effective manner consistent with the delivery
16	of quality medical care. The agency shall maximize the use of
17	prepaid per capita and prepaid aggregate fixed-sum basis
18	services when appropriate and other alternative service delivery
19	and reimbursement methodologies, including competitive bidding
20	pursuant to s. 287.057, designed to facilitate the cost-
21	effective purchase of a case-managed continuum of care. The
22	agency shall also require providers to minimize the exposure of
23	recipients to the need for acute inpatient, custodial, and other
24	institutional care and the inappropriate or unnecessary use of
25	high-cost services. The agency may establish prior authorization
26	requirements for certain populations of Medicaid beneficiaries,
27	certain drug classes, or particular drugs to prevent fraud,
28	abuse, overuse, and possible dangerous drug interactions. The
29	Pharmaceutical and Therapeutics Committee shall make
30	recommendations to the agency on drugs for which prior
31	authorization is required. The agency shall inform the
32	Pharmaceutical and Therapeutics Committee of its decisions
33	regarding drugs subject to prior authorization.
34	(45) The agency shall work with the Department of Children
35	and Family Services to develop a model home and community-based
36	waiver to serve children who are diagnosed with familial
37	dysautonomia or Riley-Day syndrome caused by a mutation of the
38	IKBKAP gene on chromosome 9. The agency shall seek federal
39	waiver approval and implement the approved waiver subject to the
40	availability of funds and any limitations provided in the
41	General Appropriations Act. The agency may adopt rules to
42	implement this waiver program.
43	Section 2. This act shall take effect July 1, 2004.
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