SENATE AMENDMENT
    Bill No. CS for SB 560
    Amendment No. ___   Barcode 830508
                            CHAMBER ACTION
              Senate                               House
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       04/26/2004 06:50 PM         .                    
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11  Senator Wilson moved the following amendment:
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13         Senate Amendment (with title amendment) 
14         On page 11, between lines 20 and 21,
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16  insert:  
17         Section 3.  Subsection (44) of section 409.912, Florida
18  Statutes, is amended to read:
19         409.912  Cost-effective purchasing of health care.--The
20  agency shall purchase goods and services for Medicaid
21  recipients in the most cost-effective manner consistent with
22  the delivery of quality medical care.  The agency shall
23  maximize the use of prepaid per capita and prepaid aggregate
24  fixed-sum basis services when appropriate and other
25  alternative service delivery and reimbursement methodologies,
26  including competitive bidding pursuant to s. 287.057, designed
27  to facilitate the cost-effective purchase of a case-managed
28  continuum of care. The agency shall also require providers to
29  minimize the exposure of recipients to the need for acute
30  inpatient, custodial, and other institutional care and the
31  inappropriate or unnecessary use of high-cost services. The
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    3:53 PM   04/26/04                              s0560c1c-331bb


                                                  SENATE AMENDMENT
    Bill No. CS for SB 560
    Amendment No. ___   Barcode 830508
 1  agency may establish prior authorization requirements for
 2  certain populations of Medicaid beneficiaries, certain drug
 3  classes, or particular drugs to prevent fraud, abuse, overuse,
 4  and possible dangerous drug interactions. The Pharmaceutical
 5  and Therapeutics Committee shall make recommendations to the
 6  agency on drugs for which prior authorization is required. The
 7  agency shall inform the Pharmaceutical and Therapeutics
 8  Committee of its decisions regarding drugs subject to prior
 9  authorization.
10         (44)  The agency may contract on a prepaid or fixed-sum
11  basis with appropriately licensed prepaid dental health plans
12  to provide dental services, provided administrative expenses
13  do not exceed 15 percent of the contract.
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15  (Redesignate subsequent sections.)
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18  ================ T I T L E   A M E N D M E N T ===============
19  And the title is amended as follows:
20         On page 1, line 15, after the semicolon,
21  
22  insert:
23         amending s. 409.912, F.S.; providing a limit on
24         certain expenses of the Agency for Health Care
25         Administration;
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    3:53 PM   04/26/04                              s0560c1c-331bb