Amendment

Bill No. 0645

Amendment No. 368287

CHAMBER ACTION
Senate		House
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1	Representative Jennings offered the following:
2
3	Amendment (with title amendment)
4	Remove everything after the enacting clause and insert:
5	Section 1.  Section 381.736, Florida Statutes, is created
6	to read:
7	381.736  Florida Healthy People 2010 Program.--
8	(1)  The Department of Health shall, using existing
9	resources, monitor and report Florida's status on the Florida
10	Healthy People 2010 goals and objectives currently tracked and
11	available to the department. The federal Healthy People 2010
12	goals and objectives are designed to measure and help to improve
13	the health of all Americans by advancing the following goals:
14	(a)  Increase the quality and years of healthy life.
15	(b)  Eliminate health disparities among different segments
16	of the population.
17	(2)  The department shall report to the Legislature by
18	December 31 of each year on the status of disparities in health
19	among minorities and nonminorities, using health indicators that
20	are consistent with those identified by the federal Healthy
21	People 2010 goals and objectives.
22	(3)  To reduce negative health consequences that result
23	from ignoring racial and ethnic cultures, the department shall
24	work with minority physician networks to develop programs to
25	educate health care professionals about the importance of
26	culture in health status. These programs shall include, but need
27	not be limited to:
28	(a)  The education of health care providers about the
29	prevalence of specific health conditions among certain minority
30	groups.
31	(b)  The training of clinicians to be sensitive to cultural
32	diversity among patients and to recognize that inherent biases
33	can lead to disparate treatments.
34	(c)  The creation of initiatives that educate private-
35	sector health care and managed care organizations about the
36	importance of cross-cultural training of health care
37	professionals and the effect of such training on the
38	professional-patient relationship.
39	(d)  The fostering of increased use of interpreter services
40	in health care settings.
41	(4)  The department shall work with and promote the
42	establishment of public and private partnerships with charitable
43	organizations, hospitals, and minority physician networks to
44	increase the proportion of health care professionals from
45	minority backgrounds.
46	(5)  The department shall work with and promote research on
47	methods by which to reduce disparities in health care at
48	colleges and universities that have historically large minority
49	enrollments, including centers of excellence in this state
50	identified by the National Center on Minority Health and Health
51	Disparities, by working with those colleges, universities, and
52	with community representatives to encourage local minority
53	students to pursue professions in health care.
54	Section 2.  Present subsections (23), (24), (25), and (26)
55	of section 409.901, Florida Statutes, are renumbered as
56	subsections (24), (25), (26), and (27), respectively, and a new
57	subsection (23) is added to that section, to read:
58	409.901  Definitions; ss. 409.901-409.920.--As used in ss.
59	409.901-409.920, except as otherwise specifically provided, the
60	term:
61	(23)  "Minority physician network" means a network of
62	primary care physicians with experience managing Medicaid or
63	Medicare recipients that is predominantly owned by minorities,
64	as defined in s. 288.703(3), which may have a collaborative
65	partnership with a public college or university and a tax-exempt
66	charitable corporation.
67	Section 3.  Subsection (45) is added to section 409.912,
68	Florida Statutes, to read:
69	409.912  Cost-effective purchasing of health care.--The
70	agency shall purchase goods and services for Medicaid recipients
71	in the most cost-effective manner consistent with the delivery
72	of quality medical care.  The agency shall maximize the use of
73	prepaid per capita and prepaid aggregate fixed-sum basis
74	services when appropriate and other alternative service delivery
75	and reimbursement methodologies, including competitive bidding
76	pursuant to s. 287.057, designed to facilitate the cost-
77	effective purchase of a case-managed continuum of care. The
78	agency shall also require providers to minimize the exposure of
79	recipients to the need for acute inpatient, custodial, and other
80	institutional care and the inappropriate or unnecessary use of
81	high-cost services. The agency may establish prior authorization
82	requirements for certain populations of Medicaid beneficiaries,
83	certain drug classes, or particular drugs to prevent fraud,
84	abuse, overuse, and possible dangerous drug interactions. The
85	Pharmaceutical and Therapeutics Committee shall make
86	recommendations to the agency on drugs for which prior
87	authorization is required. The agency shall inform the
88	Pharmaceutical and Therapeutics Committee of its decisions
89	regarding drugs subject to prior authorization.
90	(45)  The agency shall contract with minority physician
91	networks that have a history of providing health care services
92	to historically underserved minorities. The network must provide
93	cost-effective Medicaid services, comply with the requirements
94	of the MediPass program, and provide its primary care physicians
95	with access to data and other management tools necessary to
96	assist them in ensuring the appropriate use of services,
97	including inpatient hospital services and pharmaceuticals. The
98	providers in the network must be enrolled in the MediPass
99	program.
100	(a)  The agency shall provide for the development and
101	expansion of minority physician networks in each service area to
102	provide services to Medicaid recipients who are eligible to
103	participate under federal law and rules.
104	(b)  The agency shall reimburse the minority physician
105	network as a fee-for-service provider, including the case
106	management fee for primary care, or as a capitated rate provider
107	for Medicaid services. Any savings shall be shared with the
108	minority physician network pursuant to the contract.
109	(c)  For purposes of this subsection, the term "cost-
110	effective" means that a network's per-member, per-month costs to
111	the state, including, but not limited to, fee-for-service costs,
112	administrative costs, and case-management fees, must be no
113	greater than the state's costs associated with contracts for
114	Medicaid services established under subsection (3), which shall
115	be actuarially adjusted for case mix, model, and service area.
116	The agency shall conduct actuarially sound audits adjusted for
117	case mix and model in order to ensure such cost-effectiveness
118	and shall publish the audit results on its Internet website and
119	submit the audit results annually to the Governor, the President
120	of the Senate, and the Speaker of the House of Representatives
121	no later than December 31. Contracts established pursuant to
122	this subsection which are not cost-effective may not be renewed.
123	(d)  The agency may apply for any federal waivers needed to
124	implement this paragraph.
125	Section 4.  This act shall take effect July 1, 2004.
126
127	================= T I T L E  A M E N D M E N T =================
128	Remove the entire title and insert:
129	A bill to be entitled
130	An act relating to minority health care; creating s.
131	381.736, F.S.; providing for the Department of Health to
132	monitor and report on Florida's status regarding the
133	Healthy People 2010 goals and objectives currently tracked
134	by the department; requiring an annual report to the
135	Legislature; requiring the department to work with various
136	groups to educate health care professionals on racial and
137	ethnic issues in health, to recruit and train health care
138	professionals from minority backgrounds, and to promote
139	certain research; amending s. 409.901, F.S.; defining the
140	term "minority physician network"; amending s. 409.912,
141	F.S.; requiring the Agency for Health Care Administration
142	to contract for a Medicaid minority physician network;
143	providing guidelines for the operation of the network;
144	defining the term "cost-effective"; requiring the agency
145	to conduct actuarially sound audits; providing an
146	effective date.

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