HB 0645

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

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