Florida Senate - 2005 COMMITTEE AMENDMENT
Bill No. SB 2364
Barcode 491808
CHAMBER ACTION
Senate House
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11 The Committee on Health Care (Fasano) recommended the
12 following amendment:
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14 Senate Amendment (with title amendment)
15 On page 8, between lines 24 and 25,
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17 insert:
18 Section 3. Subsection (2) of section 430.705, Florida
19 Statutes, is amended, and subsection (10) is added to that
20 section, to read:
21 430.705 Implementation of the long-term care community
22 diversion pilot projects.--
23 (2)(a) The department shall select projects whose
24 design and providers demonstrate capacity to maximize the
25 placement of participants in the least restrictive appropriate
26 care setting.
27 (b) The department shall select providers that meet
28 all of the following criteria. Providers shall:
29 1. Have a plan administrator who is dedicated to the
30 diversion pilot project and project staff who perform the
31 necessary project administrative functions, including data
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Florida Senate - 2005 COMMITTEE AMENDMENT
Bill No. SB 2364
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1 collection, reporting, and analysis.
2 2. Demonstrate the ability to provide program
3 enrollees with a choice of care provider by contracting with
4 multiple providers that provide the same type of service.
5 3. Demonstrate through performance or other documented
6 means the capacity for prompt payment of claims as specified
7 under s. 641.3155.
8 4. Maintain an insolvency protection account in a bank
9 or savings and loan association located in this state with a
10 balance of at least $100,000 into which monthly deposits equal
11 to at least 5 percent of premiums received under the project
12 are made until the balance equals 2 percent of the total
13 contract amount. The account shall be established with such
14 terms as to ensure that funds may be withdrawn only with the
15 signature approval of designated department representatives.
16 5. Maintain a surplus of at least $1.5 million as
17 determined by the department. Each applicant and each provider
18 shall furnish to the department initial and annual unqualified
19 audited financial statements prepared by a certified public
20 accountant that expressly confirm that the applicant or
21 provider satisfies this surplus requirement. The department
22 may approve a waiver of compliance with the surplus
23 requirement for an existing diversion provider. The
24 department's approval of this waiver must be contingent on the
25 provider demonstrating proof to the department that the entity
26 has posted and maintains a $1.5 million performance bond that
27 is written by an insurer licensed to transact insurance in
28 this state, in lieu of meeting the surplus requirement. The
29 department may not approve a waiver of compliance with the
30 surplus requirement that extends beyond June 30, 2006. As used
31 in this subparagraph, the term:
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Florida Senate - 2005 COMMITTEE AMENDMENT
Bill No. SB 2364
Barcode 491808
1 a. "Existing diversion provider" means an entity that
2 is approved by the department, on or before June 30, 2005, to
3 provide services to consumers through any long-term care
4 community diversion pilot project authorized under ss.
5 430.701-430.709.
6 b. "Surplus" has the same meaning as in s. 641.19(19).
7 (c) The requirements of paragraph (b) do not apply to
8 entities selected to provide services in the pilot projects
9 authorized under s. 430.205(6)(b)2. The department, in
10 consultation with the agency, shall develop by rule minimum
11 financial solvency and reporting standards for these providers
12 which are reflective of the amount of risk the provider will
13 assume under the pilot project. The standards adopted by rule
14 shall ensure safety for the pilot project enrollees and
15 financial protection for the state in the event of a
16 provider's inability to continue providing services under the
17 project. The department shall select providers that:
18 (a) Are determined by the Department of Financial
19 Services to:
20 1. Meet surplus requirements specified in s. 641.225;
21 2. Demonstrate the ability to comply with the
22 standards for financial solvency specified in s. 641.285;
23 3. Demonstrate the ability to provide for the prompt
24 payment of claims as specified in s. 641.3155; and
25 4. Demonstrate the ability to provide technology with
26 the capability for data collection that meets the security
27 requirements of the federal Health Insurance Portability and
28 Accountability Act of 1996, 42 C.F.R. ss. 160 and 164.
29 (b) Demonstrate the ability to contract with multiple
30 providers that provide the same type of service.
31 (10) The department, in consultation with the agency,
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Florida Senate - 2005 COMMITTEE AMENDMENT
Bill No. SB 2364
Barcode 491808
1 may adopt any rules necessary to administer the long-term care
2 community diversion pilot projects authorized under ss.
3 430.701-430.709.
4 Section 4. Subsection (1) of section 430.707, Florida
5 Statutes, is amended to read:
6 430.707 Contracts.--
7 (1) The department, in consultation with the agency,
8 shall select and contract with managed care organizations and,
9 on a prepaid basis, with other qualified providers as defined
10 in s. 430.703(7) to provide long-term care within community
11 diversion pilot project areas. All providers shall The agency
12 shall evaluate and report quarterly to the department
13 regarding the entity's the compliance by other qualified
14 providers with all the financial and quality assurance
15 requirements of the contract.
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17 (Redesignate subsequent sections.)
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20 ================ T I T L E A M E N D M E N T ===============
21 And the title is amended as follows:
22 On page 2, line 6, after the semicolon,
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24 insert:
25 amending s. 430.705, F.S.; revising eligibility
26 requirements relating to financial solvency for
27 entities that provide services under the
28 long-term care community diversion pilot
29 projects; authorizing the department to adopt
30 rules; amending s. 430.707, F.S.; requiring
31 project providers to report quarterly to the
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Florida Senate - 2005 COMMITTEE AMENDMENT
Bill No. SB 2364
Barcode 491808
1 department regarding compliance with financial
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