Florida Senate - 2005                        SENATOR AMENDMENT
    Bill No. CS for CS for SB 838
                        Barcode 962280
                            CHAMBER ACTION
              Senate                               House
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       05/03/2005 11:03 AM         .                    
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11  Senator Saunders moved the following amendment:
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13         Senate Amendment 
14         On page 57, between lines 17 and 18,
15  
16  insert:  
17         (50)  The agency shall contract with established
18  federally qualified health centers that provide services to
19  historically underserved and uninsured patients. The networks
20  must provide cost-effective Medicaid services, comply with the
21  requirements of a MediPass provider, and provide their primary
22  care physicians with access to data and other management tools
23  necessary to assist them in ensuring the appropriate use of
24  services, including inpatient hospital services and
25  pharmaceuticals.
26         (a)  The agency shall provide for the development and
27  expansion of federally qualified health center based provider
28  service networks in each service area to provide services to
29  Medicaid recipients who are eligible to participate under
30  federal law and rules.
31         (b)  The agency shall reimburse each federally
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    4:36 PM   05/02/05                             s0838c2b-37-c9m


    Florida Senate - 2005                        SENATOR AMENDMENT
    Bill No. CS for CS for SB 838
                        Barcode 962280
 1  qualified health center based network as a fee-for-service
 2  provider, including the case management fee for primary care
 3  or as a capitated rate provider for Medicaid services. Any
 4  savings shall be shared with the federally qualified health
 5  center networks under the contract.
 6         (c)  For purposes of this subsection, the term
 7  "cost-effective" means that a network's per-member, per-month
 8  costs to the state, including, but not limited to,
 9  fee-for-service costs, administrative costs, and
10  case-management fees must be no greater than the state's costs
11  associated with contracts for Medicaid services, which shall
12  be actuarially adjusted for case mix, model, and service area.
13  The agency shall conduct actuarially sound audits adjusted for
14  case mix and model in order to ensure such cost-effectiveness
15  and shall publish the audit results on its Internet website
16  and submit the audit results annually to the Governor, the
17  President of the Senate, and the Speaker of the House of
18  Representatives no later than December 31.
19         (d)  The agency may apply for any federal waivers
20  needed to administer this subsection.
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22  (Redesignate subsequent sections.)
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    4:36 PM   05/02/05                             s0838c2b-37-c9m