Florida Senate - 2006 COMMITTEE AMENDMENT
Bill No. CS for SB 1412
Barcode 662612
CHAMBER ACTION
Senate House
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11 The Committee on Judiciary (Villalobos) recommended the
12 following amendment:
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14 Senate Amendment (with title amendment)
15 On page 7, line 21, through page 9, line 6, delete
16 those lines
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18 and insert: (8) Representatives from managed care
19 organizations, Medicaid, the Office of the Inspector General
20 of the agency, the Medicaid Fraud Control Unit, and the
21 Department of Law Enforcement shall meet at least twice each
22 year to review and discuss fraud and abuse case studies and
23 enforcement matters.
24 (9) Any Medicaid funds recovered by the state from a
25 provider or recipient representing payment or payments made by
26 a managed care organization compensated by the state by
27 capitation shall be returned to the capitated managed care
28 organization from which the payment to the provider or
29 recipient originated, including interest, if any. The agency,
30 the Medicaid Fraud Control Unit, and the Department of Law
31 Enforcement may not return recovered funds associated with a
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8:56 AM 03/28/06 s1412c1c-ju38-tz4
Florida Senate - 2006 COMMITTEE AMENDMENT
Bill No. CS for SB 1412
Barcode 662612
1 fraudulent or abusive act committed by an employee or agent of
2 the managed care organization if the officers, directors, or
3 managing agents of the managed care organization actively and
4 knowingly participated in the fraud or abuse or negligently
5 failed to monitor and prevent activities constituting fraud or
6 abuse. Any funds returned to a managed care organization may
7 not include monetary fines, penalties, or sanctions imposed by
8 the agency, the Medicaid Fraud Control Unit, or the Department
9 of Law Enforcement under s. 409.913 which do not represent
10 payment or payments made by a managed care organization. The
11 agency, the Medicaid Fraud Control Unit, and the Department of
12 Law Enforcement may recover investigative, legal, and expert
13 witness costs, if any, under s. 409.913 which are separate and
14 apart from recovery of payment or payments made by a managed
15 care organization.
16 (10) The agency and the Medicaid Fraud Control Unit,
17 in conjunction with managed care organizations, must track and
18 publish on an annual basis all Medicaid fraud recoveries by
19 providers made under this section. Such information shall be
20 submitted to the Department of Health by the provider as
21 required by law in order that the Department of Health can
22 publish the information on the physician's profile.
23 (11) The agency shall adopt rules to administer this
24 section.
25 (12) Notwithstanding any other law to the contrary,
26 health maintenance organizations under contract with the
27 agency under s. 409.912 or s. 409.91211 are exempt from ss.
28 626.989 and 626.9891 for Medicaid lines of business.
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8:56 AM 03/28/06 s1412c1c-ju38-tz4
Florida Senate - 2006 COMMITTEE AMENDMENT
Bill No. CS for SB 1412
Barcode 662612
1 ================ T I T L E A M E N D M E N T ===============
2 And the title is amended as follows:
3 On page 1, line 30, through page 2, line 3, delete
4 those lines
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6 and insert:
7 concerning suspected fraud or abuse; requiring
8 representatives from managed care organizations
9 and other specified governmental organizations
10 to meet at least twice each year to review and
11 discuss fraud and abuse case studies and
12 enforcement matters; requiring that any
13 recovery of
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