Senate Bill sb2226

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    Florida Senate - 2006                                  SB 2226

    By Senator Rich





    34-1155A-06

  1                      A bill to be entitled

  2         An act relating to developmental disabilities;

  3         amending s. 409.912, F.S.; requiring the Agency

  4         for Health Care Administration to develop a

  5         waiver program to serve children and adults

  6         with specified disorders; requiring the agency

  7         to seek federal approval and implement the

  8         approved waiver in the General Appropriations

  9         Act; providing an appropriation; providing an

10         effective date.

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12  Be It Enacted by the Legislature of the State of Florida:

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14         Section 1.  Subsection (51) of section 409.912, Florida

15  Statutes, is amended to read:

16         409.912  Cost-effective purchasing of health care.--The

17  agency shall purchase goods and services for Medicaid

18  recipients in the most cost-effective manner consistent with

19  the delivery of quality medical care. To ensure that medical

20  services are effectively utilized, the agency may, in any

21  case, require a confirmation or second physician's opinion of

22  the correct diagnosis for purposes of authorizing future

23  services under the Medicaid program. This section does not

24  restrict access to emergency services or poststabilization

25  care services as defined in 42 C.F.R. part 438.114. Such

26  confirmation or second opinion shall be rendered in a manner

27  approved by the agency. The agency shall maximize the use of

28  prepaid per capita and prepaid aggregate fixed-sum basis

29  services when appropriate and other alternative service

30  delivery and reimbursement methodologies, including

31  competitive bidding pursuant to s. 287.057, designed to

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    Florida Senate - 2006                                  SB 2226
    34-1155A-06




 1  facilitate the cost-effective purchase of a case-managed

 2  continuum of care. The agency shall also require providers to

 3  minimize the exposure of recipients to the need for acute

 4  inpatient, custodial, and other institutional care and the

 5  inappropriate or unnecessary use of high-cost services. The

 6  agency shall contract with a vendor to monitor and evaluate

 7  the clinical practice patterns of providers in order to

 8  identify trends that are outside the normal practice patterns

 9  of a provider's professional peers or the national guidelines

10  of a provider's professional association. The vendor must be

11  able to provide information and counseling to a provider whose

12  practice patterns are outside the norms, in consultation with

13  the agency, to improve patient care and reduce inappropriate

14  utilization. The agency may mandate prior authorization, drug

15  therapy management, or disease management participation for

16  certain populations of Medicaid beneficiaries, certain drug

17  classes, or particular drugs to prevent fraud, abuse, overuse,

18  and possible dangerous drug interactions. The Pharmaceutical

19  and Therapeutics Committee shall make recommendations to the

20  agency on drugs for which prior authorization is required. The

21  agency shall inform the Pharmaceutical and Therapeutics

22  Committee of its decisions regarding drugs subject to prior

23  authorization. The agency is authorized to limit the entities

24  it contracts with or enrolls as Medicaid providers by

25  developing a provider network through provider credentialing.

26  The agency may competitively bid single-source-provider

27  contracts if procurement of goods or services results in

28  demonstrated cost savings to the state without limiting access

29  to care. The agency may limit its network based on the

30  assessment of beneficiary access to care, provider

31  availability, provider quality standards, time and distance

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    Florida Senate - 2006                                  SB 2226
    34-1155A-06




 1  standards for access to care, the cultural competence of the

 2  provider network, demographic characteristics of Medicaid

 3  beneficiaries, practice and provider-to-beneficiary standards,

 4  appointment wait times, beneficiary use of services, provider

 5  turnover, provider profiling, provider licensure history,

 6  previous program integrity investigations and findings, peer

 7  review, provider Medicaid policy and billing compliance

 8  records, clinical and medical record audits, and other

 9  factors. Providers shall not be entitled to enrollment in the

10  Medicaid provider network. The agency shall determine

11  instances in which allowing Medicaid beneficiaries to purchase

12  durable medical equipment and other goods is less expensive to

13  the Medicaid program than long-term rental of the equipment or

14  goods. The agency may establish rules to facilitate purchases

15  in lieu of long-term rentals in order to protect against fraud

16  and abuse in the Medicaid program as defined in s. 409.913.

17  The agency may seek federal waivers necessary to administer

18  these policies.

19         (51)  The agency shall work with the Agency for Persons

20  with Disabilities to develop a model home and community-based

21  waiver to serve children and adults who are diagnosed with

22  familial dysautonomia or Riley-Day syndrome caused by a

23  mutation of the IKBKAP gene on chromosome 9. The agency shall

24  seek federal waiver approval and implement the approved waiver

25  subject to the availability of funds and any limitations

26  provided in the General Appropriations Act. The agency may

27  adopt rules to implement this waiver program.

28         Section 2.  The sums of $171,840 from the General

29  Revenue Fund and $246,160 from the Medical Care Trust Fund are

30  appropriated to the Agency for Health Care Administration for

31  

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    Florida Senate - 2006                                  SB 2226
    34-1155A-06




 1  the purpose of implementing this act during the 2006-2007

 2  fiscal year.

 3         Section 3.  This act shall take effect upon becoming a

 4  law.

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 6            *****************************************

 7                          SENATE SUMMARY

 8    Requires the Agency for Health Care Administration to
      develop a waiver program to serve children and adults
 9    with specified disorders. Requires the agency to seek
      federal approval and implement the approved waiver
10    without being subject to the availability of funds and
      certain limitations. Provides an appropriation.
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