| 1 | A bill to be entitled |
| 2 | An act relating to a Medicaid comprehensive geriatric fall |
| 3 | prevention program; creating s. 409.91212, F.S.; requiring |
| 4 | the Agency for Health Care Administration to establish a |
| 5 | Medicaid comprehensive geriatric fall prevention program; |
| 6 | directing the agency to develop the program as an |
| 7 | expansion of a certain pilot project conducted in Broward |
| 8 | and Miami-Dade Counties; requiring the agency to evaluate |
| 9 | the program and report to the Legislature; requiring a |
| 10 | plan and timetable for statewide implementation contingent |
| 11 | upon certain findings; specifying a timeframe for |
| 12 | implementing a certain form of reimbursement; providing |
| 13 | legislative intent; providing an effective date. |
| 14 |
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| 15 | Be It Enacted by the Legislature of the State of Florida: |
| 16 |
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| 17 | Section 1. Section 409.91212, Florida Statutes, is created |
| 18 | to read: |
| 19 | 409.91212 Medicaid comprehensive geriatric fall prevention |
| 20 | program.-- |
| 21 | (1)(a) The Agency for Health Care Administration shall |
| 22 | establish a Medicaid comprehensive geriatric fall prevention |
| 23 | program in Broward and Miami-Dade Counties. The program shall be |
| 24 | evidence based and shall expand the geriatric fall prevention |
| 25 | demonstration project developed under state contracts M0337 and |
| 26 | M0509 that were awarded by the agency in fiscal year 2003-2004. |
| 27 | The program shall serve 8,000 Medicaid recipients 60 years of |
| 28 | age or older during the first year of operation and shall be in |
| 29 | operation within 120 days after the effective date of this act. |
| 30 | (b) The agency shall evaluate the cost-effectiveness and |
| 31 | clinical effectiveness of the program and report its findings to |
| 32 | the President of the Senate and the Speaker of the House of |
| 33 | Representatives by January 1, 2009. If the findings indicate the |
| 34 | program is cost-effective and clinically effective, the report |
| 35 | shall include a plan and timetable for statewide implementation. |
| 36 | In evaluating the cost-effectiveness and clinical effectiveness |
| 37 | of the program, the agency must consider findings from program |
| 38 | evaluations and site visit reports relating to the demonstration |
| 39 | project described in paragraph (a). |
| 40 | (2) Services provided under subsection (1) shall be |
| 41 | reimbursed on the same basis as provided for under the |
| 42 | demonstration project contracts described in subsection (1). |
| 43 | Beginning on the first day of operation in the third year of |
| 44 | program implementation, as authorized under this section, |
| 45 | services shall be reimbursed only on a capitated, risk-adjusted |
| 46 | basis. |
| 47 | (3) It is the intent of the Legislature that the Medicaid |
| 48 | comprehensive geriatric fall prevention program authorized by |
| 49 | this section be incorporated into the Medicaid program, as |
| 50 | provided under ss. 409.901-409.920, and included by the agency |
| 51 | as a requirement for the certification or credentialing of any |
| 52 | health plan to participate in the integrated, fixed-payment |
| 53 | delivery system for Medicaid recipients who are 60 years of age |
| 54 | or older as established in s. 409.912(5) and in the |
| 55 | certification or credentialing of any health plan participating |
| 56 | in the Medicaid managed care pilot program as established in s. |
| 57 | 409.91211 that enrolls Medicaid recipients who are at risk for |
| 58 | geriatric falls. |
| 59 | Section 2. This act shall take effect July 1, 2006. |