Senate Bill sb2466

    Florida Senate - 2007                                  SB 2466

    By Senator Joyner





    18-1385A-07                                         See HB 987

  1                      A bill to be entitled

  2         An act relating to reimbursement of Medicaid

  3         providers; amending s. 409.908, F.S.; requiring

  4         the Agency for Health Care Administration to

  5         provide reimbursement for physician and dental

  6         services at certain levels and rates; providing

  7         an effective date.

  8  

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

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11         Section 1.  Paragraph (d) is added to subsection (12)

12  of section 409.908, Florida Statutes, to read:

13         409.908  Reimbursement of Medicaid providers.--Subject

14  to specific appropriations, the agency shall reimburse

15  Medicaid providers, in accordance with state and federal law,

16  according to methodologies set forth in the rules of the

17  agency and in policy manuals and handbooks incorporated by

18  reference therein. These methodologies may include fee

19  schedules, reimbursement methods based on cost reporting,

20  negotiated fees, competitive bidding pursuant to s. 287.057,

21  and other mechanisms the agency considers efficient and

22  effective for purchasing services or goods on behalf of

23  recipients. If a provider is reimbursed based on cost

24  reporting and submits a cost report late and that cost report

25  would have been used to set a lower reimbursement rate for a

26  rate semester, then the provider's rate for that semester

27  shall be retroactively calculated using the new cost report,

28  and full payment at the recalculated rate shall be effected

29  retroactively. Medicare-granted extensions for filing cost

30  reports, if applicable, shall also apply to Medicaid cost

31  reports. Payment for Medicaid compensable services made on

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CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2007                                  SB 2466
    18-1385A-07                                         See HB 987




 1  behalf of Medicaid eligible persons is subject to the

 2  availability of moneys and any limitations or directions

 3  provided for in the General Appropriations Act or chapter 216.

 4  Further, nothing in this section shall be construed to prevent

 5  or limit the agency from adjusting fees, reimbursement rates,

 6  lengths of stay, number of visits, or number of services, or

 7  making any other adjustments necessary to comply with the

 8  availability of moneys and any limitations or directions

 9  provided for in the General Appropriations Act, provided the

10  adjustment is consistent with legislative intent.

11         (12)

12         (d)  Notwithstanding any other provision of this

13  subsection, the agency shall provide reimbursement for

14  physician and dental services provided to children younger

15  than 21 years of age at least at the level provided by federal

16  law for physician reimbursement under the Medicare program and

17  provide reimbursement for dental services at 50 percent of

18  usual and customary rates provided for dental services. The

19  agency shall include in all managed care contracts a

20  requirement to provide at least such reimbursement for

21  physician and dental services.

22         Section 2.  This act shall take effect July 1, 2007.

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CODING: Words stricken are deletions; words underlined are additions.