| 1 | Representative(s) Bucher offered the following: |
| 2 |
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| 3 | Amendment (with title amendment) |
| 4 | Remove line(s) 99-134 and insert: |
| 5 | basis in two areas of the state. The pilot areas shall be Area 1 |
| 6 | and Area 7 of the Agency for Health Care Administration. In one |
| 7 | of the areas Enrollment in the pilot areas shall be on a |
| 8 | voluntary basis and in accordance with approved federal waivers |
| 9 | and this section. The agency and its program contractors and |
| 10 | providers shall not enroll any individual in the integrated |
| 11 | program because the individual or the person legally responsible |
| 12 | for the individual fails to choose to enroll in the integrated |
| 13 | program. Enrollment in the integrated program shall be |
| 14 | exclusively by affirmative choice of the eligible individual or |
| 15 | by the person legally responsible for the individual. The |
| 16 | integrated program must transfer all Medicaid services for |
| 17 | eligible elderly individuals who choose to participate into an |
| 18 | integrated-care management model designed to serve Medicaid |
| 19 | recipients in the community. The integrated program must combine |
| 20 | all funding for Medicaid services provided to individuals 60 |
| 21 | years of age or older into the integrated program system, |
| 22 | including funds for Medicaid home and community-based waiver |
| 23 | services; all Medicaid services authorized in ss. 409.905 and |
| 24 | 409.906, excluding funds for Medicaid nursing home services |
| 25 | unless the agency is able to demonstrate how the integration of |
| 26 | the funds will improve coordinated care for these services in a |
| 27 | less costly manner; and Medicare coinsurance and deductibles for |
| 28 | persons dually eligible for Medicaid and Medicare as prescribed |
| 29 | in s. 409.908(13). |
| 30 | (a) Individuals who are 60 years of age or older and |
| 31 | enrolled in the developmental disabilities waiver program, the |
| 32 | family and supported-living waiver program, the project AIDS |
| 33 | care waiver program, the traumatic brain injury and spinal cord |
| 34 | injury waiver program, the consumer-directed care waiver |
| 35 | program, and the program of all-inclusive care for the elderly |
| 36 | program, and residents of institutional care facilities for the |
| 37 | developmentally disabled, must be excluded from the integrated |
| 38 | program system. |
| 39 | (b) The integrated program must use a competitive |
| 40 | procurement process to select managed care entities who meet or |
| 41 |
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| 42 | ======= T I T L E A M E N D M E N T ======= |
| 43 | Remove line 8 and insert: |
| 44 | certain requirements; removing a condition for permitting |
| 45 | Medicaid nursing home funds to be used to fund the program; |
| 46 | requiring selection of managed care |