CS/CS/HB 1175

1	A bill to be entitled
2	An act relating to transportation services for the
3	transportation disadvantaged; amending s. 409.908, F.S.;
4	authorizing the Agency for Health Care Administration to
5	continue to contract for Medicaid nonemergency
6	transportation services in a specified agency service area
7	with managed care plans under certain conditions; amending
8	s. 427.011, F.S.; revising definitions; defining the term
9	"purchasing agency"; amending s. 427.012, F.S.; revising
10	the number of members required for a quorum at a meeting
11	of the Commission for the Transportation Disadvantaged;
12	amending s. 427.013, F.S.; revising responsibilities of
13	the commission; deleting a requirement that the commission
14	establish by rule acceptable ranges of trip costs;
15	removing a provision for functioning and oversight of the
16	quality assurance and management review program; requiring
17	the commission to incur expenses for promotional services
18	and items; amending s. 427.0135, F.S.; revising and
19	creating duties and responsibilities for agencies that
20	purchase transportation services for the transportation
21	disadvantaged; providing requirements for the payment of
22	rates; requiring an agency to negotiate with the
23	commission before procuring transportation disadvantaged
24	services; requiring an agency to identify its allocation
25	for transportation disadvantaged services in its
26	legislative budget request; amending s. 427.015, F.S.;
27	revising provisions relating to the function of the
28	metropolitan planning organization or designated official
29	planning agency; amending s. 427.0155, F.S.; revising
30	duties of community transportation coordinators; amending
31	s. 427.0157, F.S.; revising duties of coordinating boards;
32	amending s. 427.0158, F.S.; deleting provisions requiring
33	the school board to provide information relating to school
34	buses to the transportation coordinator; providing for the
35	transportation coordinator to request certain information
36	regarding public transportation; amending s. 427.0159,
37	F.S.; revising provisions relating to the Transportation
38	Disadvantaged Trust Fund; providing for the deposit of
39	funds by an agency purchasing transportation services;
40	amending s. 427.016, F.S.; providing for construction and
41	application of specified provisions to certain acts of a
42	purchasing agency in lieu of the Medicaid agency;
43	requiring that an agency identify the allocation of funds
44	for transportation disadvantaged services in its
45	legislative budget request; providing an effective date.
46
47	Be It Enacted by the Legislature of the State of Florida:
48
49	Section 1.  Subsection (18) of section 409.908, Florida
50	Statutes, is amended to read:
51	409.908  Reimbursement of Medicaid providers.--Subject to
52	specific appropriations, the agency shall reimburse Medicaid
53	providers, in accordance with state and federal law, according
54	to methodologies set forth in the rules of the agency and in
55	policy manuals and handbooks incorporated by reference therein.
56	These methodologies may include fee schedules, reimbursement
57	methods based on cost reporting, negotiated fees, competitive
58	bidding pursuant to s. 287.057, and other mechanisms the agency
59	considers efficient and effective for purchasing services or
60	goods on behalf of recipients. If a provider is reimbursed based
61	on cost reporting and submits a cost report late and that cost
62	report would have been used to set a lower reimbursement rate
63	for a rate semester, then the provider's rate for that semester
64	shall be retroactively calculated using the new cost report, and
65	full payment at the recalculated rate shall be effected
66	retroactively. Medicare-granted extensions for filing cost
67	reports, if applicable, shall also apply to Medicaid cost
68	reports. Payment for Medicaid compensable services made on
69	behalf of Medicaid eligible persons is subject to the
70	availability of moneys and any limitations or directions
71	provided for in the General Appropriations Act or chapter 216.
72	Further, nothing in this section shall be construed to prevent
73	or limit the agency from adjusting fees, reimbursement rates,
74	lengths of stay, number of visits, or number of services, or
75	making any other adjustments necessary to comply with the
76	availability of moneys and any limitations or directions
77	provided for in the General Appropriations Act, provided the
78	adjustment is consistent with legislative intent.
79	(18)  Unless otherwise provided for in the General
80	Appropriations Act, a provider of transportation services shall
81	be reimbursed the lesser of the amount billed by the provider or
82	the Medicaid maximum allowable fee established by the agency,
83	except when the agency has entered into a direct contract with
84	the provider, or with a community transportation coordinator,
85	for the provision of an all-inclusive service, or when services
86	are provided pursuant to an agreement negotiated between the
87	agency and the provider. The agency, as provided for in s.
88	427.0135, shall purchase transportation services through the
89	community coordinated transportation system, if available,
90	unless the agency, after consultation with the commission,
91	determines that it cannot reach mutually acceptable contract
92	terms with the commission. The agency may then contract for the
93	same transportation services provided in a more cost-effective
94	manner and of comparable or higher quality and standards
95	determines a more cost-effective method for Medicaid clients.
96	Nothing in this subsection shall be construed to limit or
97	preclude the agency from contracting for services using a
98	prepaid capitation rate or from establishing maximum fee
99	schedules, individualized reimbursement policies by provider
100	type, negotiated fees, prior authorization, competitive bidding,
101	increased use of mass transit, or any other mechanism that the
102	agency considers efficient and effective for the purchase of
103	services on behalf of Medicaid clients, including implementing a
104	transportation eligibility process. The agency shall not be
105	required to contract with any community transportation
106	coordinator or transportation operator that has been determined
107	by the agency, the Department of Legal Affairs Medicaid Fraud
108	Control Unit, or any other state or federal agency to have
109	engaged in any abusive or fraudulent billing activities. The
110	agency is authorized to competitively procure transportation
111	services or make other changes necessary to secure approval of
112	federal waivers needed to permit federal financing of Medicaid
113	transportation services at the service matching rate rather than
114	the administrative matching rate. Notwithstanding chapter 427,
115	the agency is authorized to continue contracting for Medicaid
116	nonemergency transportation services in agency service area 11
117	with managed care plans that were under contract for those
118	services before July 1, 2004.
119	Section 2.  Subsections (8), (12), and (13) of section
120	427.011, Florida Statutes, are amended to read:
121	427.011  Definitions.--For the purposes of ss. 427.011-
122	427.017:
123	(8)  "Purchasing agency" "Member department" means a
124	department or agency whose head is an ex officio, nonvoting
125	advisor to a member of the commission, or an agency that
126	purchases transportation services for the transportation
127	disadvantaged.
128	(12)  "Annual budget estimate" means a budget estimate of
129	funding resources available for providing transportation
130	services to the transportation disadvantaged and which is
131	prepared annually to cover a period of 1 state fiscal year.
132	(12)(13)  "Nonsponsored transportation disadvantaged
133	services" means transportation disadvantaged services that are
134	not sponsored or subsidized by any funding source other than the
135	Transportation Disadvantaged Trust Fund.
136	Section 3.  Subsection (4) of section 427.012, Florida
137	Statutes, is amended to read:
138	427.012  The Commission for the Transportation
139	Disadvantaged.--There is created the Commission for the
140	Transportation Disadvantaged in the Department of
141	Transportation.
142	(4)  The commission shall meet at least quarterly, or more
143	frequently at the call of the chairperson. Four Five members of
144	the commission constitute a quorum, and a majority vote of the
145	members present is necessary for any action taken by the
146	commission.
147	Section 4.  Subsections (7), (8), (9), (14), and (26) of
148	section 427.013, Florida Statutes, are amended, and subsection
149	(29) is added to that section, to read:
150	427.013  The Commission for the Transportation
151	Disadvantaged; purpose and responsibilities.--The purpose of the
152	commission is to accomplish the coordination of transportation
153	services provided to the transportation disadvantaged. The goal
154	of this coordination is shall be to assure the cost-effective
155	provision of transportation by qualified community
156	transportation coordinators or transportation operators for the
157	transportation disadvantaged without any bias or presumption in
158	favor of multioperator systems or not-for-profit transportation
159	operators over single operator systems or for-profit
160	transportation operators. In carrying out this purpose, the
161	commission shall:
162	(7)  Unless otherwise provided by state or federal law,
163	ensure Assure that all procedures, guidelines, and directives
164	issued by purchasing agencies member departments are conducive
165	to the coordination of transportation services.
166	(8)(a)  Ensure Assure that purchasing agencies member
167	departments purchase all trips within the coordinated system,
168	unless they have fulfilled the requirements of s. 427.0135(3)
169	and use a more cost-effective alternative provider that meets
170	comparable quality and standards.
171	(b)  Unless the purchasing agency has negotiated with the
172	commission pursuant to the requirements of s. 427.0135(3),
173	provide, by rule, criteria and procedures for purchasing
174	agencies member departments to use if they wish to use an
175	alternative provider. Agencies Departments must demonstrate
176	either that the proposed alternative provider can provide a trip
177	of comparable acceptable quality and standards for the clients
178	at a lower cost than that provided within the coordinated
179	system, or that the coordinated system cannot accommodate the
180	agency's department's clients.
181	(9)  Unless the purchasing agency has negotiated with the
182	commission pursuant to the requirements of s. 427.0135(3),
183	develop by rule standards for community transportation
184	coordinators and any transportation operator or coordination
185	contractor from whom service is purchased or arranged by the
186	community transportation coordinator covering coordination,
187	operation, safety, insurance, eligibility for service, costs,
188	and utilization of transportation disadvantaged services. These
189	standards and rules must include, but are not limited to:
190	(a)  Inclusion, by rule, of acceptable ranges of trip costs
191	for the various modes and types of transportation services
192	provided.
193	(a)(b)  Minimum performance standards for the delivery of
194	services. These standards must be included in coordinator
195	contracts and transportation operator contracts with clear
196	penalties for repeated or continuing violations.
197	(b)(c)  Minimum liability insurance requirements for all
198	transportation services purchased, provided, or coordinated for
199	the transportation disadvantaged through the community
200	transportation coordinator.
201	(14)  Consolidate, for each state agency, the annual budget
202	estimates for transportation disadvantaged services, and the
203	amounts of each agency's actual expenditures, together with the
204	actual expenditures annual budget estimates of each official
205	planning agency, local government, and directly federally funded
206	agency and the amounts collected by each official planning
207	agency issue a report.
208	(26)  Develop a quality assurance and management review
209	program to monitor, based upon approved commission standards,
210	services contracted for by an agency, and those provided by a
211	community transportation operator pursuant to s. 427.0155. Staff
212	of the quality assurance and management review program shall
213	function independently and be directly responsible to the
214	executive director.
215	(29)  Incur expenses for the purchase of advertisements,
216	marketing services, and promotional items.
217	Section 5.  Section 427.0135, Florida Statutes, is amended
218	to read:
219	427.0135  Purchasing agencies Member departments; duties
220	and responsibilities.--Each purchasing agency member department,
221	in carrying out the policies and procedures of the commission,
222	shall:
223	(1)(a)  Use the coordinated transportation system for
224	provision of services to its clients, unless each department or
225	purchasing agency meets the criteria outlined in rule or statute
226	to use an alternative provider.
227	(b)  Subject to the provisions of s. 409.908(18), the
228	Medicaid agency shall purchase transportation services through
229	the community coordinated transportation system unless a more
230	cost-effective method is determined by the agency for Medicaid
231	clients or unless otherwise limited or directed by the General
232	Appropriations Act.
233	(2)  Pay the rates established in the service plan or
234	negotiated statewide contract, unless the purchasing agency has
235	completed the procedure for using an alternative provider and
236	demonstrated that a proposed alternative provider can provide a
237	more cost-effective transportation service of comparable quality
238	and standards or unless the agency has satisfied the
239	requirements of subsection (3).
240	(3)  Not procure transportation disadvantaged services
241	without initially negotiating with the commission, as provided
242	in s. 287.057(5)(f)13., or unless otherwise authorized by
243	statute. If the purchasing agency, after consultation with the
244	commission, determines that it cannot reach mutually acceptable
245	contract terms with the commission, the purchasing agency may
246	contract for the same transportation services provided in a more
247	cost-effective manner and of comparable or higher quality and
248	standards. The Medicaid agency shall implement this subsection
249	in a manner consistent with s. 409.908(18) and as otherwise
250	limited or directed by the General Appropriations Act.
251	(4)  Identify in the legislative budget request provided to
252	the Governor each year for the General Appropriations Act the
253	specific amount of money the purchasing agency will allocate to
254	provide transportation disadvantaged services.
255	(5)(2)  Provide the commission, by September 15 of each
256	year, an accounting of all funds spent as well as how many trips
257	were purchased with agency funds.
258	(6)(3)  Assist communities in developing coordinated
259	transportation systems designed to serve the transportation
260	disadvantaged. However, a purchasing agency member department
261	may not serve as the community transportation coordinator in any
262	designated service area.
263	(7)(4)  Ensure Assure that its rules, procedures,
264	guidelines, and directives are conducive to the coordination of
265	transportation funds and services for the transportation
266	disadvantaged.
267	(8)(5)  Provide technical assistance, as needed, to
268	community transportation coordinators or transportation
269	operators or participating agencies.
270	Section 6.  Subsections (2) and (3) of section 427.015,
271	Florida Statutes, are amended to read:
272	427.015  Function of the metropolitan planning organization
273	or designated official planning agency in coordinating
274	transportation for the transportation disadvantaged.--
275	(2)  Each metropolitan planning organization or designated
276	official planning agency shall recommend to the commission a
277	single community transportation coordinator. However, a
278	purchasing agency member department may not serve as the
279	community transportation coordinator in any designated service
280	area. The coordinator may provide all or a portion of needed
281	transportation services for the transportation disadvantaged but
282	shall be responsible for the provision of those coordinated
283	services. Based on approved commission evaluation criteria, the
284	coordinator shall subcontract or broker those services that are
285	more cost-effectively and efficiently provided by subcontracting
286	or brokering. The performance of the coordinator shall be
287	evaluated based on the commission's approved evaluation criteria
288	by the coordinating board at least annually. A copy of the
289	evaluation shall be submitted to the metropolitan planning
290	organization or the designated official planning agency, and the
291	commission. The recommendation or termination of any community
292	transportation coordinator shall be subject to approval by the
293	commission.
294	(3)  Each metropolitan planning organization or designated
295	official planning agency shall request each local government in
296	its jurisdiction to provide the actual expenditures an estimate
297	of all local and direct federal funds to be expended for
298	transportation for the disadvantaged. The metropolitan planning
299	organization or designated official planning agency shall
300	consolidate this information into a single report and forward
301	it, by September 15 the beginning of each fiscal year, to the
302	commission.
303	Section 7.  Subsection (7) of section 427.0155, Florida
304	Statutes, is amended to read:
305	427.0155  Community transportation coordinators; powers and
306	duties.--Community transportation coordinators shall have the
307	following powers and duties:
308	(7)  In cooperation with the coordinating board and
309	pursuant to criteria developed by the Commission for the
310	Transportation Disadvantaged, establish eligibility guidelines
311	and priorities with regard to the recipients of nonsponsored
312	transportation disadvantaged services that are purchased with
313	Transportation Disadvantaged Trust Fund moneys.
314	Section 8.  Subsection (4) of section 427.0157, Florida
315	Statutes, is amended to read:
316	427.0157  Coordinating boards; powers and duties.--The
317	purpose of each coordinating board is to develop local service
318	needs and to provide information, advice, and direction to the
319	community transportation coordinators on the coordination of
320	services to be provided to the transportation disadvantaged. The
321	commission shall, by rule, establish the membership of
322	coordinating boards. The members of each board shall be
323	appointed by the metropolitan planning organization or
324	designated official planning agency. The appointing authority
325	shall provide each board with sufficient staff support and
326	resources to enable the board to fulfill its responsibilities
327	under this section. Each board shall meet at least quarterly and
328	shall:
329	(4)  Assist the community transportation coordinator in
330	establishing eligibility guidelines and priorities with regard
331	to the recipients of nonsponsored transportation disadvantaged
332	services that are purchased with Transportation Disadvantaged
333	Trust Fund moneys.
334	Section 9.  Subsections (2) and (3) of section 427.0158,
335	Florida Statutes, are amended to read:
336	427.0158  School bus and public transportation.--
337	(2)  The school boards shall cooperate in the utilization
338	of their vehicles to enhance coordinated disadvantaged
339	transportation disadvantaged services by providing the
340	information as requested by the community transportation
341	coordinator required by this section and by allowing the use of
342	their vehicles at actual cost upon request when those vehicles
343	are available for such use and are not transporting students.
344	Semiannually, no later than October 1 and April 30, a designee
345	from the local school board shall provide the community
346	transportation coordinator with copies to the coordinated
347	transportation board, the following information for vehicles not
348	scheduled 100 percent of the time for student transportation
349	use:
350	(a)  The number and type of vehicles by adult capacity,
351	including days and times, that the vehicles are available for
352	coordinated transportation disadvantaged services;
353	(b)  The actual cost per mile by vehicle type available;
354	(c)  The actual driver cost per hour;
355	(d)  Additional actual cost associated with vehicle use
356	outside the established workday or workweek of the entity; and
357	(e)  Notification of lead time required for vehicle use.
358	(3)  The public transit fixed route or fixed schedule
359	system shall cooperate in the utilization of its regular service
360	to enhance coordinated transportation disadvantaged services by
361	providing the information as requested by the community
362	transportation coordinator required by this section. Annually,
363	no later than October 1, a designee from the local public
364	transit fixed route or fixed schedule system shall provide The
365	community transportation coordinator may request, without
366	limitation, with copies to the coordinated transportation board,
367	the following information:
368	(a)  A copy of all current schedules, route maps, system
369	map, and fare structure;
370	(b)  A copy of the current charter policy;
371	(c)  A copy of the current charter rates and hour
372	requirements; and
373	(d)  Required notification time to arrange for a charter.
374	Section 10.  Subsection (4) is added to section 427.0159,
375	Florida Statutes, to read:
376	427.0159  Transportation Disadvantaged Trust Fund.--
377	(4)  A purchasing agency may deposit funds into the
378	Transportation Disadvantaged Trust Fund for the commission to
379	implement, manage, and administer the purchasing agency's
380	transportation disadvantaged funds, as defined in s.
381	427.011(10).
382	Section 11.  Paragraph (b) of subsection (1) and subsection
383	(2) of section 427.016, Florida Statutes, are amended to read:
384	427.016  Expenditure of local government, state, and
385	federal funds for the transportation disadvantaged.--
386	(1)
387	(b)  Nothing in This subsection does not shall be construed
388	to limit or preclude a purchasing the Medicaid agency from
389	establishing maximum fee schedules, individualized reimbursement
390	policies by provider type, negotiated fees, competitive bidding,
391	or any other mechanism, including contracting after initial
392	negotiation with the commission, which that the agency considers
393	more cost-effective and of comparable or higher quality and
394	standards than those of the commission efficient and effective
395	for the purchase of services on behalf of its Medicaid clients
396	if it has fulfilled the requirements of s. 427.0135(3) or the
397	procedure for using an alternative provider. State and local
398	agencies shall not contract for any transportation disadvantaged
399	services, including Medicaid reimbursable transportation
400	services, with any community transportation coordinator or
401	transportation operator that has been determined by the Agency
402	for Health Care Administration, the Department of Legal Affairs
403	Medicaid Fraud Control Unit, or any state or federal agency to
404	have engaged in any abusive or fraudulent billing activities.
405	(2)  Each year, each agency, whether or not it is an ex
406	officio, nonvoting advisor to a member of the Commission for the
407	Transportation Disadvantaged, shall identify in the legislative
408	budget request provided to the Governor for the General
409	Appropriations Act inform the commission in writing, before the
410	beginning of each fiscal year, of the specific amount of any
411	money the agency will allocate allocated for the provision of
412	transportation disadvantaged services. Additionally, each state
413	agency shall, by September 15 of each year, provide the
414	commission with an accounting of the actual amount of funds
415	expended and the total number of trips purchased.
416	Section 12.  This act shall take effect July 1, 2008.

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