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A bill to be entitled

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An act relating to the reimbursement of Medicaid

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providers; amending s. 409.908, F.S.; requiring the Agency

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for Health Care Administration to provide reimbursement

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for physician and dental services at certain levels and

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rates; providing an effective date.

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

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

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section 409.908, Florida Statutes, to read:

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     409.908  Reimbursement of Medicaid providers.--Subject to

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specific appropriations, the agency shall reimburse Medicaid

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providers, in accordance with state and federal law, according to

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methodologies set forth in the rules of the agency and in policy

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manuals and handbooks incorporated by reference therein. These

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methodologies may include fee schedules, reimbursement methods

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based on cost reporting, negotiated fees, competitive bidding

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pursuant to s. 287.057, and other mechanisms the agency considers

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efficient and effective for purchasing services or goods on

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behalf of recipients. If a provider is reimbursed based on cost

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reporting and submits a cost report late and that cost report

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

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semester, then the provider's rate for that semester shall be

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retroactively calculated using the new cost report, and full

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payment at the recalculated rate shall be effected retroactively.

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Medicare-granted extensions for filing cost reports, if

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applicable, shall also apply to Medicaid cost reports. Payment

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for Medicaid compensable services made on behalf of Medicaid

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eligible persons is subject to the availability of moneys and any

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limitations or directions provided for in the General

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Appropriations Act or chapter 216. Further, nothing in this

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section shall be construed to prevent or limit the agency from

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adjusting fees, reimbursement rates, lengths of stay, number of

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visits, or number of services, or making any other adjustments

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necessary to comply with the availability of moneys and any

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limitations or directions provided for in the General

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Appropriations Act, provided the adjustment is consistent with

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legislative intent.

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     (12)

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     (d) Notwithstanding any other provision of this subsection,

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the agency shall provide reimbursement for physician and dental

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services provided to children younger than 21 years of age at

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least at the level provided by federal law for physician

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reimbursement under the Medicare program and provide

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reimbursement for dental services at 50 percent of usual and

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customary rates provided for dental services. The agency shall

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include in all managed care contracts a requirement to provide at

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least such reimbursement for physician and dental services.

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     Section 2.  This act shall take effect July 1, 2008.