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A bill to be entitled

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An act relating to optional Medicaid services; amending s.

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409.906, F.S.; requiring the Agency for Health Care

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Administration to limit payments for certain medical

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equipment and medical supplies to providers that meet

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specified criteria; requiring surety bonds for certain

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provider locations; providing an exception; requiring

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background screening of certain provider staff as a

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condition of employment; 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.  Subsection (10) of section 409.906, Florida

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Statutes, is amended to read:

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     409.906  Optional Medicaid services.--Subject to specific

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appropriations, the agency may make payments for services which

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are optional to the state under Title XIX of the Social Security

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Act and are furnished by Medicaid providers to recipients who are

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determined to be eligible on the dates on which the services were

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provided. Any optional service that is provided shall be provided

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only when medically necessary and in accordance with state and

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federal law. Optional services rendered by providers in mobile

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units to Medicaid recipients may be restricted or prohibited by

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the agency. Nothing in this section shall be construed to prevent

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or limit the agency from adjusting fees, reimbursement rates,

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

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making any other adjustments necessary to comply with the

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availability of moneys and any limitations or directions provided

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for in the General Appropriations Act or chapter 216. If

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necessary to safeguard the state's systems of providing services

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to elderly and disabled persons and subject to the notice and

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review provisions of s. 216.177, the Governor may direct the

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Agency for Health Care Administration to amend the Medicaid state

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plan to delete the optional Medicaid service known as

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"Intermediate Care Facilities for the Developmentally Disabled."

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Optional services may include:

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     (10)  DURABLE MEDICAL EQUIPMENT.--The agency may authorize

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and pay for certain durable medical equipment and medical

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supplies provided to a Medicaid recipient as medically necessary.

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As of January 1, 2009, the agency shall limit payment for durable

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medical equipment and medical supplies to providers who meet all

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of the following criteria:

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     (a) Unless specifically exempted under rule 59G-4.070,

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Florida Administrative Code, a durable medical equipment and

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medical supply provider must be accredited by an agency-approved

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accreditation organization specifically designated as a durable

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medical equipment and medical supply provider accrediting

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organization. The provider must be reaccredited periodically and

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shall be subject to unannounced reviews by the accrediting

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organization.

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     (b) A durable medical equipment and medical supply provider

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must have a physical business location, with durable medical

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equipment and medical supplies on site and readily available to

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the general public, which meets the following criteria:

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     1. The location must maintain a substantial stock that is

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readily available and sufficient to meet the needs of its

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customers.

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     2. The location must be clearly identified with signage

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that can be read from 20 feet away that readily identifies the

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business location as a business that furnishes durable medical

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equipment and medical supplies.

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     3. The location must have a functional landline business

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phone.

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     4. The location may not be located at the same street

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address as another Medicaid durable medical equipment and medical

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supply provider or an enrolled Medicaid pharmacy that is also

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enrolled as a durable medical equipment and medical supply

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provider.

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     5. For an out-of-state provider, the location may not be

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more than 50 miles from the state line. Exceptions may be made

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for manufacturers of a specific type of unique durable medical

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equipment that is not otherwise available from other durable

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medical equipment and medical supply providers located within the

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state.

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     6. Unless the provider is an out-of-state manufacturer

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business that is located more than 50 miles from the state line

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and has been exempted under subparagraph 5., the location must be

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easily accessible to the public during normal scheduled, posted

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business hours and must operate no less than 5 hours per day and

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no less than 5 days per week, with the exception of scheduled and

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posted holidays.

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     (c) Unless specifically exempted under rule 59G-4.070,

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Florida Administrative Code, a durable medical equipment and

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medical supply provider must provide a $50,000 surety bond for

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each provider location, with up to a maximum of five bonds

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statewide or an aggregate bond of $250,000 statewide, as

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identified by the provider's federal employer identification

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number. A provider that qualifies for a statewide or an aggregate

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bond must identify all of its locations in any Medicaid durable

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medical equipment and medical supply provider enrollment

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application or bond renewal.

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     (d) A level 2 background screening, pursuant to s. 435.04,

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is required as a condition of employment for provider staff in

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direct contact with and providing direct services to recipients

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of durable medical equipment and medical supplies in their homes.

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This requirement includes, but is not limited to, repair and

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service technicians, fitters, and delivery staff.

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     Section 2.  This act shall take effect upon becoming a law.