HB 329

1	A bill to be entitled
2	An act relating to reimbursement of Medicaid providers;
3	amending s. 409.908, F.S.; requiring the Agency for
4	Health Care Administration to provide reimbursement for
5	physician and dental services at certain levels and
6	rates; providing an effective date.
7
8	Be It Enacted by the Legislature of the State of Florida:
9
10	Section 1.  Paragraph (d) is added to subsection (12) of
11	section 409.908, Florida Statutes, to read:
12	409.908  Reimbursement of Medicaid providers.--Subject to
13	specific appropriations, the agency shall reimburse Medicaid
14	providers, in accordance with state and federal law, according
15	to methodologies set forth in the rules of the agency and in
16	policy manuals and handbooks incorporated by reference
17	therein. These methodologies may include fee schedules,
18	reimbursement methods based on cost reporting, negotiated
19	fees, competitive bidding pursuant to s. 287.057, and other
20	mechanisms the agency considers efficient and effective for
21	purchasing services or goods on behalf of recipients. If a
22	provider is reimbursed based on cost reporting and submits a
23	cost report late and that cost report would have been used to
24	set a lower reimbursement rate for a rate semester, then the
25	provider's rate for that semester shall be retroactively
26	calculated using the new cost report, and full payment at the
27	recalculated rate shall be effected retroactively. Medicare-
28	granted extensions for filing cost reports, if applicable,
29	shall also apply to Medicaid cost reports. Payment for
30	Medicaid compensable services made on behalf of Medicaid
31	eligible persons is subject to the availability of moneys and
32	any limitations or directions provided for in the General
33	Appropriations Act or chapter 216. Further, nothing in this
34	section shall be construed to prevent or limit the agency from
35	adjusting fees, reimbursement rates, lengths of stay, number
36	of visits, or number of services, or making any other
37	adjustments necessary to comply with the availability of
38	moneys and any limitations or directions provided for in the
39	General Appropriations Act, provided the adjustment is
40	consistent with legislative intent.
41	(12)
42	(d)  Notwithstanding any other provision of this
43	subsection, the agency shall provide reimbursement for
44	physician and dental services provided to children younger
45	than 21 years of age at least at the level provided by federal
46	law for physician reimbursement under the Medicare program and
47	provide reimbursement for dental services at 50 percent of
48	usual and customary rates provided for dental services. The
49	agency shall include in all managed care contracts a
50	requirement to provide at least such reimbursement for
51	physician and dental services.
52	Section 2.  This act shall take effect July 1, 2008.

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