| 1 | A bill to be entitled |
| 2 | An act relating to hospital outpatient services; amending |
| 3 | s. 409.905, F.S.; authorizing the Agency for Health Care |
| 4 | Administration to pay for hospital outpatient services |
| 5 | provided to Medicaid recipients under the direction of a |
| 6 | licensed advanced registered nurse practitioner; providing |
| 7 | an exception to limits on payment for hospital outpatient |
| 8 | services provided to Medicaid recipients for services |
| 9 | provided in certain clinics; providing an effective date. |
| 10 |
|
| 11 | Be It Enacted by the Legislature of the State of Florida: |
| 12 |
|
| 13 | Section 1. Subsection (6) of section 409.905, Florida |
| 14 | Statutes, is amended to read: |
| 15 | 409.905 Mandatory Medicaid services.-The agency may make |
| 16 | payments for the following services, which are required of the |
| 17 | state by Title XIX of the Social Security Act, furnished by |
| 18 | Medicaid providers to recipients who are determined to be |
| 19 | eligible on the dates on which the services were provided. Any |
| 20 | service under this section shall be provided only when medically |
| 21 | necessary and in accordance with state and federal law. |
| 22 | Mandatory services rendered by providers in mobile units to |
| 23 | Medicaid recipients may be restricted by the agency. Nothing in |
| 24 | this section shall be construed to prevent or limit the agency |
| 25 | from adjusting fees, reimbursement rates, lengths of stay, |
| 26 | number of visits, number of services, or any other adjustments |
| 27 | necessary to comply with the availability of moneys and any |
| 28 | limitations or directions provided for in the General |
| 29 | Appropriations Act or chapter 216. |
| 30 | (6) HOSPITAL OUTPATIENT SERVICES.-The agency shall pay for |
| 31 | preventive, diagnostic, therapeutic, or palliative care and |
| 32 | other services provided to a recipient in the outpatient portion |
| 33 | of a hospital licensed under part I of chapter 395, and provided |
| 34 | under the direction of a licensed physician, licensed advanced |
| 35 | registered nurse practitioner, or licensed dentist, except that |
| 36 | payment for such care and services is limited to $1,500 per |
| 37 | state fiscal year per recipient, unless an exception has been |
| 38 | made by the agency, and with the exception of a Medicaid |
| 39 | recipient under age 21 or a Medicaid recipient of any age who is |
| 40 | receiving such care in a community-based clinic of a publicly |
| 41 | owned hospital, in which case the only limitation is medical |
| 42 | necessity. |
| 43 | Section 2. This act shall take effect July 1, 2010. |