Florida Senate - 2011 COMMITTEE AMENDMENT Bill No. SB 1458 Barcode 235806 LEGISLATIVE ACTION Senate . House . . . . . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— The Committee on Health Regulation (Garcia) recommended the following: 1 Senate Amendment to Amendment (423426) (with title 2 amendment) 3 4 Between lines 75 and 76 5 insert: 6 Section 4. Subsection (41) of section 409.912, Florida 7 Statutes, is amended to read: 8 409.912 Cost-effective purchasing of health care.—The 9 agency shall purchase goods and services for Medicaid recipients 10 in the most cost-effective manner consistent with the delivery 11 of quality medical care. To ensure that medical services are 12 effectively utilized, the agency may, in any case, require a 13 confirmation or second physician’s opinion of the correct 14 diagnosis for purposes of authorizing future services under the 15 Medicaid program. This section does not restrict access to 16 emergency services or poststabilization care services as defined 17 in 42 C.F.R. part 438.114. Such confirmation or second opinion 18 shall be rendered in a manner approved by the agency. The agency 19 shall maximize the use of prepaid per capita and prepaid 20 aggregate fixed-sum basis services when appropriate and other 21 alternative service delivery and reimbursement methodologies, 22 including competitive bidding pursuant to s. 287.057, designed 23 to facilitate the cost-effective purchase of a case-managed 24 continuum of care. The agency shall also require providers to 25 minimize the exposure of recipients to the need for acute 26 inpatient, custodial, and other institutional care and the 27 inappropriate or unnecessary use of high-cost services. The 28 agency shall contract with a vendor to monitor and evaluate the 29 clinical practice patterns of providers in order to identify 30 trends that are outside the normal practice patterns of a 31 provider’s professional peers or the national guidelines of a 32 provider’s professional association. The vendor must be able to 33 provide information and counseling to a provider whose practice 34 patterns are outside the norms, in consultation with the agency, 35 to improve patient care and reduce inappropriate utilization. 36 The agency may mandate prior authorization, drug therapy 37 management, or disease management participation for certain 38 populations of Medicaid beneficiaries, certain drug classes, or 39 particular drugs to prevent fraud, abuse, overuse, and possible 40 dangerous drug interactions. The Pharmaceutical and Therapeutics 41 Committee shall make recommendations to the agency on drugs for 42 which prior authorization is required. The agency shall inform 43 the Pharmaceutical and Therapeutics Committee of its decisions 44 regarding drugs subject to prior authorization. The agency is 45 authorized to limit the entities it contracts with or enrolls as 46 Medicaid providers by developing a provider network through 47 provider credentialing. The agency may competitively bid single 48 source-provider contracts if procurement of goods or services 49 results in demonstrated cost savings to the state without 50 limiting access to care. The agency may limit its network based 51 on the assessment of beneficiary access to care, provider 52 availability, provider quality standards, time and distance 53 standards for access to care, the cultural competence of the 54 provider network, demographic characteristics of Medicaid 55 beneficiaries, practice and provider-to-beneficiary standards, 56 appointment wait times, beneficiary use of services, provider 57 turnover, provider profiling, provider licensure history, 58 previous program integrity investigations and findings, peer 59 review, provider Medicaid policy and billing compliance records, 60 clinical and medical record audits, and other factors. Providers 61 shall not be entitled to enrollment in the Medicaid provider 62 network. The agency shall determine instances in which allowing 63 Medicaid beneficiaries to purchase durable medical equipment and 64 other goods is less expensive to the Medicaid program than long 65 term rental of the equipment or goods. The agency may establish 66 rules to facilitate purchases in lieu of long-term rentals in 67 order to protect against fraud and abuse in the Medicaid program 68 as defined in s. 409.913. The agency may seek federal waivers 69 necessary to administer these policies. 70 (41) The agency shall establishprovide for the development71ofa demonstration projectby establishmentin Miami-Dade County 72 of a long-term-care facility and a psychiatric facility licensed 73 pursuant to chapter 395 to improve access to health care for a 74 predominantly minority, medically underserved, and medically 75 complex population and to evaluate alternatives to nursing home 76 care and general acute care for such population. Such project is 77 to be located in a health care condominium and collocated 78colocatedwith licensed facilities providing a continuum of 79 care. These projects areThe establishment of this project is80 not subject to the provisions of s. 408.036 or s. 408.039. 81 82 ================= T I T L E A M E N D M E N T ================ 83 And the title is amended as follows: 84 Delete lines 2259 - 2268 85 and insert: 86 An act relating to assisted care communities; amending 87 s. 400.141, F.S.; revising licensing requirements for 88 registered pharmacists under contract with a nursing 89 home and related health care facilities; amending s. 90 408.810, F.S.; providing additional licensing 91 requirements for assisted living facilities; amending 92 s. 408.820, F.S.; providing that certain assisted 93 living facilities are exempt from requirements of part 94 II of ch. 408, F.S., related to health care licensing; 95 amending s. 409.912, F.S.; requiring the Agency for 96 Health Care Administration to provide for the 97 development of a demonstration project for a 98 psychiatric facility in Miami-Dade County; amending s. 99 429.01, F.S.;