Florida Senate - 2012                             CS for SB 1600
       
       
       
       By the Committee on Health Regulation; and Senator Storms
       
       
       
       
       588-02724-12                                          20121600c1
    1                        A bill to be entitled                      
    2         An act relating to telebehavioral health care
    3         services; amending s. 409.906, F.S.; requiring that
    4         the Agency for Health Care Administration implement
    5         telebehavioral health care services by licensed mental
    6         health professionals as authorized by the Centers for
    7         Medicare and Medicaid Services for all community-based
    8         behavioral health care services, except for those
    9         services that require physical contact; requiring that
   10         telebehavioral health care services be delivered by a
   11         licensed person who is under contract with a Medicaid
   12         provider that is enrolled in this state and authorized
   13         to provide telebehavioral health care services;
   14         requiring that the agency seek authorization from the
   15         Centers for Medicare and Medicaid Services to allow
   16         the delivery of telebehavioral health care services by
   17         any person currently authorized by rule to deliver
   18         such services; providing an effective date.
   19  
   20  Be It Enacted by the Legislature of the State of Florida:
   21  
   22         Section 1. Subsection (8) of section 409.906, Florida
   23  Statutes, is amended to read:
   24         409.906 Optional Medicaid services.—Subject to specific
   25  appropriations, the agency may make payments for services which
   26  are optional to the state under Title XIX of the Social Security
   27  Act and are furnished by Medicaid providers to recipients who
   28  are determined to be eligible on the dates on which the services
   29  were provided. Any optional service that is provided shall be
   30  provided only when medically necessary and in accordance with
   31  state and federal law. Optional services rendered by providers
   32  in mobile units to Medicaid recipients may be restricted or
   33  prohibited by the agency. Nothing in this section shall be
   34  construed to prevent or limit the agency from adjusting fees,
   35  reimbursement rates, lengths of stay, number of visits, or
   36  number of services, or making any other adjustments necessary to
   37  comply with the availability of moneys and any limitations or
   38  directions provided for in the General Appropriations Act or
   39  chapter 216. If necessary to safeguard the state’s systems of
   40  providing services to elderly and disabled persons and subject
   41  to the notice and review provisions of s. 216.177, the Governor
   42  may direct the Agency for Health Care Administration to amend
   43  the Medicaid state plan to delete the optional Medicaid service
   44  known as “Intermediate Care Facilities for the Developmentally
   45  Disabled.” Optional services may include:
   46         (8) COMMUNITY MENTAL HEALTH SERVICES.—
   47         (a) The agency may pay for rehabilitative services provided
   48  to a recipient by a mental health or substance abuse provider
   49  under contract with the agency or the Department of Children and
   50  Family Services to provide such services. Those services that
   51  which are psychiatric in nature shall be rendered or recommended
   52  by a psychiatrist, and those services that which are medical in
   53  nature shall be rendered or recommended by a physician or
   54  psychiatrist. The agency shall must develop a provider
   55  enrollment process for community mental health providers which
   56  bases provider enrollment on an assessment of service need. The
   57  provider enrollment process shall be designed to control costs,
   58  prevent fraud and abuse, consider provider expertise and
   59  capacity, and assess provider success in managing utilization of
   60  care and measuring treatment outcomes. Providers will be
   61  selected through a competitive procurement or selective
   62  contracting process. In addition to other community mental
   63  health providers, the agency shall consider for enrollment
   64  mental health programs licensed under chapter 395 and group
   65  practices licensed under chapter 458, chapter 459, chapter 490,
   66  or chapter 491. The agency may is also authorized to continue
   67  operation of its behavioral health utilization management
   68  program and may develop new services if these actions are
   69  necessary to ensure savings from the implementation of the
   70  utilization management system. The agency shall coordinate the
   71  implementation of this enrollment process with the Department of
   72  Children and Family Services and the Department of Juvenile
   73  Justice. The agency may use is authorized to utilize diagnostic
   74  criteria in setting reimbursement rates, to preauthorize certain
   75  high-cost or highly utilized services, to limit or eliminate
   76  coverage for certain services, or to make any other adjustments
   77  necessary to comply with any limitations or directions provided
   78  for in the General Appropriations Act.
   79         (b) The agency may is authorized to implement reimbursement
   80  and use management reforms in order to comply with any
   81  limitations or directions in the General Appropriations Act,
   82  which may include, but are not limited to,: prior authorization
   83  of treatment and service plans,; prior authorization of
   84  services,; enhanced use review programs for highly used
   85  services,; and limits on services for those determined to be
   86  abusing their benefit coverages.
   87         (c) The agency shall implement telebehavioral health care
   88  services by licensed mental health professionals as authorized
   89  by the Centers for Medicare and Medicaid Services for all
   90  community-based behavioral health care services, except for
   91  those services that require physical contact, such as physical
   92  exams. Telebehavioral health care services must be delivered by
   93  a person who is licensed in this state, under contract with a
   94  Medicaid provider that is enrolled in this state, and authorized
   95  to provide services under this subsection. The agency shall also
   96  seek authorization from the Centers for Medicare and Medicaid
   97  Services to allow the delivery of telebehavioral health care
   98  services by any person currently authorized by rule to deliver
   99  such services.
  100         Section 2. This act shall take effect July 1, 2012.