Florida Senate - 2012 SENATOR AMENDMENT Bill No. SB 2002 Barcode 913706 LEGISLATIVE ACTION Senate . House . . . Floor: 1/AD/2R . 02/23/2012 03:47 PM . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— Senator Hays moved the following: 1 Senate Amendment (with title amendment) 2 3 Between lines 301 and 302 4 insert: 5 Section 10. In order to implement Specific Appropriation 6 208 of the 2012-2013 General Appropriations Act, subsection (41) 7 of section 409.912, Florida 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 are not entitled to enrollment in the Medicaid provider network. 62 The agency shall determine instances in which allowing Medicaid 63 beneficiaries to purchase durable medical equipment and other 64 goods is less expensive to the Medicaid program than long-term 65 rental of the equipment or goods. The agency may establish rules 66 to facilitate purchases in lieu of long-term rentals in order to 67 protect against fraud and abuse in the Medicaid program as 68 defined in s. 409.913. The agency may seek federal waivers 69 necessary to administer these policies. 70 (41)(a) The agency shall contract on a prepaid or fixed-sum 71 basis with appropriately licensed prepaid dental health plans to 72 provide dental services. This subsection expires October 1, 73 2014. 74 (b) Notwithstanding paragraph (a) and for the 2012-2013 75 fiscal year only, the agency is authorized to provide a Medicaid 76 prepaid dental health program in Miami-Dade County. For all 77 other counties, the agency may not limit dental services to 78 prepaid plans and must allow qualified dental providers to 79 provide dental services under Medicaid on a fee-for-service 80 reimbursement methodology. The agency may seek any necessary 81 revisions or amendments to the state plan or federal waivers in 82 order to implement this paragraph. The agency shall terminate 83 existing contracts as needed to implement this paragraph. This 84 paragraph expires July 1, 2013. 85 86 ================= T I T L E A M E N D M E N T ================ 87 And the title is amended as follows: 88 Delete line 26 89 and insert: 90 services are spent; amending s. 409.912, F.S.; 91 authorizing the Agency for Health Care Administration 92 to provide a Medicaid prepaid dental health program in 93 Miami-Dade County; authorizing the agency to seek 94 revisions or amendments to the state plan or federal 95 waivers in order to implement the program; requiring 96 that the agency terminate existing contracts as 97 necessary to implement the program; requiring certain 98 budget