Florida Senate - 2018 SB 1468 By Senator Rouson 19-01050-18 20181468__ 1 A bill to be entitled 2 An act relating to alcohol and substance abuse 3 prevention; creating s. 14.35, F.S.; creating the 4 Office of Alcohol and Drug Control Policy within the 5 Executive Office of the Governor; providing for 6 appointment of the director of the office; specifying 7 duties of the office; requiring the office to adopt 8 rules; requiring the office to submit an annual report 9 to the Governor and the Legislature; amending s. 10 409.912, F.S.; requiring the Agency for Health Care 11 Administration, in consultation with the Department of 12 Children and Families, to seek federal approval for 13 waivers to increase federal Medicaid funding for a 14 specified purpose; providing an effective date. 15 16 Be It Enacted by the Legislature of the State of Florida: 17 18 Section 1. Section 14.35, Florida Statutes, is created to 19 read: 20 14.35 Office of Alcohol and Drug Control Policy.— 21 (1) The Office of Alcohol and Drug Control Policy is 22 created within the Executive Office of the Governor. The 23 director, who shall be appointed by and serve at the pleasure of 24 the Governor, shall oversee the office. 25 (2) The office is responsible for all matters relating to 26 the research of, coordination of, and execution of programs 27 related to alcohol and drug control. 28 (3) The office shall: 29 (a) Develop a strategic plan to reduce the prevalence of 30 alcohol and substance abuse in the state. 31 (b) Monitor data and issues related to state policies 32 concerning youth alcohol use prevention and state substance 33 abuse policies, the impact of such policies on state and local 34 programs, and the flexibility of such policies to adapt to the 35 needs of local communities and service providers. 36 (c) Collect data related to drug crimes and overdoses to 37 generate statistical and analytical reports containing 38 recommendations for this state’s criminal justice system. 39 (d) Issue policy recommendations to executive branch 40 agencies for alcohol and substance abuse prevention and 41 treatment to ensure efficiency in efforts undertaken by the 42 administration. 43 (e) Work with behavioral health managing entities to 44 identify existing resources and programs in each community which 45 provide alcohol and substance abuse prevention education or 46 treatment. 47 (f) Facilitate coordination of alcohol and substance abuse 48 prevention education and treatment between the courts, local and 49 state agencies, organizations, service providers, and related 50 public or private programs concerning alcohol and substance 51 abuse. 52 (g) Assist behavioral health managing entities in 53 coordinating activities to ensure the availability of training, 54 technical assistance, and consultation to local service 55 providers for programs funded by the state which provide 56 services related to alcohol or substance abuse. 57 (h) Act as a referral source of information, using existing 58 information clearinghouse resources. 59 (i) Search for grant opportunities to fund the office and 60 its initiatives. 61 (j) Be knowledgeable on alcohol and substance abuse 62 prevention and treatment programs and initiatives in this state 63 and in other states. 64 (k) Review existing research on programs related to 65 substance abuse prevention and treatment. 66 (l) Coordinate with the Department of Education to link 67 schools with community-based agencies and county health 68 departments to implement early intervention programs for the 69 prevention of alcohol and substance abuse. 70 (m) Coordinate media campaigns to demonstrate the negative 71 impact of substance abuse disorders and to prevent the 72 development of such disorders in children, young people, and 73 adults. 74 (n) Prepare and submit legislative budget requests. 75 (o) Adopt rules necessary to administer this section. 76 (p) Submit a report annually to the Governor, the President 77 of the Senate, and the Speaker of the House of Representatives 78 on the effectiveness of state policies and coordinated state 79 efforts related to substance abuse. 80 Section 2. Subsection (14) is added to section 409.912, 81 Florida Statutes, to read: 82 409.912 Cost-effective purchasing of health care.—The 83 agency shall purchase goods and services for Medicaid recipients 84 in the most cost-effective manner consistent with the delivery 85 of quality medical care. To ensure that medical services are 86 effectively utilized, the agency may, in any case, require a 87 confirmation or second physician’s opinion of the correct 88 diagnosis for purposes of authorizing future services under the 89 Medicaid program. This section does not restrict access to 90 emergency services or poststabilization care services as defined 91 in 42 C.F.R. s. 438.114. Such confirmation or second opinion 92 shall be rendered in a manner approved by the agency. The agency 93 shall maximize the use of prepaid per capita and prepaid 94 aggregate fixed-sum basis services when appropriate and other 95 alternative service delivery and reimbursement methodologies, 96 including competitive bidding pursuant to s. 287.057, designed 97 to facilitate the cost-effective purchase of a case-managed 98 continuum of care. The agency shall also require providers to 99 minimize the exposure of recipients to the need for acute 100 inpatient, custodial, and other institutional care and the 101 inappropriate or unnecessary use of high-cost services. The 102 agency shall contract with a vendor to monitor and evaluate the 103 clinical practice patterns of providers in order to identify 104 trends that are outside the normal practice patterns of a 105 provider’s professional peers or the national guidelines of a 106 provider’s professional association. The vendor must be able to 107 provide information and counseling to a provider whose practice 108 patterns are outside the norms, in consultation with the agency, 109 to improve patient care and reduce inappropriate utilization. 110 The agency may mandate prior authorization, drug therapy 111 management, or disease management participation for certain 112 populations of Medicaid beneficiaries, certain drug classes, or 113 particular drugs to prevent fraud, abuse, overuse, and possible 114 dangerous drug interactions. The Pharmaceutical and Therapeutics 115 Committee shall make recommendations to the agency on drugs for 116 which prior authorization is required. The agency shall inform 117 the Pharmaceutical and Therapeutics Committee of its decisions 118 regarding drugs subject to prior authorization. The agency is 119 authorized to limit the entities it contracts with or enrolls as 120 Medicaid providers by developing a provider network through 121 provider credentialing. The agency may competitively bid single 122 source-provider contracts if procurement of goods or services 123 results in demonstrated cost savings to the state without 124 limiting access to care. The agency may limit its network based 125 on the assessment of beneficiary access to care, provider 126 availability, provider quality standards, time and distance 127 standards for access to care, the cultural competence of the 128 provider network, demographic characteristics of Medicaid 129 beneficiaries, practice and provider-to-beneficiary standards, 130 appointment wait times, beneficiary use of services, provider 131 turnover, provider profiling, provider licensure history, 132 previous program integrity investigations and findings, peer 133 review, provider Medicaid policy and billing compliance records, 134 clinical and medical record audits, and other factors. Providers 135 are not entitled to enrollment in the Medicaid provider network. 136 The agency shall determine instances in which allowing Medicaid 137 beneficiaries to purchase durable medical equipment and other 138 goods is less expensive to the Medicaid program than long-term 139 rental of the equipment or goods. The agency may establish rules 140 to facilitate purchases in lieu of long-term rentals in order to 141 protect against fraud and abuse in the Medicaid program as 142 defined in s. 409.913. The agency may seek federal waivers 143 necessary to administer these policies. 144 (14) The agency, in consultation with the department, shall 145 seek federal approval for a waiver to increase the availability 146 of federal Medicaid funding to provide programs that improve the 147 quality of and access to treatment for individuals with 148 substance abuse disorders served by the Medicaid program and to 149 provide a more comprehensive continuum of care for individuals 150 with substance abuse disorders, including detoxification 151 services, residential services, medication-assisted treatment, 152 targeted case management, and recovery support that Medicaid is 153 unable to cover without a waiver. 154 Section 3. This act shall take effect July 1, 2018.