Florida Senate - 2019 SB 504 By Senator Rouson 19-00883-19 2019504__ 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 of a 13 waiver to increase federal Medicaid funding for 14 specified purposes relating to substance use 15 disorders; providing an effective date. 16 17 Be It Enacted by the Legislature of the State of Florida: 18 19 Section 1. Section 14.35, Florida Statutes, is created to 20 read: 21 14.35 Office of Alcohol and Drug Control Policy.— 22 (1) The Office of Alcohol and Drug Control Policy is 23 created within the Executive Office of the Governor. The 24 director, who shall be appointed by and serve at the pleasure of 25 the Governor, shall oversee the office. 26 (2) The office is responsible for all matters relating to 27 the research, coordination, and execution of programs related to 28 alcohol and drug control. 29 (3) The office shall: 30 (a) Develop a strategic plan to reduce the prevalence of 31 alcohol and substance abuse in the state. 32 (b) Monitor data and issues related to state policies 33 concerning youth alcohol use prevention and state substance 34 abuse policies, the impact of such policies on state and local 35 programs, and the flexibility of such policies to adapt to the 36 needs of local communities and service providers. 37 (c) Collect data related to drug crimes and overdoses to 38 generate statistical and analytical reports containing 39 recommendations for this state’s criminal justice system. 40 (d) Issue policy recommendations to executive branch 41 agencies for alcohol and substance abuse prevention and 42 treatment to ensure the administration operates efficiently. 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 treatment or prevention 46 education. 47 (f) Facilitate coordination of alcohol and substance abuse 48 treatment and prevention education among 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 this 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 about 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 use disorders and to prevent the development 72 of such disorders in children, young people, and adults. 73 (n) Prepare and submit legislative budget requests. 74 (o) Adopt rules necessary to administer this section. 75 (p) Submit a report annually to the Governor, the President 76 of the Senate, and the Speaker of the House of Representatives 77 on the effectiveness of state policies and coordinated state 78 efforts related to substance abuse. 79 Section 2. Subsection (14) is added to section 409.912, 80 Florida Statutes, to read: 81 409.912 Cost-effective purchasing of health care.—The 82 agency shall purchase goods and services for Medicaid recipients 83 in the most cost-effective manner consistent with the delivery 84 of quality medical care. To ensure that medical services are 85 effectively utilized, the agency may, in any case, require a 86 confirmation or second physician’s opinion of the correct 87 diagnosis for purposes of authorizing future services under the 88 Medicaid program. This section does not restrict access to 89 emergency services or poststabilization care services as defined 90 in 42 C.F.R. s. 438.114. Such confirmation or second opinion 91 shall be rendered in a manner approved by the agency. The agency 92 shall maximize the use of prepaid per capita and prepaid 93 aggregate fixed-sum basis services when appropriate and other 94 alternative service delivery and reimbursement methodologies, 95 including competitive bidding pursuant to s. 287.057, designed 96 to facilitate the cost-effective purchase of a case-managed 97 continuum of care. The agency shall also require providers to 98 minimize the exposure of recipients to the need for acute 99 inpatient, custodial, and other institutional care and the 100 inappropriate or unnecessary use of high-cost services. The 101 agency shall contract with a vendor to monitor and evaluate the 102 clinical practice patterns of providers in order to identify 103 trends that are outside the normal practice patterns of a 104 provider’s professional peers or the national guidelines of a 105 provider’s professional association. The vendor must be able to 106 provide information and counseling to a provider whose practice 107 patterns are outside the norms, in consultation with the agency, 108 to improve patient care and reduce inappropriate utilization. 109 The agency may mandate prior authorization, drug therapy 110 management, or disease management participation for certain 111 populations of Medicaid beneficiaries, certain drug classes, or 112 particular drugs to prevent fraud, abuse, overuse, and possible 113 dangerous drug interactions. The Pharmaceutical and Therapeutics 114 Committee shall make recommendations to the agency on drugs for 115 which prior authorization is required. The agency shall inform 116 the Pharmaceutical and Therapeutics Committee of its decisions 117 regarding drugs subject to prior authorization. The agency is 118 authorized to limit the entities it contracts with or enrolls as 119 Medicaid providers by developing a provider network through 120 provider credentialing. The agency may competitively bid single 121 source-provider contracts if procurement of goods or services 122 results in demonstrated cost savings to the state without 123 limiting access to care. The agency may limit its network based 124 on the assessment of beneficiary access to care, provider 125 availability, provider quality standards, time and distance 126 standards for access to care, the cultural competence of the 127 provider network, demographic characteristics of Medicaid 128 beneficiaries, practice and provider-to-beneficiary standards, 129 appointment wait times, beneficiary use of services, provider 130 turnover, provider profiling, provider licensure history, 131 previous program integrity investigations and findings, peer 132 review, provider Medicaid policy and billing compliance records, 133 clinical and medical record audits, and other factors. Providers 134 are not entitled to enrollment in the Medicaid provider network. 135 The agency shall determine instances in which allowing Medicaid 136 beneficiaries to purchase durable medical equipment and other 137 goods is less expensive to the Medicaid program than long-term 138 rental of the equipment or goods. The agency may establish rules 139 to facilitate purchases in lieu of long-term rentals in order to 140 protect against fraud and abuse in the Medicaid program as 141 defined in s. 409.913. The agency may seek federal waivers 142 necessary to administer these policies. 143 (14) The agency, in consultation with the department, shall 144 seek federal approval for a waiver to increase the availability 145 of federal Medicaid funding to provide programs that improve the 146 quality of and access to treatment for individuals with 147 substance use disorders served by the Medicaid program and to 148 provide a more comprehensive continuum of care for individuals 149 with substance use disorders, including detoxification services, 150 residential services, medication-assisted treatment, targeted 151 case management, and recovery support, which Medicaid is unable 152 to cover without a waiver. 153 Section 3. This act shall take effect July 1, 2019.