Florida Senate - 2020                              CS for SB 190
       By the Committee on Health Policy; and Senators Montford,
       Harrell, Berman, and Cruz
       588-03478-20                                           2020190c1
    1                        A bill to be entitled                      
    2         An act relating to Medicaid school-based services;
    3         amending s. 409.9071, F.S.; revising applicable
    4         provisions for the reimbursement of school-based
    5         services by the Agency for Health Care Administration
    6         to certain school districts; deleting a requirement
    7         specifying the use of certified state and local
    8         education funds for school-based services; conforming
    9         a provision to changes made by the act; deleting an
   10         obsolete provision; amending s. 409.9072, F.S.;
   11         revising a requirement for the agency’s reimbursement
   12         of school-based services to certain charter and
   13         private schools; revising qualifications for health
   14         care practitioners engaged by schools to provide
   15         services; conforming a provision to changes made by
   16         the act; amending s. 409.908, F.S.; specifying the
   17         federal agency that may waive certain school-based
   18         provider qualifications; providing an effective date.
   20  Be It Enacted by the Legislature of the State of Florida:
   22         Section 1. Subsection (1), paragraph (b) of subsection (2),
   23  and subsection (6) of section 409.9071, Florida Statutes, are
   24  amended to read:
   25         409.9071 Medicaid provider agreements for school districts
   26  certifying state match.—
   27         (1) The agency shall reimburse school-based services as
   28  provided in ss. 409.908(21) and 1011.70 former s. 236.0812
   29  pursuant to the rehabilitative services option provided under 42
   30  U.S.C. s. 1396d(a)(13). For purposes of this section, billing
   31  agent consulting services are shall be considered billing agent
   32  services, as that term is used in s. 409.913(10), and, as such,
   33  payments to such persons may shall not be based on amounts for
   34  which they bill nor based on the amount a provider receives from
   35  the Medicaid program. This provision may shall not restrict
   36  privatization of Medicaid school-based services. Subject to any
   37  limitations provided for in the General Appropriations Act, the
   38  agency, in compliance with appropriate federal authorization,
   39  shall develop policies and procedures and shall allow for
   40  certification of state and local education funds that which have
   41  been provided for school-based services as specified in s.
   42  1011.70 and authorized by a physician’s order where required by
   43  federal Medicaid law. Any state or local funds certified
   44  pursuant to this section shall be for children with specified
   45  disabilities who are eligible for both Medicaid and part B or
   46  part H of the Individuals with Disabilities Education Act
   47  (IDEA), or the exceptional student education program, or who
   48  have an individualized educational plan.
   49         (2) School districts that wish to enroll as Medicaid
   50  providers and that certify state match in order to receive
   51  federal Medicaid reimbursements for services, pursuant to
   52  subsection (1), shall agree to:
   53         (b) Develop and maintain the financial and other student
   54  individual education plan records needed to document the
   55  appropriate use of state and federal Medicaid funds.
   56         (6) Retroactive reimbursements for services as specified in
   57  former s. 236.0812 as of July 1, 1996, including reimbursement
   58  for the 1995-1996 and 1996-1997 school years, are subject to
   59  federal approval.
   60         Section 2. Subsections (1) and (5) and paragraph (b) of
   61  subsection (2) of section 409.9072, Florida Statutes, are
   62  amended to read:
   63         409.9072 Medicaid provider agreements for charter schools
   64  and private schools.—
   65         (1) Subject to a specific appropriation by the Legislature,
   66  the agency shall reimburse private schools as defined in s.
   67  1002.01 and schools designated as charter schools under s.
   68  1002.33 which are Medicaid providers for school-based services
   69  pursuant to the rehabilitative services option provided under 42
   70  U.S.C. s. 1396d(a)(13) to children younger than 21 years of age
   71  with specified disabilities who are eligible for both Medicaid
   72  and part B or part H of the Individuals with Disabilities
   73  Education Act (IDEA) or the exceptional student education
   74  program, or who have an individualized educational plan.
   75         (2) Schools that wish to enroll as Medicaid providers and
   76  receive Medicaid reimbursement under this section must apply to
   77  the agency for a provider agreement and must agree to:
   78         (b) Develop and maintain the financial and student
   79  individual education plan records needed to document the
   80  appropriate use of state and federal Medicaid funds.
   81         (5) For reimbursements to private schools and charter
   82  schools under this section, the agency shall apply the
   83  reimbursement schedule developed under s. 409.9071(5). Health
   84  care practitioners engaged by a school to provide services under
   85  this section must be enrolled as Medicaid providers and meet the
   86  qualifications specified under 42 C.F.R. s. 440.110, as
   87  applicable. Each school’s continued participation in providing
   88  Medicaid services under this section is contingent upon the
   89  school providing to the agency an annual accounting of how the
   90  Medicaid reimbursements are used.
   91         Section 3. Subsection (21) of section 409.908, Florida
   92  Statutes, is amended to read:
   93         409.908 Reimbursement of Medicaid providers.—Subject to
   94  specific appropriations, the agency shall reimburse Medicaid
   95  providers, in accordance with state and federal law, according
   96  to methodologies set forth in the rules of the agency and in
   97  policy manuals and handbooks incorporated by reference therein.
   98  These methodologies may include fee schedules, reimbursement
   99  methods based on cost reporting, negotiated fees, competitive
  100  bidding pursuant to s. 287.057, and other mechanisms the agency
  101  considers efficient and effective for purchasing services or
  102  goods on behalf of recipients. If a provider is reimbursed based
  103  on cost reporting and submits a cost report late and that cost
  104  report would have been used to set a lower reimbursement rate
  105  for a rate semester, then the provider’s rate for that semester
  106  shall be retroactively calculated using the new cost report, and
  107  full payment at the recalculated rate shall be effected
  108  retroactively. Medicare-granted extensions for filing cost
  109  reports, if applicable, shall also apply to Medicaid cost
  110  reports. Payment for Medicaid compensable services made on
  111  behalf of Medicaid eligible persons is subject to the
  112  availability of moneys and any limitations or directions
  113  provided for in the General Appropriations Act or chapter 216.
  114  Further, nothing in this section shall be construed to prevent
  115  or limit the agency from adjusting fees, reimbursement rates,
  116  lengths of stay, number of visits, or number of services, or
  117  making any other adjustments necessary to comply with the
  118  availability of moneys and any limitations or directions
  119  provided for in the General Appropriations Act, provided the
  120  adjustment is consistent with legislative intent.
  121         (21) The agency shall reimburse school districts that which
  122  certify the state match pursuant to ss. 409.9071 and 1011.70 for
  123  the federal portion of the school district’s allowable costs to
  124  deliver the services, based on the reimbursement schedule. The
  125  school district shall determine the costs for delivering
  126  services as authorized in ss. 409.9071 and 1011.70 for which the
  127  state match will be certified. Reimbursement of school-based
  128  providers is contingent on such providers being enrolled as
  129  Medicaid providers and meeting the qualifications contained in
  130  42 C.F.R. s. 440.110, unless otherwise waived by the United
  131  States Department of Health and Human Services federal Health
  132  Care Financing Administration. Speech therapy providers who are
  133  certified through the Department of Education pursuant to rule
  134  6A-4.0176, Florida Administrative Code, are eligible for
  135  reimbursement for services that are provided on school premises.
  136  Any employee of the school district who has been fingerprinted
  137  and has received a criminal background check in accordance with
  138  Department of Education rules and guidelines is shall be exempt
  139  from any agency requirements relating to criminal background
  140  checks.
  141         Section 4. This act shall take effect July 1, 2020.