Florida Senate - 2023                                    SB 1084
       
       
        
       By Senator Trumbull
       
       
       
       
       
       2-01342A-23                                           20231084__
    1                        A bill to be entitled                      
    2         An act relating to the long-term managed care program;
    3         amending s. 409.981, F.S.; requiring the Agency for
    4         Health Care Administration to select, through a
    5         specified procurement process, a qualified long-term
    6         care plan to implement a pilot program in Miami-Dade
    7         County to provide coverage of comprehensive services
    8         for Medicaid recipients who have developmental
    9         disabilities; providing requirements for the pilot
   10         program and the selected qualified plan; requiring the
   11         agency to contract for an independent evaluation of
   12         the performance of the plan; providing requirements
   13         for the evaluation; requiring the agency to submit the
   14         results of the evaluation to the Legislature by a
   15         specified date; providing an effective date.
   16          
   17  Be It Enacted by the Legislature of the State of Florida:
   18  
   19         Section 1. Subsection (6) is added to section 409.981,
   20  Florida Statutes, to read:
   21         409.981 Eligible long-term care plans.—
   22         (6) INTEGRATED PLAN FOR PERSONS WITH DEVELOPMENTAL
   23  DISABILITIES.—The agency shall select, pursuant to s.
   24  287.057(1)(c), a single qualified plan to implement a pilot
   25  program in Miami-Dade County which provides coverage of
   26  comprehensive services for Medicaid recipients as defined in s.
   27  409.962 who have a developmental disability as defined in s.
   28  393.063.
   29         (a) Comprehensive coverage includes benefits described in
   30  s. 409.973, community-based services described in s. 393.066(3),
   31  and long-term care plan benefits described in s. 409.98.
   32         (b) Participation in the pilot program is voluntary and
   33  limited to the maximum number of enrollees specified in the
   34  General Appropriations Act. Potential participants will be
   35  selected from individuals on the waitlist for iBudget waiver
   36  services.
   37         (c) The selected plan shall be paid a risk-adjusted
   38  capitation rate.
   39         (d) A qualified plan must be a provider service network as
   40  defined in s. 409.962, the owners of which include licensed
   41  health care providers with experience serving iBudget clients.
   42         (e) The selected plan must provide all categories of
   43  benefits through a single, integrated model of care.
   44         (f) The selected plan must document revenues and
   45  expenditures related to the pilot program and submit periodic
   46  financial reports to the agency. Pretax income may be subject to
   47  the income sharing ratios established in s. 409.967(3)(f).
   48         (g) Services must be provided to enrollees in accordance
   49  with an individualized care plan that is evaluated and updated
   50  at least quarterly or as warranted by changes in an enrollee’s
   51  circumstances.
   52         (h) The agency shall contract for an independent evaluation
   53  of the performance of the integrated plan based on specific
   54  measures of access, quality, and cost. The agency shall submit
   55  the results of the evaluation to the President of the Senate and
   56  the Speaker of the House of Representatives by October 1, 2024.
   57         Section 2. This act shall take effect upon becoming a law.