SB 2514 First Engrossed (ntc)
20252514e1
1 A bill to be entitled
2 An act relating to health and human services; amending
3 s. 381.4019, F.S.; authorizing certain dental and
4 dental hygiene students to apply for the Dental
5 Student Loan Repayment Program before obtaining active
6 employment; amending s. 381.915, F.S.; revising the
7 definitions of the terms “cancer center” and “Florida
8 based”; defining the term “Cancer Connect
9 Collaborative” or “collaborative”; making clarifying
10 changes; deleting an obsolete date; revising the
11 composition of the collaborative; deleting obsolete
12 provisions; requiring the collaborative to review all
13 submitted Cancer Innovation Fund grant applications
14 using certain parameters; requiring the collaborative
15 to give priority to certain applications; requiring
16 that licensed or certified health care providers,
17 facilities, or entities meet certain criteria to be
18 eligible for specified grant funding; specifying such
19 criteria; requiring the Department of Health to
20 appoint peer review panels for a specified purpose;
21 requiring that priority scores be forwarded to the
22 collaborative and be considered in determining which
23 proposals the collaborative recommends for certain
24 grant funding; requiring the collaborative and peer
25 review panels to establish and follow certain
26 guidelines and adhere to a certain policy; prohibiting
27 a member of the collaborative or a panel from
28 participating in certain discussions or decisions
29 under certain circumstances; requiring, beginning on a
30 specified date and annually thereafter, the
31 collaborative to prepare and submit a specified report
32 to the Governor and the Legislature; requiring that
33 the report include certain information; revising the
34 requirements for a specified report by the department;
35 requiring, beginning on a specified date, that certain
36 allocation agreements include certain information;
37 providing legislative findings; creating the Cancer
38 Connect Collaborative Research Incubator within the
39 department, and overseen by the collaborative, to
40 provide funding for a specified purpose over a
41 specified timeframe; specifying the incubator’s
42 targeted area of cancer research for the first
43 specified timeframe; providing that grants issued
44 through the incubator are contingent upon the
45 appropriation of funds and must be awarded through a
46 specified process; requiring that priority be given to
47 certain applicants; authorizing the prioritization of
48 certain grant proposals; providing that applications
49 for incubator funding may be submitted by specified
50 hospitals; requiring that all qualified applicants
51 have equal access and opportunity to compete for
52 research funding; requiring that incubator grants be
53 recommended by the collaborative and awarded by the
54 department in a certain manner; requiring the
55 department to appoint peer review panels for a
56 specified purpose; requiring that priority scores be
57 forwarded to the collaborative and be considered in
58 determining which proposals the collaborative
59 recommends for funding; requiring the collaborative
60 and peer review panels to establish and follow certain
61 guidelines and adhere to a certain policy; prohibiting
62 a member of the collaborative or a panel from
63 participating in certain discussions or decisions;
64 requiring recipients of incubator grant funds to enter
65 into an allocation agreement with the department;
66 specifying requirements for such allocation
67 agreements; requiring, beginning on a specified date
68 and annually until a specified date, the collaborative
69 to prepare and submit a specified report to the
70 Governor and the Legislature; requiring the
71 collaborative to make a certain recommendation under
72 certain circumstances; requiring that a specified
73 report include certain information; amending s.
74 381.922, F.S.; establishing the Bascom Palmer Eye
75 Institute VisionGen Initiative within the William G.
76 “Bill” Bankhead, Jr., and David Coley Cancer Research
77 Program; providing the purpose of the initiative;
78 providing that funding for the initiative is subject
79 to annual appropriation; amending s. 381.986, F.S.;
80 requiring the department to revoke the medical
81 marijuana use registry registration of qualified
82 patients and caregivers who enter certain pleas or are
83 found guilty of certain offenses; authorizing a person
84 seeking reinstatement of qualified patient or
85 caregiver registration to submit a new application
86 with a certain attestation; providing criminal
87 penalties for knowingly making a false attestation;
88 reviving, reenacting, and amending s. 400.0225, F.S.,
89 relating to consumer satisfaction surveys; requiring
90 the Agency for Health Care Administration to develop
91 user-friendly consumer satisfaction surveys for
92 nursing home facilities; specifying requirements for
93 the surveys; authorizing family members, guardians,
94 and other resident designees to assist the resident in
95 completing the survey; prohibiting employees and
96 volunteers of the facility or of a corporation or
97 business entity with an ownership interest in the
98 facility from attempting to influence a resident’s
99 responses to the survey; requiring the agency to
100 specify certain protocols for administration of the
101 survey; requiring the agency to publish on its website
102 aggregated survey data in a manner that allows for
103 comparison between nursing home facilities; amending
104 s. 400.141, F.S.; requiring medical directors of
105 nursing home facilities to obtain, or to be in the
106 process of obtaining, certain qualifications by a
107 specified date; requiring the agency to include such
108 medical director’s name on each nursing home
109 facility’s online provider profile; requiring nursing
110 home facilities to conduct biennial patient safety
111 culture surveys; specifying requirements for
112 administration of such surveys; requiring nursing home
113 facilities to submit the results of such surveys
114 biennially to the agency in a format specified by
115 agency rule; authorizing nursing home facilities to
116 develop an internal action plan between surveys to
117 identify measures for improvement of the survey and
118 submit such plan to the agency; amending s. 400.191,
119 F.S.; requiring the agency to include the results from
120 specified consumer satisfaction surveys as part of the
121 Nursing Home Guide on its website; amending s.
122 408.051, F.S.; requiring nursing home facilities that
123 maintain certain electronic health records to make
124 available certain data to the agency’s Florida Health
125 Information Exchange program for a specified purpose;
126 authorizing the agency to adopt rules; amending s.
127 408.061, F.S.; exempting nursing homes operated by
128 state agencies from certain financial reporting
129 requirements; requiring the agency to impose
130 administrative fines against nursing homes and home
131 offices of nursing homes for failing to comply with
132 certain reporting requirements; defining the term
133 “violation”; providing construction; requiring the
134 agency to adopt rules; providing requirements for such
135 rules; amending s. 408.08, F.S.; prohibiting nursing
136 homes subject to certain administrative fines from
137 being fined under a specified provision for the same
138 violation; amending s. 409.904, F.S.; providing a
139 presumption of eligibility for continued coverage of
140 certain services for certain persons during a
141 redetermination process; requiring certain persons to
142 notify the agency and the Department of Children and
143 Families of certain material changes; authorizing the
144 department to conduct a redetermination of
145 eligibility; requiring the department to provide
146 certain persons notification and the results of such
147 redeterminations; requiring the agency to seek federal
148 authorization to exempt certain persons from annual
149 redetermination of eligibility by a certain date;
150 requiring the agency and department to develop a
151 certain process; amending s. 409.906, F.S.;
152 authorizing the agency to pay for certain blood-based
153 biomarker tests; amending s. 409.908, F.S.; requiring
154 the agency to revise its methodology for calculating
155 Quality Incentive Program payments; providing
156 requirements for such revision; requiring the agency
157 to submit an annual report to the Governor and the
158 Legislature on payments made under the Quality
159 Incentive Program; specifying requirements for the
160 report; amending s. 409.909, F.S.; revising the number
161 of resident positions for which the agency may
162 allocate certain funding to hospitals and qualifying
163 institutions; deleting provisions creating the
164 Graduate Medical Education Committee within the
165 agency; amending s. 409.91256, F.S.; revising the
166 purpose of the Training, Education, and Clinicals in
167 Health Funding Program; revising the definition of the
168 term “qualified facility”; specifying an allowed
169 reimbursement rate to qualified facilities under the
170 program for nursing students; amending s. 409.967,
171 F.S.; requiring the agency to review certain audit
172 reports for compliance; requiring a certified public
173 accountant to correct certain audit report
174 deficiencies and resubmit the report before the report
175 is considered final; amending s. 409.9745, F.S.;
176 requiring a managed care plan to provide coverage for
177 certain blood-based biomarker tests; amending s.
178 409.977, F.S.; authorizing the agency to exceed a
179 certain amount of financial assistance for a high-cost
180 patient under certain circumstances; requiring the
181 agency to submit a certain annual report to the
182 Legislature beginning on a specified date; requiring
183 that the report contain certain information; amending
184 s. 430.84, F.S.; authorizing the state administering
185 agency to exclude certain areas from designation as
186 service areas under contracts with PACE organizations
187 under certain circumstances; requiring the state to
188 determine whether a certain unmet need exists in a
189 certain area upon receipt of a letter of intent to
190 provide PACE services from a new applicant; requiring
191 such applicants to meet certain requirements;
192 requiring the agency to contract with a third-party
193 vendor to conduct a comprehensive study of nursing
194 home quality incentive programs in other states;
195 providing requirements for the study; requiring the
196 agency to submit a final report on the study to the
197 Governor and the Legislature by a specified date;
198 providing an effective date.
199
200 Be It Enacted by the Legislature of the State of Florida:
201
202 Section 1. Present subsections (5) through (10) of section
203 381.4019, Florida Statutes, are redesignated as subsections (6)
204 through (11), respectively, and a new subsection (5) is added to
205 that section, to read:
206 381.4019 Dental Student Loan Repayment Program.—The Dental
207 Student Loan Repayment Program is established to support the
208 state Medicaid program and promote access to dental care by
209 supporting qualified dentists and dental hygienists who treat
210 medically underserved populations in dental health professional
211 shortage areas or medically underserved areas.
212 (5) A dental student or dental hygiene student who
213 demonstrates an offer of employment in a public health program
214 or private practice as specified in paragraph (2)(a) may apply
215 for the loan program before obtaining active employment but may
216 not be awarded funds from the loan program until he or she meets
217 the requirements of subsection (2).
218 Section 2. Present paragraphs (c), (d), and (e) of
219 subsection (3) and present subsections (12) and (13) of section
220 381.915, Florida Statutes, are redesignated as paragraphs (d),
221 (e), and (f) of subsection (3) and subsections (13) and (14),
222 respectively, a new paragraph (c) is added to subsection (3),
223 paragraph (d) is added to subsection (10), a new subsection (12)
224 is added to that section, and paragraph (b) and present
225 paragraph (c) of subsection (3), paragraphs (a), (b), (e), (f),
226 and (h) of subsection (8), and subsections (9) and (11) of that
227 section are amended, to read:
228 381.915 Casey DeSantis Cancer Research Program.—
229 (3) On or before September 15 of each year, the department
230 shall calculate an allocation fraction to be used for
231 distributing funds to participating cancer centers. On or before
232 the final business day of each quarter of the state fiscal year,
233 the department shall distribute to each participating cancer
234 center one-fourth of that cancer center’s annual allocation
235 calculated under subsection (6). The allocation fraction for
236 each participating cancer center is based on the cancer center’s
237 tier-designated weight under subsection (4) multiplied by each
238 of the following allocation factors based on activities in this
239 state: number of reportable cases, peer-review costs, and
240 biomedical education and training. As used in this section, the
241 term:
242 (b) “Cancer center” means a comprehensive center with at
243 least one geographic site in the state, a freestanding center
244 located in the state, a center situated within an academic
245 institution, or a Florida-based formal research-based consortium
246 under centralized leadership that has achieved NCI designation
247 or is prepared to achieve NCI designation by June 30, 2024.
248 (c) “Cancer Connect Collaborative” or “collaborative” means
249 the council created under subsection (8).
250 (d)(c) “Florida-based” means that a cancer center’s actual
251 or sought designated status is or would be recognized by the NCI
252 as primarily located in Florida and not in another state, or
253 that a health care provider or facility is physically located in
254 Florida and provides services in Florida.
255 (8) The Cancer Connect Collaborative, a council as defined
256 in s. 20.03, is created within the department to advise the
257 department and the Legislature on developing a holistic approach
258 to the state’s efforts to fund cancer research, cancer
259 facilities, and treatments for cancer patients. The
260 collaborative may make recommendations on proposed legislation,
261 proposed rules, best practices, data collection and reporting,
262 issuance of grant funds, and other proposals for state policy
263 relating to cancer research or treatment.
264 (a) The Surgeon General shall serve as an ex officio,
265 nonvoting member of the collaborative and shall serve as the
266 chair.
267 (b) The collaborative shall be composed of the following
268 voting members, to be appointed by September 1, 2024:
269 1. Two members appointed by the Governor, three members one
270 member appointed by the President of the Senate, and three
271 members one member appointed by the Speaker of the House of
272 Representatives, based on the criteria of this subparagraph. The
273 appointing officers shall make their appointments prioritizing
274 members who have the following experience or expertise:
275 a. The practice of a health care profession specializing in
276 oncology clinical care or research;
277 b. The development of preventive and therapeutic treatments
278 to control cancer;
279 c. The development of innovative research into the causes
280 of cancer, the development of effective treatments for persons
281 with cancer, or cures for cancer; or
282 d. Management-level experience with a cancer center
283 licensed under chapter 395.
284 2. One member who is a resident of this state who can
285 represent the interests of cancer patients in this state,
286 appointed by the Governor.
287 (e) Members of the collaborative whose terms have expired
288 may continue to serve until replaced or reappointed, but for no
289 more than 6 months after the expiration of their terms.
290 (f) Members of the collaborative shall serve without
291 compensation but are entitled to reimbursement for per diem and
292 travel expenses pursuant to s. 112.061.
293 (h) The collaborative shall develop a long-range
294 comprehensive plan for the Casey DeSantis Cancer Research
295 Program. In the development of the plan, the collaborative must
296 solicit input from cancer centers, research institutions,
297 biomedical education institutions, hospitals, and medical
298 providers. The collaborative shall submit the plan to the
299 Governor, the President of the Senate, and the Speaker of the
300 House of Representatives no later than December 1, 2024. The
301 plan must include, but need not be limited to, all of the
302 following components:
303 1. Expansion of grant fund opportunities to include a
304 broader pool of Florida-based cancer centers, research
305 institutions, biomedical education institutions, hospitals, and
306 medical providers to receive funding through the Cancer
307 Innovation Fund.
308 2. An evaluation to determine metrics that focus on patient
309 outcomes, quality of care, and efficacy of treatment.
310 3. A compilation of best practices relating to cancer
311 research or treatment.
312 (9)(a) The collaborative shall advise the department on the
313 awarding of grants issued through the Cancer Innovation Fund.
314 During any fiscal year for which funds are appropriated to the
315 fund, the collaborative shall review all submitted grant
316 applications using the parameters provided in paragraph (c) and
317 make recommendations to the department for awarding grants to
318 support innovative cancer research and treatment models,
319 including emerging research and treatment trends and promising
320 treatments that may serve as catalysts for further research and
321 treatments. The department shall make the final grant allocation
322 awards. The collaborative shall give priority to applications
323 seeking to expand the reach of cancer screening efforts and
324 innovative cancer treatment models into underserved areas of
325 this state.
326 (b) To be eligible for grant funding under this subsection,
327 a licensed or certified health care provider, facility, or
328 entity must meet at least one of the following criteria:
329 1. Operates as a licensed hospital that has a minimum of 30
330 percent of its current cancer patients residing in rural or
331 underserved areas.
332 2. Operates as a licensed health care clinic or facility
333 that employs or contracts with at least one physician licensed
334 under chapter 458 or chapter 459 who is board certified in
335 oncology and that administers chemotherapy treatments for
336 cancer.
337 3. Operates as a licensed facility that employs or
338 contracts with at least one physician licensed under chapter 458
339 or chapter 459 who is board certified in oncology and that
340 administers radiation therapy treatments for cancer.
341 4. Operates as a licensed health care clinic or facility
342 that provides cancer screening services at no cost or a minimal
343 cost to patients.
344 5. Operates as a rural hospital as defined in s.
345 395.602(2)(b).
346 6. Operates as a critical access hospital as defined in s.
347 408.07(14).
348 7. Operates as a specialty hospital as defined in s.
349 395.002(28)(a) which provides cancer treatment for patients from
350 birth to 18 years of age.
351 8. Operates as a licensed hospital that is accredited by
352 the American College of Surgeons as a Comprehensive Community
353 Cancer Program or Integrated Network Cancer Program.
354 9. Engages in biomedical research intended to develop
355 therapies, medical pharmaceuticals, treatment protocols, or
356 medical procedures intended to cure cancer or improve the
357 quality of life of cancer patients.
358 10. Educates or trains students, postdoctoral fellows, or
359 licensed or certified health care practitioners in the
360 screening, diagnosis, or treatment of cancer.
361 (c) To ensure that all proposals for grant funding issued
362 through the Cancer Innovation Fund are appropriate and are
363 evaluated fairly on the basis of scientific merit, the
364 department shall appoint peer review panels of independent,
365 scientifically qualified individuals to review the scientific
366 merit of each proposal and establish its priority score. The
367 priority scores must be forwarded to the collaborative and must
368 be considered in determining which proposals the collaborative
369 recommends for grant funding through the Cancer Innovation Fund.
370 (d) The collaborative and the peer review panels shall
371 establish and follow rigorous guidelines for ethical conduct and
372 adhere to a strict policy with regard to conflicts of interest
373 regarding the assessment of Cancer Innovation Fund grant
374 applications. A member of the collaborative or a panel may not
375 participate in any discussion or decision of the collaborative
376 or a panel with respect to a research proposal by any firm,
377 entity, or agency with which the member is associated as a
378 member of the governing body or as an employee or with which the
379 member has entered into a contractual arrangement.
380 (e) Beginning December 1, 2025, and annually thereafter,
381 the collaborative shall prepare and submit a report to the
382 Governor, the President of the Senate, and the Speaker of the
383 House of Representatives which identifies and evaluates the
384 performance and the impact of grants issued through the Cancer
385 Innovation Fund on cancer treatment, research, screening,
386 diagnosis, prevention, practitioner training, workforce
387 education, and cancer patient survivorship. The report must
388 include all of the following:
389 1. Amounts of grant funds awarded to each recipient.
390 2. Descriptions of each recipient’s research or project
391 which include, but need not be limited to, the following:
392 a. Goals or projected outcomes.
393 b. Population to be served.
394 c. Research methods or project implementation plan.
395 3. An assessment of grant recipients which evaluates their
396 progress toward achieving objectives specified in each
397 recipient’s grant application.
398 4. Recommendations for best practices that may be
399 implemented by health care providers in this state who diagnose,
400 treat, and screen for cancer, based on the outcomes of projects
401 funded through the Cancer Innovation Fund.
402 (10) Beginning July 1, 2025, and each year thereafter, the
403 department, in conjunction with participating cancer centers,
404 shall submit a report to the Cancer Control and Research
405 Advisory Council and the collaborative on specific metrics
406 relating to cancer mortality and external funding for cancer
407 related research in this state. If a cancer center does not
408 endorse this report or produce an equivalent independent report,
409 the cancer center is ineligible to receive program funding for 1
410 year. The department must submit this annual report, and any
411 equivalent independent reports, to the Governor, the President
412 of the Senate, and the Speaker of the House of Representatives
413 no later than September 15 of each year the report or reports
414 are submitted by the department. The report must include:
415 (d) A description of the numbers and types of cancer cases
416 treated annually at each participating cancer center, including
417 reportable and nonreportable cases.
418 (11) Beginning July 1, 2025 2024, each allocation agreement
419 issued by the department relating to cancer center payments
420 under paragraph (2)(a) subsection (2) must include all of the
421 following:
422 (a) A line-item budget narrative documenting the annual
423 allocation of funds to a cancer center.
424 (b) A cap on the annual award of 15 percent for
425 administrative expenses.
426 (c) A requirement for the cancer center to submit quarterly
427 reports of all expenditures made by the cancer center with funds
428 received through the Casey DeSantis Cancer Research Program.
429 (d) A provision to allow the department and other state
430 auditing bodies to audit all financial records, supporting
431 documents, statistical records, and any other documents
432 pertinent to the allocation agreement.
433 (e) A provision requiring the annual reporting of outcome
434 data and protocols used in achieving those outcomes.
435 (12)(a) The Legislature finds that targeted areas of cancer
436 research require increased resources and that Florida should
437 become a leader in promoting research opportunities for these
438 targeted areas. Floridians should not have to leave the state to
439 receive the most advanced cancer care and treatment. To meet
440 this need, the Cancer Connect Collaborative Research Incubator,
441 or “incubator” as used in this subsection, is created within the
442 department, to be overseen by the collaborative, to provide
443 funding for a targeted area of cancer research over a 5-year
444 period. For the 5-year period beginning July 1, 2025, the
445 incubator’s targeted area of cancer research is pediatric
446 cancer.
447 (b) Contingent upon the appropriation of funds by the
448 Legislature, grants issued through the incubator must be awarded
449 through a peer-reviewed, competitive process. Priority must be
450 given to applicants that focus on enhancing both research and
451 treatment by increasing participation in clinical trials related
452 to the targeted area of cancer research, including all of the
453 following:
454 1. Identifying strategies to increase enrollment in cancer
455 clinical trials.
456 2. Supporting public and private professional education
457 programs to raise awareness and knowledge about cancer clinical
458 trials.
459 3. Providing tools for cancer patients and community-based
460 oncologists to help identify available cancer clinical trials in
461 this state.
462 4. Creating opportunities for the state’s academic cancer
463 centers to collaborate with community-based oncologists in
464 cancer clinical trial networks.
465 (c) Priority may be given to grant proposals that foster
466 collaborations among institutions, researchers, and community
467 practitioners to support the advancement of cures through basic
468 or applied research, including clinical trials involving cancer
469 patients and related networks.
470 (d) Applications for incubator funding may be submitted by
471 any Florida-based specialty hospital as defined in s.
472 395.002(28)(a) which provides cancer treatment for patients from
473 birth to 18 years of age. All qualified applicants must have
474 equal access and opportunity to compete for research funding.
475 Incubator grants must be recommended by the collaborative and
476 awarded by the department on the basis of scientific merit, as
477 determined by a competitively open and peer-reviewed process to
478 ensure objectivity, consistency, and high quality.
479 (e) To ensure that all proposals for research funding are
480 appropriate and are evaluated fairly on the basis of scientific
481 merit, the department shall appoint peer review panels of
482 independent, scientifically qualified individuals to review the
483 scientific merit of each proposal and establish its priority
484 score. The priority scores must be forwarded to the
485 collaborative and must be considered in determining which
486 proposals the collaborative recommends for funding.
487 (f) The collaborative and the peer review panels shall
488 establish and follow rigorous guidelines for ethical conduct and
489 adhere to a strict policy with regard to conflicts of interest
490 regarding the assessment of incubator grant applications. A
491 member of the collaborative or a panel may not participate in
492 any discussion or decision of the collaborative or a panel
493 regarding a research proposal from any firm, entity, or agency
494 with which the member is associated as a governing body member,
495 as an employee, or through a contractual arrangement.
496 (g) Each recipient of incubator grant funds must enter into
497 an allocation agreement with the department. Each such
498 allocation agreement must include all of the following:
499 1. A line-item budget narrative documenting the annual
500 allocation of funds to a recipient.
501 2. A cap on the annual award of 15 percent for
502 administrative expenses.
503 3. A requirement for the recipient to submit quarterly
504 reports of all expenditures made by the recipient with funds
505 received through the incubator.
506 4. A provision to allow the department and other state
507 auditing bodies to audit all financial records, supporting
508 documents, statistical records, and any other documents
509 pertinent to the allocation agreement.
510 5. A provision requiring the annual reporting of outcome
511 data and protocols used in achieving those outcomes.
512 (h) Beginning December 1, 2026, and annually through
513 December 1, 2030, the collaborative shall prepare and submit a
514 report to the Governor, the President of the Senate, and the
515 Speaker of the House of Representatives which evaluates research
516 conducted through the incubator and provides details on outcomes
517 and findings available through the end of the fiscal year
518 immediately preceding each report. If the collaborative
519 recommends that the incubator be extended beyond its 5-year
520 lifespan, the collaborative shall make such recommendation in
521 the report due December 1, 2029, and shall include a
522 recommendation for the next targeted area of cancer research.
523 The report due on December 1, 2030, must include all of the
524 following:
525 1. Details of all results of the research conducted with
526 incubator funding which has been completed or the status of
527 research in progress.
528 2. An evaluation of all research conducted with incubator
529 funding during the 5 fiscal years preceding the report.
530 Section 3. Paragraph (d) is added to subsection (2) of
531 section 381.922, Florida Statutes, to read:
532 381.922 William G. “Bill” Bankhead, Jr., and David Coley
533 Cancer Research Program.—
534 (2) The program shall provide grants for cancer research to
535 further the search for cures for cancer.
536 (d) There is established within the program the Bascom
537 Palmer Eye Institute VisionGen Initiative. The purpose of the
538 initiative is to advance genetic and epigenetic research on
539 inherited eye diseases and ocular oncology by awarding grants
540 through the peer-reviewed, competitive process established under
541 subsection (3). Funding for the initiative is subject to the
542 annual appropriation of funds by the Legislature.
543 Section 4. Paragraphs (d) and (e) of subsection (5) of
544 section 381.986, Florida Statutes, are amended to read:
545 381.986 Medical use of marijuana.—
546 (5) MEDICAL MARIJUANA USE REGISTRY.—
547 (d) The department shall immediately suspend the
548 registration of a qualified patient charged with a violation of
549 chapter 893 until final disposition of the any alleged offense.
550 Based upon such final disposition Thereafter, the department may
551 extend the suspension, revoke the registration, or reinstate the
552 registration. However, the department must revoke the
553 registration of the qualified patient upon such final
554 disposition if the qualified patient was convicted of, or pled
555 guilty or nolo contendere to, regardless of adjudication, a
556 violation of chapter 893 if such violation was for trafficking
557 in, the sale, manufacture, or delivery of, or possession with
558 intent to sell, manufacture, or deliver a controlled substance.
559 If such person wishes to seek reinstatement of his or her
560 registration as a qualified patient, the person may submit a new
561 application accompanied by a notarized attestation by the
562 applicant that he or she has completed all terms of
563 incarceration, probation, community control, or supervision
564 related to the offense. A person who knowingly makes a false
565 attestation under this paragraph commits a misdemeanor of the
566 second degree, punishable as provided in s. 775.082 or s.
567 775.083.
568 (e) The department shall immediately suspend the
569 registration of a any caregiver charged with a violation of
570 chapter 893 until final disposition of the any alleged offense.
571 The department must revoke the registration of the caregiver
572 upon such final disposition if the caregiver was convicted of,
573 or pled guilty or nolo contendere to, regardless of
574 adjudication, a violation of chapter 893 if such violation was
575 for trafficking in, the sale, manufacture, or delivery of, or
576 possession with intent to sell, manufacture, or deliver a
577 controlled substance. If such person wishes to seek
578 reinstatement of his or her registration as a caregiver, the
579 person may submit a new application accompanied by a notarized
580 attestation by the applicant that he or she has completed all
581 terms of incarceration, probation, community control, or
582 supervision related to the offense. A person who knowingly makes
583 a false attestation under this paragraph commits a misdemeanor
584 of the second degree, punishable as provided in s. 775.082 or s.
585 775.083. Additionally, the department must shall revoke a
586 caregiver registration if the caregiver does not meet the
587 requirements of subparagraph (6)(b)6.
588 Section 5. Notwithstanding the repeal of section 400.0225,
589 Florida Statutes, in section 14 of chapter 2001-377, Laws of
590 Florida, that section is revived, reenacted, and amended to
591 read:
592 400.0225 Consumer satisfaction surveys.—
593 (1) The agency shall develop user-friendly consumer
594 satisfaction surveys to capture resident and family member
595 satisfaction with care provided by nursing home facilities. The
596 consumer satisfaction surveys must be based on a core set of
597 consumer satisfaction questions to allow for consistent
598 measurement and must be administered annually to a random sample
599 of long-stay and short-stay residents of each facility and their
600 family members. The survey tool must be based on an agency
601 validated survey instrument whose measures have received an
602 endorsement by the National Quality Forum.
603 (2) Family members, guardians, or other resident designees
604 may assist a resident in completing the consumer satisfaction
605 survey.
606 (3) Employees and volunteers of the nursing home facility
607 or of a corporation or business entity with an ownership
608 interest in the nursing home facility are prohibited from
609 attempting to influence a resident’s responses to the consumer
610 satisfaction survey.
611 (4) The agency shall specify the protocols for conducting
612 the consumer satisfaction surveys, ensuring survey validity,
613 reporting survey results, and protecting the identity of
614 individual respondents. The agency shall make aggregated survey
615 data available to consumers on the agency’s website pursuant to
616 s. 400.191(2)(a)15. in a manner that allows for comparison
617 between nursing home facilities, or its contractor, in
618 consultation with the nursing home industry and consumer
619 representatives, shall develop an easy-to-use consumer
620 satisfaction survey, shall ensure that every nursing facility
621 licensed pursuant to this part participates in assessing
622 consumer satisfaction, and shall establish procedures to ensure
623 that, at least annually, a representative sample of residents of
624 each facility is selected to participate in the survey. The
625 sample shall be of sufficient size to allow comparisons between
626 and among facilities. Family members, guardians, or other
627 resident designees may assist the resident in completing the
628 survey. Employees and volunteers of the nursing facility or of a
629 corporation or business entity with an ownership interest in the
630 facility are prohibited from assisting a resident with or
631 attempting to influence a resident’s responses to the consumer
632 satisfaction survey. The agency, or its contractor, shall survey
633 family members, guardians, or other resident designees. The
634 agency, or its contractor, shall specify the protocol for
635 conducting and reporting the consumer satisfaction surveys.
636 Reports of consumer satisfaction surveys shall protect the
637 identity of individual respondents. The agency shall contract
638 for consumer satisfaction surveys and report the results of
639 those surveys in the consumer information materials prepared and
640 distributed by the agency.
641 (5) The agency may adopt rules as necessary to implement
642 administer this section.
643 Section 6. Paragraph (b) of subsection (1) of section
644 400.141, Florida Statutes, is amended, and paragraph (x) is
645 added to that subsection, to read:
646 400.141 Administration and management of nursing home
647 facilities.—
648 (1) Every licensed facility shall comply with all
649 applicable standards and rules of the agency and shall:
650 (b) Appoint a medical director licensed pursuant to chapter
651 458 or chapter 459. By January 1, 2026, the medical director of
652 each nursing home facility must obtain designation as a
653 certified medical director by the American Medical Directors
654 Association, hold a similar credential bestowed by an
655 organization recognized by the agency, or be in the process of
656 seeking such designation or credentialing, according to
657 parameters adopted by agency rule. The agency shall include the
658 name of each nursing home facility’s medical director on the
659 facility’s provider profile published by the agency on its
660 website. The agency may establish by rule more specific criteria
661 for the appointment of a medical director.
662 (x) Conduct, at least biennially, a patient safety culture
663 survey using the applicable Survey on Patient Safety Culture
664 developed by the federal Agency for Healthcare Research and
665 Quality. Each facility shall conduct the survey anonymously to
666 encourage completion of the survey by staff working in or
667 employed by the facility. A facility may contract with a third
668 party to administer the survey. Each facility shall biennially
669 submit the survey data to the agency in a format specified by
670 agency rule, which must include the survey participation rate.
671 Each facility may develop an internal action plan between
672 conducting surveys to identify measures to improve the survey
673 and submit such plan to the agency.
674 Section 7. Paragraph (a) of subsection (2) of section
675 400.191, Florida Statutes, is amended to read:
676 400.191 Availability, distribution, and posting of reports
677 and records.—
678 (2) The agency shall publish the Nursing Home Guide
679 quarterly in electronic form to assist consumers and their
680 families in comparing and evaluating nursing home facilities.
681 (a) The agency shall provide an Internet site which must
682 shall include at least the following information either directly
683 or indirectly through a link to another established site or
684 sites of the agency’s choosing:
685 1. A section entitled “Have you considered programs that
686 provide alternatives to nursing home care?” which must shall be
687 the first section of the Nursing Home Guide and must which shall
688 prominently display information about available alternatives to
689 nursing homes and how to obtain additional information regarding
690 these alternatives. The Nursing Home Guide must shall explain
691 that this state offers alternative programs that allow permit
692 qualified elderly persons to stay in their homes instead of
693 being placed in nursing homes and must shall encourage
694 interested persons to call the Comprehensive Assessment Review
695 and Evaluation for Long-Term Care Services (CARES) Program to
696 inquire as to whether if they qualify. The Nursing Home Guide
697 must shall list available home and community-based programs and
698 must which shall clearly state the services that are provided,
699 including and indicate whether nursing home services are covered
700 under those programs when necessary included if needed.
701 2. A list by name and address of all nursing home
702 facilities in this state, including any prior name by which a
703 facility was known during the previous 24-month period.
704 3. Whether such nursing home facilities are proprietary or
705 nonproprietary.
706 4. The current owner of the facility’s license and the year
707 that that entity became the owner of the license.
708 5. The name of the owner or owners of each facility and
709 whether the facility is affiliated with a company or other
710 organization owning or managing more than one nursing facility
711 in this state.
712 6. The total number of beds in each facility and the most
713 recently available occupancy levels.
714 7. The number of private and semiprivate rooms in each
715 facility.
716 8. The religious affiliation, if any, of each facility.
717 9. The languages spoken by the administrator and staff of
718 each facility.
719 10. Whether or not each facility accepts Medicare or
720 Medicaid recipients or insurance, health maintenance
721 organization, United States Department of Veterans Affairs,
722 CHAMPUS program, or workers’ compensation coverage.
723 11. Recreational and other programs available at each
724 facility.
725 12. Special care units or programs offered at each
726 facility.
727 13. Whether the facility is a part of a retirement
728 community that offers other services pursuant to part III of
729 this chapter or part I or part III of chapter 429.
730 14. Survey and deficiency information, including all
731 federal and state recertification, licensure, revisit, and
732 complaint survey information, for each facility. For
733 noncertified nursing homes, state survey and deficiency
734 information, including licensure, revisit, and complaint survey
735 information, shall be provided.
736 15. The results of consumer satisfaction surveys conducted
737 pursuant to s. 400.0225.
738 Section 8. Present subsections (6) and (7) of section
739 408.051, Florida Statutes, are redesignated as subsections (7)
740 and (8), respectively, and a new subsection (6) is added to that
741 section, to read:
742 408.051 Florida Electronic Health Records Exchange Act.—
743 (6) NURSING HOME DATA.—A nursing home facility as defined
744 in s. 400.021 which maintains certified electronic health record
745 technology shall make available all admission, transfer, and
746 discharge data to the agency’s Florida Health Information
747 Exchange program for the purpose of supporting public health
748 data registries and patient care coordination. The agency may
749 adopt rules to implement this subsection.
750 Section 9. Present subsections (7) through (15) of section
751 408.061, Florida Statutes, are redesignated as subsections (8)
752 through (16), respectively, a new subsection (7) is added to
753 that section, and subsections (5) and (6) of that section are
754 amended, to read:
755 408.061 Data collection; uniform systems of financial
756 reporting; information relating to physician charges;
757 confidential information; immunity.—
758 (5) Within 120 days after the end of its fiscal year, each
759 nursing home as defined in s. 408.07, excluding nursing homes
760 operated by state agencies, shall file with the agency, on forms
761 adopted by the agency and based on the uniform system of
762 financial reporting, its actual financial experience for that
763 fiscal year, including expenditures, revenues, and statistical
764 measures. Such data may be based on internal financial reports
765 that are certified to be complete and accurate by the chief
766 financial officer of the nursing home. However, a nursing home’s
767 actual financial experience shall be its audited actual
768 experience. This audited actual experience must include the
769 fiscal year-end balance sheet, income statement, statement of
770 cash flow, and statement of retained earnings and must be
771 submitted to the agency in addition to the information filed in
772 the uniform system of financial reporting. The financial
773 statements must tie to the information submitted in the uniform
774 system of financial reporting, and a crosswalk must be submitted
775 along with the financial statements.
776 (6) Within 120 days after the end of its fiscal year, the
777 home office of each nursing home as defined in s. 408.07,
778 excluding nursing homes operated by state agencies, shall file
779 with the agency, on forms adopted by the agency and based on the
780 uniform system of financial reporting, its actual financial
781 experience for that fiscal year, including expenditures,
782 revenues, and statistical measures. Such data may be based on
783 internal financial reports that are certified to be complete and
784 accurate by the chief financial officer of the nursing home.
785 However, the home office’s actual financial experience shall be
786 its audited actual experience. This audited actual experience
787 must include the fiscal year-end balance sheet, income
788 statement, statement of cash flow, and statement of retained
789 earnings and must be submitted to the agency in addition to the
790 information filed in the uniform system of financial reporting.
791 The financial statements must tie to the information submitted
792 in the uniform system of financial reporting, and a crosswalk
793 must be submitted along with the audited financial statements.
794 (7)(a) Beginning January 1, 2026, the agency shall impose
795 an administrative fine of $10,000 per violation against a
796 nursing home or home office that fails to comply with subsection
797 (5) or subsection (6), as applicable. For purposes of this
798 paragraph, the term “violation” means failing to file the
799 financial report required by subsection (5) or subsection (6),
800 as applicable, on or before the report’s due date. Failing to
801 file the report during any subsequent 10-day period occurring
802 after the due date constitutes a separate violation until the
803 report has been submitted.
804 (b) The agency shall adopt rules to implement this
805 subsection. The rules must include provisions for a nursing home
806 or home office to present factors in mitigation of the
807 imposition of the fine’s full dollar amount. The agency may
808 determine not to impose the fine’s full dollar amount upon a
809 showing that the full fine is inappropriate under the
810 circumstances.
811 Section 10. Subsection (2) of section 408.08, Florida
812 Statutes, is amended to read:
813 408.08 Inspections and audits; violations; penalties;
814 fines; enforcement.—
815 (2) Any health care facility that refuses to file a report,
816 fails to timely file a report, files a false report, or files an
817 incomplete report and upon notification fails to timely file a
818 complete report required under s. 408.061; that violates this
819 section, s. 408.061, or s. 408.20, or rule adopted thereunder;
820 or that fails to provide documents or records requested by the
821 agency under this chapter shall be punished by a fine not
822 exceeding $1,000 per day for each day in violation, to be
823 imposed and collected by the agency. Pursuant to rules adopted
824 by the agency, the agency may, upon a showing of good cause,
825 grant a one-time extension of any deadline for a health care
826 facility to timely file a report as required by this section, s.
827 408.061, or s. 408.20. A facility fined under s. 408.061(7) may
828 not be additionally fined under this subsection for the same
829 violation.
830 Section 11. Subsection (1) of section 409.904, Florida
831 Statutes, is amended to read:
832 409.904 Optional payments for eligible persons.—The agency
833 may make payments for medical assistance and related services on
834 behalf of the following persons who are determined to be
835 eligible subject to the income, assets, and categorical
836 eligibility tests set forth in federal and state law. Payment on
837 behalf of these Medicaid eligible persons is subject to the
838 availability of moneys and any limitations established by the
839 General Appropriations Act or chapter 216.
840 (1)(a) Subject to federal waiver approval, a person who is
841 age 65 or older or is determined to be disabled, whose income is
842 at or below 88 percent of the federal poverty level, whose
843 assets do not exceed established limitations, and who is not
844 eligible for Medicare or, if eligible for Medicare, is also
845 eligible for and receiving Medicaid-covered institutional care
846 services, hospice services, or home and community-based
847 services. The agency shall seek federal authorization through a
848 waiver to provide this coverage.
849 (b)1. A person who was initially determined eligible for
850 Medicaid under paragraph (a) and is receiving Medicaid-covered
851 institutional care services or hospice services, or a person who
852 is receiving home and community-based services pursuant to s.
853 393.066 or s. 409.978, shall be presumed eligible for continued
854 coverage for such Medicaid-covered services during any
855 redetermination process, and the agency shall continue to make
856 payments for such services, unless the person experiences a
857 material change in his or her disability or economic status
858 which results in a loss of eligibility. In the event of such a
859 change in disability or economic status, the person or his or
860 her designated caregiver or responsible party must notify the
861 agency and the Department of Children and Families of such
862 change, and the department may conduct a redetermination of
863 eligibility. If such redetermination is conducted, the
864 department must notify the person or his or her designated
865 caregiver or responsible party before the commencement of the
866 redetermination and, at its conclusion, the results of the
867 redetermination.
868 2. The agency shall, no later than October 1, 2025, seek
869 federal authorization to exempt a Medicaid-eligible disabled
870 person from annual redetermination of eligibility pursuant to
871 this paragraph.
872 3. The agency and the department shall develop a process to
873 facilitate the notifications required under subparagraph 1.
874 Section 12. Paragraph (d) of subsection (29) of section
875 409.906, Florida Statutes, is amended to read:
876 409.906 Optional Medicaid services.—Subject to specific
877 appropriations, the agency may make payments for services which
878 are optional to the state under Title XIX of the Social Security
879 Act and are furnished by Medicaid providers to recipients who
880 are determined to be eligible on the dates on which the services
881 were provided. Any optional service that is provided shall be
882 provided only when medically necessary and in accordance with
883 state and federal law. Optional services rendered by providers
884 in mobile units to Medicaid recipients may be restricted or
885 prohibited by the agency. Nothing in this section shall be
886 construed to prevent or limit the agency from adjusting fees,
887 reimbursement rates, lengths of stay, number of visits, or
888 number of services, or making any other adjustments necessary to
889 comply with the availability of moneys and any limitations or
890 directions provided for in the General Appropriations Act or
891 chapter 216. If necessary to safeguard the state’s systems of
892 providing services to elderly and disabled persons and subject
893 to the notice and review provisions of s. 216.177, the Governor
894 may direct the Agency for Health Care Administration to amend
895 the Medicaid state plan to delete the optional Medicaid service
896 known as “Intermediate Care Facilities for the Developmentally
897 Disabled.” Optional services may include:
898 (29) BIOMARKER TESTING SERVICES.—
899 (d) This subsection does not require coverage of biomarker
900 testing for screening purposes. The agency may pay for blood
901 based biomarker tests at an in-network or out-of-network
902 laboratory facility for colorectal cancer screening covered
903 under a National Coverage Determination from the Centers for
904 Medicare and Medicaid Services.
905 Section 13. Paragraph (b) of subsection (2) of section
906 409.908, Florida Statutes, is amended to read:
907 409.908 Reimbursement of Medicaid providers.—Subject to
908 specific appropriations, the agency shall reimburse Medicaid
909 providers, in accordance with state and federal law, according
910 to methodologies set forth in the rules of the agency and in
911 policy manuals and handbooks incorporated by reference therein.
912 These methodologies may include fee schedules, reimbursement
913 methods based on cost reporting, negotiated fees, competitive
914 bidding pursuant to s. 287.057, and other mechanisms the agency
915 considers efficient and effective for purchasing services or
916 goods on behalf of recipients. If a provider is reimbursed based
917 on cost reporting and submits a cost report late and that cost
918 report would have been used to set a lower reimbursement rate
919 for a rate semester, then the provider’s rate for that semester
920 shall be retroactively calculated using the new cost report, and
921 full payment at the recalculated rate shall be effected
922 retroactively. Medicare-granted extensions for filing cost
923 reports, if applicable, shall also apply to Medicaid cost
924 reports. Payment for Medicaid compensable services made on
925 behalf of Medicaid-eligible persons is subject to the
926 availability of moneys and any limitations or directions
927 provided for in the General Appropriations Act or chapter 216.
928 Further, nothing in this section shall be construed to prevent
929 or limit the agency from adjusting fees, reimbursement rates,
930 lengths of stay, number of visits, or number of services, or
931 making any other adjustments necessary to comply with the
932 availability of moneys and any limitations or directions
933 provided for in the General Appropriations Act, provided the
934 adjustment is consistent with legislative intent.
935 (2)
936 (b) Subject to any limitations or directions in the General
937 Appropriations Act, the agency shall establish and implement a
938 state Title XIX Long-Term Care Reimbursement Plan for nursing
939 home care in order to provide care and services in conformance
940 with the applicable state and federal laws, rules, regulations,
941 and quality and safety standards and to ensure that individuals
942 eligible for medical assistance have reasonable geographic
943 access to such care.
944 1. The agency shall amend the long-term care reimbursement
945 plan and cost reporting system to create direct care and
946 indirect care subcomponents of the patient care component of the
947 per diem rate. These two subcomponents together shall equal the
948 patient care component of the per diem rate. Separate prices
949 shall be calculated for each patient care subcomponent,
950 initially based on the September 2016 rate setting cost reports
951 and subsequently based on the most recently audited cost report
952 used during a rebasing year. The direct care subcomponent of the
953 per diem rate for any providers still being reimbursed on a cost
954 basis shall be limited by the cost-based class ceiling, and the
955 indirect care subcomponent may be limited by the lower of the
956 cost-based class ceiling, the target rate class ceiling, or the
957 individual provider target. The ceilings and targets apply only
958 to providers being reimbursed on a cost-based system. Effective
959 October 1, 2018, a prospective payment methodology shall be
960 implemented for rate setting purposes with the following
961 parameters:
962 a. Peer Groups, including:
963 (I) North-SMMC Regions 1-9, less Palm Beach and Okeechobee
964 Counties; and
965 (II) South-SMMC Regions 10-11, plus Palm Beach and
966 Okeechobee Counties.
967 b. Percentage of Median Costs based on the cost reports
968 used for September 2016 rate setting:
969 (I) Direct Care Costs........................100 percent.
970 (II) Indirect Care Costs......................92 percent.
971 (III) Operating Costs.........................86 percent.
972 c. Floors:
973 (I) Direct Care Component.....................95 percent.
974 (II) Indirect Care Component................92.5 percent.
975 (III) Operating Component...........................None.
976 d. Pass-through Payments..................Real Estate and
977 ...............................................Personal Property
978 ...................................Taxes and Property Insurance.
979 e. Quality Incentive Program Payment
980 Pool.....................................10 percent of September
981 .......................................2016 non-property related
982 ................................payments of included facilities.
983 f. Quality Score Threshold to Qualify Quality for Quality
984 Incentive Payment...........................................20th
985 ..............................percentile of included facilities.
986 g. Fair Rental Value System Payment Parameters:
987 (I) Building Value per Square Foot based on 2018 RS Means.
988 (II) Land Valuation...10 percent of Gross Building value.
989 (III) Facility Square Footage......Actual Square Footage.
990 (IV) Movable Equipment Allowance..........$8,000 per bed.
991 (V) Obsolescence Factor......................1.5 percent.
992 (VI) Fair Rental Rate of Return................8 percent.
993 (VII) Minimum Occupancy.......................90 percent.
994 (VIII) Maximum Facility Age.....................40 years.
995 (IX) Minimum Square Footage per Bed..................350.
996 (X) Maximum Square Footage for Bed...................500.
997 (XI) Minimum Cost of a renovation/replacements$500 per bed.
998 h. Ventilator Supplemental payment of $200 per Medicaid day
999 of 40,000 ventilator Medicaid days per fiscal year.
1000 2. The agency shall revise its methodology for calculating
1001 Quality Incentive Program payments to include the results of
1002 consumer satisfaction surveys conducted pursuant to s. 400.0225
1003 as a measure of nursing home quality. The agency shall so revise
1004 the methodology after the surveys have been in effect for an
1005 amount of time the agency deems sufficient for statistical and
1006 scientific validity as a meaningful quality measure that may be
1007 incorporated into the methodology.
1008 3. The direct care subcomponent shall include salaries and
1009 benefits of direct care staff providing nursing services
1010 including registered nurses, licensed practical nurses, and
1011 certified nursing assistants who deliver care directly to
1012 residents in the nursing home facility, allowable therapy costs,
1013 and dietary costs. This excludes nursing administration, staff
1014 development, the staffing coordinator, and the administrative
1015 portion of the minimum data set and care plan coordinators. The
1016 direct care subcomponent also includes medically necessary
1017 dental care, vision care, hearing care, and podiatric care.
1018 4.3. All other patient care costs shall be included in the
1019 indirect care cost subcomponent of the patient care per diem
1020 rate, including complex medical equipment, medical supplies, and
1021 other allowable ancillary costs. Costs may not be allocated
1022 directly or indirectly to the direct care subcomponent from a
1023 home office or management company.
1024 5.4. On July 1 of each year, the agency shall report to the
1025 Legislature direct and indirect care costs, including average
1026 direct and indirect care costs per resident per facility and
1027 direct care and indirect care salaries and benefits per category
1028 of staff member per facility.
1029 6.5. Every fourth year, the agency shall rebase nursing
1030 home prospective payment rates to reflect changes in cost based
1031 on the most recently audited cost report for each participating
1032 provider.
1033 7.6. A direct care supplemental payment may be made to
1034 providers whose direct care hours per patient day are above the
1035 80th percentile and who provide Medicaid services to a larger
1036 percentage of Medicaid patients than the state average.
1037 8.7. Pediatric, Florida Department of Veterans Affairs, and
1038 government-owned facilities are exempt from the pricing model
1039 established in this subsection and shall remain on a cost-based
1040 prospective payment system. Effective October 1, 2018, the
1041 agency shall set rates for all facilities remaining on a cost
1042 based prospective payment system using each facility’s most
1043 recently audited cost report, eliminating retroactive
1044 settlements.
1045 9. By October 1, 2025, and each year thereafter, the agency
1046 shall submit to the Governor, the President of the Senate, and
1047 the Speaker of the House of Representatives a report on each
1048 Quality Incentive Program payment made pursuant to sub
1049 subparagraph 1.e. The report must, at a minimum, include all of
1050 the following information:
1051 a. The name of each facility that received a Quality
1052 Incentive Program payment and the dollar amount of such payment
1053 each facility received.
1054 b. The total number of quality incentive metric points
1055 awarded by the agency to each facility and the number of points
1056 awarded by the agency for each individual quality metric
1057 measured.
1058 c. An examination of any trends in the improvement of the
1059 quality of care provided to nursing home residents which may be
1060 attributable to incentive payments received under the Quality
1061 Incentive Program. The agency shall include examination of
1062 trends both for the program as a whole as well as for each
1063 individual quality metric used by the agency to award program
1064 payments.
1065
1066 It is the intent of the Legislature that the reimbursement plan
1067 achieve the goal of providing access to health care for nursing
1068 home residents who require large amounts of care while
1069 encouraging diversion services as an alternative to nursing home
1070 care for residents who can be served within the community. The
1071 agency shall base the establishment of any maximum rate of
1072 payment, whether overall or component, on the available moneys
1073 as provided for in the General Appropriations Act. The agency
1074 may base the maximum rate of payment on the results of
1075 scientifically valid analysis and conclusions derived from
1076 objective statistical data pertinent to the particular maximum
1077 rate of payment. The agency shall base the rates of payments in
1078 accordance with the minimum wage requirements as provided in the
1079 General Appropriations Act.
1080 Section 14. Present subsection (10) of section 409.909,
1081 Florida Statutes, as amended by section 5 of chapter 2024-12,
1082 Laws of Florida, is redesignated as subsection (9), and
1083 paragraph (a) of subsection (6) and present subsection (9) of
1084 that section are amended, to read:
1085 409.909 Statewide Medicaid Residency Program.—
1086 (6) The Slots for Doctors Program is established to address
1087 the physician workforce shortage by increasing the supply of
1088 highly trained physicians through the creation of new resident
1089 positions, which will increase access to care and improve health
1090 outcomes for Medicaid recipients.
1091 (a)1. Notwithstanding subsection (4), the agency shall
1092 annually allocate $100,000 to hospitals, qualifying
1093 institutions, and behavioral health teaching hospitals
1094 designated under s. 395.902, for each newly created resident
1095 position that is first filled on or after June 1, 2023, and
1096 filled thereafter, and that is accredited by the Accreditation
1097 Council for Graduate Medical Education or the Osteopathic
1098 Postdoctoral Training Institution in an initial or established
1099 accredited training program which is in a physician specialty or
1100 subspecialty in a statewide supply-and-demand deficit.
1101 2. Notwithstanding the requirement that a new resident
1102 position be created to receive funding under this subsection,
1103 the agency may allocate $100,000 to hospitals and qualifying
1104 institutions, pursuant to subparagraph 1., for up to 100 200
1105 resident positions that existed before July 1, 2023, if such
1106 resident position:
1107 a. Is in a physician specialty or subspecialty experiencing
1108 a statewide supply-and-demand deficit;
1109 b. Has been unfilled for a period of 3 or more years;
1110 c. Is subsequently filled on or after June 1, 2024, and
1111 remains filled thereafter; and
1112 d. Is accredited by the Accreditation Council for Graduate
1113 Medical Education or the Osteopathic Postdoctoral Training
1114 Institution in an initial or established accredited training
1115 program.
1116 3. If applications for resident positions under this
1117 paragraph exceed the number of authorized resident positions or
1118 the available funding allocated, the agency shall prioritize
1119 applications for resident positions that are in a primary care
1120 specialty as specified in paragraph (2)(a).
1121 (9) The Graduate Medical Education Committee is created
1122 within the agency.
1123 (a) The committee shall be composed of the following
1124 members:
1125 1. Three deans, or their designees, from medical schools in
1126 this state, appointed by the chair of the Council of Florida
1127 Medical School Deans.
1128 2. Four members appointed by the Governor, one of whom is a
1129 representative of the Florida Medical Association or the Florida
1130 Osteopathic Medical Association who has supervised or is
1131 currently supervising residents, one of whom is a member of the
1132 Florida Hospital Association, one of whom is a member of the
1133 Safety Net Hospital Alliance, and one of whom is a physician
1134 licensed under chapter 458 or chapter 459 practicing at a
1135 qualifying institution.
1136 3. Two members appointed by the Secretary of Health Care
1137 Administration, one of whom represents a statutory teaching
1138 hospital as defined in s. 408.07(46) and one of whom is a
1139 physician who has supervised or is currently supervising
1140 residents.
1141 4. Two members appointed by the State Surgeon General, one
1142 of whom must represent a teaching hospital as defined in s.
1143 408.07 and one of whom is a physician who has supervised or is
1144 currently supervising residents or interns.
1145 5. Two members, one appointed by the President of the
1146 Senate and one appointed by the Speaker of the House of
1147 Representatives.
1148 (b)1. The members of the committee appointed under
1149 subparagraph (a)1. shall serve 4-year terms. When such members’
1150 terms expire, the chair of the Council of Florida Medical School
1151 Deans shall appoint new members as detailed in subparagraph
1152 (a)1. from different medical schools on a rotating basis and may
1153 not reappoint a dean from a medical school that has been
1154 represented on the committee until all medical schools in the
1155 state have had an opportunity to be represented on the
1156 committee.
1157 2. The members of the committee appointed under
1158 subparagraphs (a)2.-4. shall serve 4-year terms, with the
1159 initial term being 3 years for members appointed under
1160 subparagraph (a)4. and 2 years for members appointed under
1161 subparagraph (a)3. The committee shall elect a chair to serve
1162 for a 1-year term.
1163 (c) Members shall serve without compensation but are
1164 entitled to reimbursement for per diem and travel expenses
1165 pursuant to s. 112.061.
1166 (d) The committee shall convene its first meeting by July
1167 1, 2024, and shall meet as often as necessary to conduct its
1168 business, but at least twice annually, at the call of the chair.
1169 The committee may conduct its meetings through teleconference or
1170 other electronic means. A majority of the members of the
1171 committee constitutes a quorum, and a meeting may not be held
1172 with less than a quorum present. The affirmative vote of a
1173 majority of the members of the committee present is necessary
1174 for any official action by the committee.
1175 (e) Beginning on July 1, 2025, the committee shall submit
1176 an annual report to the Governor, the President of the Senate,
1177 and the Speaker of the House of Representatives which must, at a
1178 minimum, detail all of the following:
1179 1. The role of residents and medical faculty in the
1180 provision of health care.
1181 2. The relationship of graduate medical education to the
1182 state’s physician workforce.
1183 3. The typical workload for residents and the role such
1184 workload plays in retaining physicians in the long-term
1185 workforce.
1186 4. The costs of training medical residents for hospitals
1187 and qualifying institutions.
1188 5. The availability and adequacy of all sources of revenue
1189 available to support graduate medical education.
1190 6. The use of state funds, including, but not limited to,
1191 intergovernmental transfers, for graduate medical education for
1192 each hospital or qualifying institution receiving such funds.
1193 (f) The agency shall provide reasonable and necessary
1194 support staff and materials to assist the committee in the
1195 performance of its duties. The agency shall also provide the
1196 information obtained pursuant to subsection (8) to the committee
1197 and assist the committee, as requested, in obtaining any other
1198 information deemed necessary by the committee to produce its
1199 report.
1200 Section 15. Subsection (1), paragraph (d) of subsection
1201 (2), and paragraph (a) of subsection (5) of section 409.91256,
1202 Florida Statutes, are amended to read:
1203 409.91256 Training, Education, and Clinicals in Health
1204 (TEACH) Funding Program.—
1205 (1) PURPOSE AND INTENT.—The Training, Education, and
1206 Clinicals in Health (TEACH) Funding Program is created to
1207 provide a high-quality educational experience while supporting
1208 participating federally qualified health centers, community
1209 mental health centers, rural health clinics, and certified
1210 community behavioral health clinics, and publicly funded
1211 nonprofit organizations serving Medicaid recipients or other
1212 low-income patients in areas designated as health professional
1213 shortage areas and approved by the agency by offsetting
1214 administrative costs and loss of revenue associated with
1215 training residents and students to become licensed health care
1216 practitioners. Further, it is the intent of the Legislature to
1217 use the program to support the state Medicaid program and
1218 underserved populations by expanding the available health care
1219 workforce.
1220 (2) DEFINITIONS.—As used in this section, the term:
1221 (d) “Qualified facility” means a federally qualified health
1222 center, a community mental health center, a rural health clinic,
1223 or a certified community behavioral health clinic, or a publicly
1224 funded nonprofit organization serving Medicaid recipients or
1225 other low-income patients in an area designated as a health
1226 professional shortage area and approved by the agency.
1227 (5) REIMBURSEMENT.—Qualified facilities may be reimbursed
1228 under this section only to offset the administrative costs or
1229 lost revenue associated with training students, allopathic
1230 residents, osteopathic residents, or dental residents who are
1231 enrolled in an accredited educational or residency program based
1232 in this state.
1233 (a) Subject to an appropriation, the agency may reimburse a
1234 qualified facility based on the number of clinical training
1235 hours reported under subparagraph (3)(e)1. The allowed
1236 reimbursement per student is as follows:
1237 1. A medical or dental resident at a rate of $50 per hour.
1238 2. A first-year medical student at a rate of $27 per hour.
1239 3. A second-year medical student at a rate of $27 per hour.
1240 4. A third-year medical student at a rate of $29 per hour.
1241 5. A fourth-year medical student at a rate of $29 per hour.
1242 6. A dental student at a rate of $22 per hour.
1243 7. An advanced practice registered nursing student at a
1244 rate of $22 per hour.
1245 8. A physician assistant student at a rate of $22 per hour.
1246 9. A nursing student at a rate of $22 per hour.
1247 10. A behavioral health student at a rate of $15 per hour.
1248 11.10. A dental hygiene student at a rate of $15 per hour.
1249 Section 16. Paragraph (e) of subsection (3) of section
1250 409.967, Florida Statutes, is amended to read:
1251 409.967 Managed care plan accountability.—
1252 (3) ACHIEVED SAVINGS REBATE.—
1253 (e) Once the certified public accountant completes the
1254 audit, the certified public accountant shall submit an audit
1255 report to the agency attesting to the achieved savings of the
1256 plan. The agency shall review the report to determine compliance
1257 with the requirements of this subsection. The agency shall
1258 notify the certified public accountant of any deficiencies in
1259 the audit report. The certified public accountant must correct
1260 such deficiencies in the audit report and resubmit the revised
1261 audit report to the agency before the report is considered
1262 final. Once finalized, the results of the audit report are
1263 dispositive.
1264 Section 17. Section 409.9745, Florida Statutes, is amended
1265 to read:
1266 409.9745 Managed care plan biomarker testing.—
1267 (1) A managed care plan must provide coverage for biomarker
1268 testing for recipients, as authorized under s. 409.906, at the
1269 same scope, duration, and frequency as the Medicaid program
1270 provides for other medically necessary treatments.
1271 (a)(2) A recipient and health care provider shall have
1272 access to a clear and convenient process to request
1273 authorization for biomarker testing as provided under this
1274 section. Such process shall be made readily accessible on the
1275 website of the managed care plan.
1276 (b)(3) This section does not require coverage of biomarker
1277 testing for screening purposes.
1278 (c)(4) The agency shall include the rate impact of this
1279 section in the applicable Medicaid managed medical assistance
1280 program and long-term care managed care program rates.
1281 (2) A managed care plan must provide coverage for blood
1282 based biomarker tests for colorectal cancer screening covered
1283 under a National Coverage Determination from the Centers for
1284 Medicare and Medicaid Services at the same scope and frequency
1285 as described in the National Coverage Determination.
1286 Section 18. Subsection (4) of section 409.977, Florida
1287 Statutes, is amended to read:
1288 409.977 Enrollment.—
1289 (4) The agency shall develop a process to enable a
1290 recipient with access to employer-sponsored health care coverage
1291 to opt out of all managed care plans and to use Medicaid
1292 financial assistance to pay for the recipient’s share of the
1293 cost in such employer-sponsored coverage. The agency shall also
1294 enable recipients with access to other insurance or related
1295 products providing access to health care services created
1296 pursuant to state law, including any product available under the
1297 Florida Health Choices Program, or any health exchange, to opt
1298 out. The amount of financial assistance provided for each
1299 recipient may not exceed the amount of the Medicaid premium that
1300 would have been paid to a managed care plan for that recipient.
1301 The agency shall require Medicaid recipients with access to
1302 employer-sponsored health care coverage to enroll in that
1303 coverage and use Medicaid financial assistance to pay for the
1304 recipient’s share of the cost for such coverage. The amount of
1305 financial assistance provided for each recipient may not exceed
1306 the amount of the Medicaid premium that would have been paid to
1307 a managed care plan for that recipient. The agency may exceed
1308 this amount for a high-cost patient if it determines it would be
1309 cost effective to do so. The agency shall annually, beginning
1310 June 30, 2026, submit an annual report on the program to the
1311 Legislature including, but not limited to, the level of
1312 participation; participant demographics, income levels, type of
1313 employer-based coverage, and amount of health care utilization;
1314 and a cost-effectiveness analysis both in the aggregate and on
1315 an individual patient basis.
1316 Section 19. Paragraph (b) of subsection (3) of section
1317 430.84, Florida Statutes, is amended to read:
1318 430.84 Program of All-Inclusive Care for the Elderly.—
1319 (3) PACE ORGANIZATION SELECTION.—The agency, in
1320 consultation with the department, shall, on a continuous basis,
1321 review and consider applications required by the CMS for PACE
1322 that have been submitted to the agency by entities seeking
1323 initial state approval to become PACE organizations. Notice of
1324 such applications shall be published in the Florida
1325 Administrative Register.
1326 (b) Each applicant must propose to serve a unique and
1327 defined geographic service area. In designating a service area
1328 under a contract with a PACE organization, the state
1329 administering agency may exclude from designation an area that
1330 is already covered under another PACE organization contract in
1331 order to avoid unnecessary duplication of services and avoid
1332 impairing the financial service viability of an existing PACE
1333 organization. However, if a new applicant submits a letter of
1334 intent to provide PACE services in an area where an existing
1335 PACE organization is under contract and has been operating for
1336 at least 10 years, the state shall determine whether there is an
1337 unmet need that could be provided by the new PACE organization
1338 and the applicant must satisfactorily demonstrate to the state
1339 administering agency that there is justification for the
1340 proposed PACE organization in such service area. All applicants
1341 must demonstrate in the application that the PACE services
1342 provided by the proposed PACE organization will be comprehensive
1343 and organized to meet all state and CMS requirements without
1344 duplication of services or target populations. No more than one
1345 PACE organization may be authorized to provide services within
1346 any unique and defined geographic service area.
1347 Section 20. (1) To support and enhance quality outcomes in
1348 Florida’s nursing homes, the Agency for Health Care
1349 Administration shall contract with a third-party vendor to
1350 conduct a comprehensive study of nursing home quality incentive
1351 programs in other states.
1352 (a) At a minimum, the study must include a detailed
1353 analysis of quality incentive programs implemented in each of
1354 the states examined, identify components of such programs which
1355 have demonstrably improved nursing home quality outcomes, and
1356 provide recommendations to modify or enhance this state’s
1357 existing Medicaid Quality Incentive Program based on its
1358 historical performance and trends since it was first
1359 implemented.
1360 (b) The study must also include:
1361 1. An in-depth review of emerging and existing technologies
1362 applicable to nursing home care and an analysis of how their
1363 adoption in this state could improve quality of care,
1364 operational efficiency, and quality of life outcomes for nursing
1365 home residents; and
1366 2. An examination of other states’ Medicaid add-on payment
1367 structures related to the provision of ventilator care,
1368 bariatric services, and behavioral health services.
1369 (2) The agency shall submit a final report on the study,
1370 including findings and actionable recommendations, to the
1371 Governor, the President of the Senate, and the Speaker of the
1372 House of Representatives by January 5, 2026.
1373 Section 21. This act shall take effect July 1, 2025.