CS/SB 1658--Health care.This is a conforming bill to the General Appropriations Act (GAA GAA Goals Against Average (Hockey) GAA Gaelic Athletic Association GAA Gravure Association of America (Rochester, NY) GAA German Agro Action GAA Global Aquaculture Alliance GAA Gay Activists Alliance ) and contains various statutory revisions to conform to budget adjustments in the area of health care. More specifically, the bill: amends [section]395.7017, F.S., authorizing the Agency for Health Care Administration (AHCA AHCA Agency for Health Care Administration AHCA American Health Care Association AHCA American Hockey Coaches Association AHCA American Highland Cattle Association AHCA Australian Health Care Agreement AHCA Austin Healey Club of America ) to promulgate To officially announce, to publish, to make known to the public; to formally announce a statute or a decision by a court. rules relating to assessments on inpatient and outpatient services outpatient services Hospital-based services Managed care Medical and other services provided, to a nonadmitted Pt, by a hospital or other qualified facility–eg, mental health clinic, rural health clinic, mobile X-ray unit, free-standing dialysis unit Examples and health care entities as authorized in ch. 395, Part IV, F.S.; amends [section][section]409.815 & 409.818, F.S., conforming state statutes to new federal requirements mandated under the Children's Health Children's Health Definition Children's health encompasses the physical, mental, emotional, and social well-being of children from infancy through adolescence. Insurance Program Reauthorization Act legislation; amends [section]409.904, F.S., extending the sunset date to December 31, 2010 for the Medicaid Aged and Disabled and Medically Needy for adults programs; amends [section]409.905, F.S., requiring prior authorization prior authorization, n See predetermination. prior authorization Health insurance A cost containment measure that provides full payment of health benefits only if the hospitalization or medical treatment has been for home health services health services Managed care The benefits covered under a health contract visits not associated with a skilled nursing visit if the home health agency's billing rate exceeds the state average by 50 percent or more; requiring home health agencies to submit supporting documentation when requesting prior authorization; and establishing reimbursement requirements and an exemption for home health services. The bill also amends [section]409.905 (5)(c), F.S., allowing the Medicaid inpatient per diem rate to be adjusted; amends [section]409.906, F.S., limiting vision services for adult Medicaid beneficiaries, effective January 1, 2010; amends [section]409.9082, F.S., providing an additional provision to exempt or apply a lower quality assessment rate; eliminating an option for discontinuing the quality assessment program for nursing home providers; and authorizing the use of the quality assessments to restore Fiscal Year 2009-2010 rate reductions; amends [section]409.9083, F.S., creating a quality assessment program for privately operated intermediate care facilities for the developmentally disabled; amends [section][section]409.911, 409.9112, 409.9113, 409.9117, & 409.9119, F.S., revising the method for calculating disproportionate share payments to hospitals; amends [section]409.912, F.S., specifying that the implementation of an integrated fixed payment service delivery program (Florida Senior Care) is subject to a specific appropriation. The bill also amends [section]409.912 (8)(b), F.S., providing authorization to pay exclusive provider organization exclusive provider organization (EPO), n a dental benefits plan that provides benefits only if care is rendered by institutional and professional providers with whom the plan contracts (with some exceptions for emergency and out-of-area services). under contract with the AHCA to provide services in rural area with no health maintenance organization in accordance with the appropriate fee schedule for services provided; amends [section]409.91211, F.S., delaying the conversion of provider services networks, including the Children's Medical Services Network, operating in reform counties under a fee-for-services model to a capitation model from September 1, 2009 until September 1, 2011; amends [section]409.9122, F.S., removing the requirement for MediPass program beneficiaries in counties with two or more managed care plans to be assigned to a managed care plan if they fail to make a choice during the annual enrollment period; amends [section]409.916, F.S., providing for quality assessment fees received from Medicaid providers to be deposited into the Grants and Donations Trust Fund and used for the purposes established by law and the GAA; amends [section]430.04, F.S., transferring the administrative duties, functions, and appropriations for the Medicaid waivers and programs that serve the elderly from the AHCA to the Department of Elder Affairs (DOEA DOEA Department of Elder Affairs (Florida State Government) ); amends [section]430.707, F.S., directing the AHCA, in consultation with the DOEA, to accept and forward to Centers for Medicare and Medicaid Services The Centers for Medicare and Medicaid Services (CMS), previously known as the Health Care Financing Administration (HCFA), is a federal agency within the United States Department of Health and Human Services (DHHS) that administers the Medicare program and (CMS (1) See content management system and color management system. (2) (Conversational Monitor System) Software that provides interactive communications for IBM's VM operating system. ) an application to expand a Program of All-inclusive Care for the Elderly PACE Program of All-inclusive Care for the Elderly PACE programs provide comprehensive health services for individuals over age 55 who are sufficiently frail to be categorized as "nursing home eligible" by their state's Medicaid program. (PACE) pilot project from a current PACE entity in good standing with the AHCA, DOEA, and CMS to expedite the application approval process. The bill also authorizes the AHCA, subject to federal approval of the application to be a PACE site, to contract with a hospice organization to serve up to 100 elderly beneficiaries; and creates two undesignated sections of law establishing two new pilot projects, a home health agency monitoring pilot project and a comprehensive home health care management pilot project, in Miami-Dade County to combat an increase in fraud and abuse in the delivery of home health services, to be implemented by January 1, 2010. These provisions were approved by the Governor and take effect July 1, 2009. Ch. 09-55, L.O.F. |
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