Bill Text: FL S0190 | 2020 | Regular Session | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

---

Bill Title: Health Care for Children

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2020-03-10 - Laid on Table, refer to CS/HB 81 [S0190 Detail]

Download: Florida-2020-S0190-Introduced.html

---

       Florida Senate - 2020                                     SB 190
       
       
        
       By Senator Montford
       
       
       
       
       
       3-00173-20                                             2020190__
    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; conforming a provision to changes
   14         made by the act; amending s. 409.908, F.S.; specifying
   15         the federal agency that may waive certain school-based
   16         provider qualifications; providing an effective date.
   17          
   18  Be It Enacted by the Legislature of the State of Florida:
   19  
   20         Section 1. Subsection (1), paragraph (b) of subsection (2),
   21  and subsection (6) of section 409.9071, Florida Statutes, are
   22  amended to read:
   23         409.9071 Medicaid provider agreements for school districts
   24  certifying state match.—
   25         (1) The agency shall reimburse school-based services as
   26  provided in ss. 409.908(21) and 1011.70 former s. 236.0812
   27  pursuant to the rehabilitative services option provided under 42
   28  U.S.C. s. 1396d(a)(13). For purposes of this section, billing
   29  agent consulting services are shall be considered billing agent
   30  services, as that term is used in s. 409.913(10), and, as such,
   31  payments to such persons may shall not be based on amounts for
   32  which they bill nor based on the amount a provider receives from
   33  the Medicaid program. This provision may shall not restrict
   34  privatization of Medicaid school-based services. Subject to any
   35  limitations provided for in the General Appropriations Act, the
   36  agency, in compliance with appropriate federal authorization,
   37  shall develop policies and procedures and shall allow for
   38  certification of state and local education funds that which have
   39  been provided for school-based services as specified in s.
   40  1011.70 and authorized by a physician’s order where required by
   41  federal Medicaid law. Any state or local funds certified
   42  pursuant to this section shall be for children with specified
   43  disabilities who are eligible for both Medicaid and part B or
   44  part H of the Individuals with Disabilities Education Act
   45  (IDEA), or the exceptional student education program, or who
   46  have an individualized educational plan.
   47         (2) School districts that wish to enroll as Medicaid
   48  providers and that certify state match in order to receive
   49  federal Medicaid reimbursements for services, pursuant to
   50  subsection (1), shall agree to:
   51         (b) Develop and maintain the financial and other student
   52  individual education plan records needed to document the
   53  appropriate use of state and federal Medicaid funds.
   54         (6) Retroactive reimbursements for services as specified in
   55  former s. 236.0812 as of July 1, 1996, including reimbursement
   56  for the 1995-1996 and 1996-1997 school years, are subject to
   57  federal approval.
   58         Section 2. Subsection (1) and paragraph (b) of subsection
   59  (2) of section 409.9072, Florida Statutes, are amended to read:
   60         409.9072 Medicaid provider agreements for charter schools
   61  and private schools.—
   62         (1) Subject to a specific appropriation by the Legislature,
   63  the agency shall reimburse private schools as defined in s.
   64  1002.01 and schools designated as charter schools under s.
   65  1002.33 which are Medicaid providers for school-based services
   66  pursuant to the rehabilitative services option provided under 42
   67  U.S.C. s. 1396d(a)(13) to children younger than 21 years of age
   68  with specified disabilities who are eligible for both Medicaid
   69  and part B or part H of the Individuals with Disabilities
   70  Education Act (IDEA) or the exceptional student education
   71  program, or who have an individualized educational plan.
   72         (2) Schools that wish to enroll as Medicaid providers and
   73  receive Medicaid reimbursement under this section must apply to
   74  the agency for a provider agreement and must agree to:
   75         (b) Develop and maintain the financial and student
   76  individual education plan records needed to document the
   77  appropriate use of state and federal Medicaid funds.
   78         Section 3. Subsection (21) of section 409.908, Florida
   79  Statutes, is amended to read:
   80         409.908 Reimbursement of Medicaid providers.—Subject to
   81  specific appropriations, the agency shall reimburse Medicaid
   82  providers, in accordance with state and federal law, according
   83  to methodologies set forth in the rules of the agency and in
   84  policy manuals and handbooks incorporated by reference therein.
   85  These methodologies may include fee schedules, reimbursement
   86  methods based on cost reporting, negotiated fees, competitive
   87  bidding pursuant to s. 287.057, and other mechanisms the agency
   88  considers efficient and effective for purchasing services or
   89  goods on behalf of recipients. If a provider is reimbursed based
   90  on cost reporting and submits a cost report late and that cost
   91  report would have been used to set a lower reimbursement rate
   92  for a rate semester, then the provider’s rate for that semester
   93  shall be retroactively calculated using the new cost report, and
   94  full payment at the recalculated rate shall be effected
   95  retroactively. Medicare-granted extensions for filing cost
   96  reports, if applicable, shall also apply to Medicaid cost
   97  reports. Payment for Medicaid compensable services made on
   98  behalf of Medicaid eligible persons is subject to the
   99  availability of moneys and any limitations or directions
  100  provided for in the General Appropriations Act or chapter 216.
  101  Further, nothing in this section shall be construed to prevent
  102  or limit the agency from adjusting fees, reimbursement rates,
  103  lengths of stay, number of visits, or number of services, or
  104  making any other adjustments necessary to comply with the
  105  availability of moneys and any limitations or directions
  106  provided for in the General Appropriations Act, provided the
  107  adjustment is consistent with legislative intent.
  108         (21) The agency shall reimburse school districts that which
  109  certify the state match pursuant to ss. 409.9071 and 1011.70 for
  110  the federal portion of the school district’s allowable costs to
  111  deliver the services, based on the reimbursement schedule. The
  112  school district shall determine the costs for delivering
  113  services as authorized in ss. 409.9071 and 1011.70 for which the
  114  state match will be certified. Reimbursement of school-based
  115  providers is contingent on such providers being enrolled as
  116  Medicaid providers and meeting the qualifications contained in
  117  42 C.F.R. s. 440.110, unless otherwise waived by the United
  118  States Department of Health and Human Services federal Health
  119  Care Financing Administration. Speech therapy providers who are
  120  certified through the Department of Education pursuant to rule
  121  6A-4.0176, Florida Administrative Code, are eligible for
  122  reimbursement for services that are provided on school premises.
  123  Any employee of the school district who has been fingerprinted
  124  and has received a criminal background check in accordance with
  125  Department of Education rules and guidelines is shall be exempt
  126  from any agency requirements relating to criminal background
  127  checks.
  128         Section 4. This act shall take effect July 1, 2020.