Bill Text: FL S1646 | 2012 | Regular Session | Comm Sub
Bill Title: Medicaid
Spectrum: Bipartisan Bill
Status: (Failed) 2012-03-09 - Died in Budget, companion bill(s) passed, see HB 5301 (Ch. [S1646 Detail]
Download: Florida-2012-S1646-Comm_Sub.html
Florida Senate - 2012 CS for SB 1646
By the Committee on Budget Subcommittee on Health and Human
Services Appropriations; and Senator Flores
603-04244-12 20121646c1
1 A bill to be entitled
2 An act relating to Medicaid; amending s. 409.905,
3 F.S.; revising the date for adjusting hospital
4 inpatient rates; amending s. 409.9122, F.S.; deleting
5 a geographic limitation on where HIV/AIDS recipients
6 must reside for the purposes of being assigned to
7 certain managed care plans; amending s. 1004.435,
8 F.S.; revising legislative intent to delete provisions
9 relating to research activities for cancer control;
10 changing the name of the cancer control and research
11 advisory council to the Florida Cancer Control and
12 Resource Advisory Council; providing for the
13 appointment and terms of council members and duties of
14 the council; providing for a nominating committee to
15 make recommendations for gubernatorial appointments to
16 the council; providing for council membership
17 categories; providing for an executive committee of
18 the council and duties of the committee; authorizing
19 consultants to the council; providing duties of the
20 council for the development, review, and approval of
21 the Florida Cancer Plan; deleting responsibilities of
22 the council and the Board of Governors of the State
23 University System relating to cancer research;
24 authorizing the Department of Health to adopt rules
25 for implementation of the section; providing
26 department duties relating to the development and
27 establishment of the Florida Cancer Plan; revising the
28 name of the cancer control fund and deleting the use
29 of funds for cancer research; amending ss. 458.324 and
30 459.0125, F.S.; conforming cross-references; requiring
31 that the Agency for Health Care Administration create
32 a demonstration project to address funding issues
33 related to the Medicaid program’s share of medical
34 residency training expenditures; providing for a
35 federally qualified health center to establish a
36 graduate medical education program in Miami-Dade
37 County through Florida International University;
38 providing requirements for the agreement between the
39 university and managed care organizations allocating
40 funds for the project; requiring that the Agency for
41 Health Care Administration provide an annual report to
42 the Governor and Legislature; providing an effective
43 date.
44
45 Be It Enacted by the Legislature of the State of Florida:
46
47 Section 1. Paragraph (c) of subsection (5) of section
48 409.905, Florida Statutes, is amended to read:
49 409.905 Mandatory Medicaid services.—The agency may make
50 payments for the following services, which are required of the
51 state by Title XIX of the Social Security Act, furnished by
52 Medicaid providers to recipients who are determined to be
53 eligible on the dates on which the services were provided. Any
54 service under this section shall be provided only when medically
55 necessary and in accordance with state and federal law.
56 Mandatory services rendered by providers in mobile units to
57 Medicaid recipients may be restricted by the agency. Nothing in
58 this section shall be construed to prevent or limit the agency
59 from adjusting fees, reimbursement rates, lengths of stay,
60 number of visits, number of services, or any other adjustments
61 necessary to comply with the availability of moneys and any
62 limitations or directions provided for in the General
63 Appropriations Act or chapter 216.
64 (5) HOSPITAL INPATIENT SERVICES.—The agency shall pay for
65 all covered services provided for the medical care and treatment
66 of a recipient who is admitted as an inpatient by a licensed
67 physician or dentist to a hospital licensed under part I of
68 chapter 395. However, the agency shall limit the payment for
69 inpatient hospital services for a Medicaid recipient 21 years of
70 age or older to 45 days or the number of days necessary to
71 comply with the General Appropriations Act.
72 (c) The agency shall implement a methodology for
73 establishing base reimbursement rates for each hospital based on
74 allowable costs, as defined by the agency. Rates shall be
75 calculated annually and take effect July 1 of each year based on
76 the most recent complete and accurate cost report submitted by
77 each hospital. Adjustments may not be made to the rates after
78 October 31 September 30 of the state fiscal year in which the
79 rates take rate takes effect. Errors in cost reporting or
80 calculation of rates discovered after October 31 September 30
81 must be reconciled in a subsequent rate period. The agency may
82 not make any adjustment to a hospital’s reimbursement rate more
83 than 5 years after a hospital is notified of an audited rate
84 established by the agency. The requirement that the agency may
85 not make any adjustment to a hospital’s reimbursement rate more
86 than 5 years after a hospital is notified of an audited rate
87 established by the agency is remedial and applies shall apply to
88 actions by providers involving Medicaid claims for hospital
89 services. Hospital rates are shall be subject to such limits or
90 ceilings as may be established in law or described in the
91 agency’s hospital reimbursement plan. Specific exemptions to the
92 limits or ceilings may be provided in the General Appropriations
93 Act.
94 Section 2. Paragraph (l) of subsection (2) of section
95 409.9122, Florida Statutes, is amended to read:
96 409.9122 Mandatory Medicaid managed care enrollment;
97 programs and procedures.—
98 (2)
99 (l) If the Medicaid recipient is diagnosed with HIV/AIDS
100 and resides in Broward County, Miami-Dade County, or Palm Beach
101 County, the agency shall assign the Medicaid recipient to a
102 managed care plan that is a health maintenance organization
103 authorized under chapter 641, is under contract with the agency
104 on July 1, 2011, and which offers a delivery system through a
105 university-based teaching and research-oriented organization
106 that specializes in providing health care services and treatment
107 for individuals diagnosed with HIV/AIDS.
108
109 This subsection expires October 1, 2014.
110 Section 3. Section 1004.435, Florida Statutes, is amended
111 to read:
112 1004.435 Cancer control and resource advisory council
113 research.—
114 (1) SHORT TITLE.—This section shall be known and may be
115 cited as the “Florida Cancer Control and Research Act.”
116 (2) LEGISLATIVE INTENT.—It is The finding of the
117 Legislature finds that:
118 (a) Advances in scientific knowledge have led to the
119 development of preventive and therapeutic capabilities in the
120 control of cancer. Such knowledge and therapy must be made
121 available to all citizens of this state through educational and
122 therapeutic programs.
123 (b) The present state of our knowledge concerning the
124 prevalence, cause or associated factors, and treatment of cancer
125 have resulted primarily from a vast federal investment into
126 basic and clinical research, some of which is expended in this
127 state. These research activities must continue, but programs
128 must be established to extend this knowledge in preventive
129 measures and patient treatment throughout the state.
130 (c) Research in cancer has implicated the environment as a
131 causal factor for many types of cancer, i.e., sunshine, X rays,
132 diet, smoking, etc., and programs are needed to further document
133 such cause and effect relationships. Proven causes of cancer
134 should be publicized and be the subject of educational programs
135 for the prevention of cancer.
136 (b)(d) An effective cancer control program would mobilize
137 the scientific, educational, and medical resources that
138 presently exist into an intense attack against cancer this dread
139 disease.
140 (3) DEFINITIONS.—As The following words and phrases when
141 used in this section, the term have, unless the context clearly
142 indicates otherwise, the meanings given to them in this
143 subsection:
144 (a) “Cancer” means all malignant neoplasms, regardless of
145 the tissue of origin, including lymphoma and leukemia.
146 (b) “Council” means the Florida Cancer Control and Resource
147 Research Advisory Council, which is an advisory body appointed
148 to function on a continuing basis for the study of cancer and to
149 recommend which recommends solutions and policy alternatives to
150 the Board of Governors and the State Surgeon General and which
151 is established by this section.
152 (c) “Department” means the Department of Health.
153 (d) “Fund” means the Florida Cancer Control and Research
154 Fund established by this section.
155 (e) “Plan” means the Florida Cancer Plan.
156 (f)(e) “Qualified nonprofit association” means any
157 association, incorporated or unincorporated, which that has
158 received tax-exempt status from the Internal Revenue Service.
159 (4) FLORIDA CANCER CONTROL AND RESOURCE RESEARCH ADVISORY
160 COUNCIL; CREATION; COMPOSITION.—
161 (a) There is created within the H. Lee Moffitt Cancer
162 Center and Research Institute, Inc., the Florida Cancer Control
163 and Resource Research Advisory Council. The council shall serve
164 as a resource and clearinghouse for comprehensive cancer control
165 in the state and shall facilitate effective communication,
166 shared resources, and synergism between and among the cancer
167 stakeholder organizations and groups within the state.
168 1. The council shall consist of members representing the
169 various cancer constituencies in the state. The council shall
170 include three members representing the general public appointed
171 by the Governor, one member appointed by the President of the
172 Senate, one member appointed by the Speaker of the House of
173 Representatives, one member appointed by the State Surgeon
174 General, and 32 members representing cancer stakeholders in the
175 state who are appointed by the Governor. Of the 32 members, at
176 least 10 members must be individuals who are minority persons as
177 defined in s. 288.703. Each council member must be a resident of
178 the state, and all members are voting members of the council.
179 2. Of the three members representing the general public
180 appointed by the Governor, one shall serve an initial term of 2
181 years, one shall serve an initial term of 3 years, and one shall
182 serve an initial term of 4 years, beginning July 1, 2012;
183 thereafter, these gubernatorial appointments to the council
184 shall be for 4-year terms. The remaining members appointed by
185 the Governor and the members appointed by the President of the
186 Senate, the Speaker of the House of Representatives, and the
187 State Surgeon General shall serve 4-year terms. A chair and vice
188 chair shall each be elected by the council membership for 2-year
189 terms. The council shall consist of 35 members, which includes
190 the chairperson, all of whom must be residents of this state.
191 All members, except those appointed by the Speaker of the House
192 of Representatives and the President of the Senate, must be
193 appointed by the Governor. At least one of the members appointed
194 by the Governor must be 60 years of age or older. One member
195 must be a representative of the American Cancer Society; one
196 member must be a representative of the Florida Tumor Registrars
197 Association; one member must be a representative of the
198 Sylvester Comprehensive Cancer Center of the University of
199 Miami; one member must be a representative of the Department of
200 Health; one member must be a representative of the University of
201 Florida Shands Cancer Center; one member must be a
202 representative of the Agency for Health Care Administration; one
203 member must be a representative of the Florida Nurses
204 Association; one member must be a representative of the Florida
205 Osteopathic Medical Association; one member must be a
206 representative of the American College of Surgeons; one member
207 must be a representative of the School of Medicine of the
208 University of Miami; one member must be a representative of the
209 College of Medicine of the University of Florida; one member
210 must be a representative of NOVA Southeastern College of
211 Osteopathic Medicine; one member must be a representative of the
212 College of Medicine of the University of South Florida; one
213 member must be a representative of the College of Public Health
214 of the University of South Florida; one member must be a
215 representative of the Florida Society of Clinical Oncology; one
216 member must be a representative of the Florida Obstetric and
217 Gynecologic Society who has had training in the specialty of
218 gynecologic oncology; one member must be a representative of the
219 Florida Ovarian Cancer Alliance Speaks (FOCAS) organization; one
220 member must be a representative of the Florida Medical
221 Association; one member must be a member of the Florida
222 Pediatric Society; one member must be a representative of the
223 Florida Radiological Society; one member must be a
224 representative of the Florida Society of Pathologists; one
225 member must be a representative of the H. Lee Moffitt Cancer
226 Center and Research Institute, Inc.; three members must be
227 representatives of the general public acting as consumer
228 advocates; one member must be a member of the House of
229 Representatives appointed by the Speaker of the House of
230 Representatives; one member must be a member of the Senate
231 appointed by the President of the Senate; one member must be a
232 representative of the Florida Dental Association; one member
233 must be a representative of the Florida Hospital Association;
234 one member must be a representative of the Association of
235 Community Cancer Centers; one member shall be a representative
236 from a statutory teaching hospital affiliated with a community
237 based cancer center; one member must be a representative of the
238 Florida Association of Pediatric Tumor Programs, Inc.; one
239 member must be a representative of the Cancer Information
240 Service; one member must be a representative of the Florida
241 Agricultural and Mechanical University Institute of Public
242 Health; and one member must be a representative of the Florida
243 Society of Oncology Social Workers. Of the members of the
244 council appointed by the Governor, at least 10 must be
245 individuals who are minority persons as defined by s. 288.703.
246 (b) A nominating committee shall annually review applicants
247 for the council and make recommendations for gubernatorial
248 appointments to the council. The nominating committee shall be
249 comprised of a minimum of seven council members selected by, and
250 including, the vice chair. The nominating committee shall
251 constitute a subgroup of the council membership in that at least
252 one member shall represent each membership category identified
253 in paragraph (c). The individuals selected by the nominating
254 committee shall be forwarded for gubernatorial appointment and
255 are eligible for reappointment one time.
256 (c) The 32 members appointed by the Governor who represent
257 cancer stakeholders in the state shall be recommended by cancer
258 stakeholder organizations or groups, by council nomination, or
259 through self-referrals. The membership categories and the
260 maximum number of members in each category include:
261 1. Five members from university-based health care delivery
262 systems with major cancer programs, including the H. Lee Moffitt
263 Cancer Center and Research Institute, Inc., the University of
264 Florida Shands Cancer Center, and the University of Miami
265 Sylvester Comprehensive Cancer Center.
266 2. Five members from community-based health care delivery
267 systems or practices with American College of Surgeons
268 accredited cancer programs.
269 3. Four members from nonprofit or voluntary organizations,
270 including a representative from the American Cancer Society.
271 4. Three members from health and health care disparities
272 research and outreach cancer programs.
273 5. Five members from state governmental agencies, including
274 the Department of Health, the Department of Education, and the
275 Biomedical Research Advisory Council.
276 6. Five members from cancer-related professional
277 organizations, including the Florida Society of Clinical
278 Oncology, the Florida Society of Oncology Social Workers, the
279 Florida Society of Pathologists, the Florida Dental Association,
280 the Florida Medical Association, and the Florida Osteopathic
281 Medical Association.
282 7. Five members each representing one of the state regional
283 cancer collaboratives.
284 (d) An executive committee, which shall be responsible for
285 coordinating the activities and planning the direction of the
286 council, shall be comprised of the council’s chair and vice
287 chair, the appointee of the Speaker of the House of
288 Representatives, the appointee of the President of the Senate,
289 the appointee of the State Surgeon General, and four members
290 selected by the chair. The positions on the executive committee
291 shall be for terms of 2 years corresponding to the chair’s term
292 in office. Membership on the executive committee shall
293 constitute a subgroup of the council membership in that at least
294 one member shall represent each membership category identified
295 in paragraph (c). Additional members may serve at the discretion
296 of the chair.
297 (e) The council may invite additional state cancer
298 stakeholder organizations or groups or individuals with
299 expertise, experience, or resources to serve as consultants to
300 assist the council in accomplishing its mission. Such services
301 may include consultative participation in council activities,
302 associated task forces, or projects. Consultants do not have
303 voting rights on the council.
304 (b) The terms of the members shall be 4 years from their
305 respective dates of appointment.
306 (c) A chairperson shall be appointed by the Governor for a
307 term of 2 years. The chairperson shall appoint an executive
308 committee of no fewer than three persons to serve at the
309 pleasure of the chairperson. This committee will prepare
310 material for the council but make no final decisions.
311 (f)(d) The council shall meet at least no less than
312 semiannually at the call of the chair chairperson or, in his or
313 her absence or incapacity, at the call of the State Surgeon
314 General. Twenty Sixteen members constitute a quorum for the
315 purpose of exercising all of the powers of the council. A vote
316 of the majority of the members present is sufficient for all
317 actions of the council.
318 (g)(e) The council members shall serve without pay.
319 Pursuant to the provisions of s. 112.061, the council members
320 may be entitled to be reimbursed for per diem and travel
321 expenses.
322 (h)(f) A No member of the council may not shall participate
323 in any discussion or decision to recommend grants or contracts
324 to any qualified nonprofit association or to any agency of this
325 state or its political subdivisions with which the member is
326 associated as a member of the governing body or as an employee
327 or with which the member has entered into a contractual
328 arrangement.
329 (i)(g) The council may prescribe, amend, and repeal bylaws
330 governing the manner in which the business of the council is
331 conducted.
332 (j)(h) The council shall advise the Board of Governors, the
333 State Surgeon General, the Governor, and the Legislature with
334 respect to cancer control and resources research in this state.
335 (k)(i) The council shall approve each year a program for
336 cancer control and research to be known as the “Florida Cancer
337 Plan” which shall be consistent with the State Health Plan and
338 integrated and coordinated with existing or emerging programs in
339 this state. The council shall review and approve the plan at
340 least every 4 years.
341 (l)(j) The council shall formulate and recommend to the
342 State Surgeon General, the Governor, the President of the
343 Senate, and the Speaker of the House of Representatives a plan
344 for the prevention and early detection of cancer which is
345 evidence-based and consistent with standards of practice and
346 supported by evidence-based medicine care and treatment of
347 persons suffering from cancer and recommend the establishment of
348 standard requirements for the organization, equipment, and
349 conduct of cancer units or departments in hospitals and clinics
350 in this state. The council may recommend to the State Surgeon
351 General the designation of cancer units following a survey of
352 the needs and facilities for treatment of cancer in the various
353 localities throughout the state. The State Surgeon General shall
354 consider the plan in developing departmental priorities and
355 funding priorities and standards under chapter 395.
356 (m)(k) The council shall provide expertise and input in the
357 content and development of is responsible for including in the
358 Florida Cancer Plan, which is otherwise generated through the
359 Department of Health. Recommendations must include for the
360 coordination and integration of medical, nursing, paramedical,
361 lay, and other state efforts plans concerned with cancer control
362 and research. Committees may shall be formed to develop
363 strategies for taking action regarding by the council so that
364 the following areas will be established as entities for actions:
365 1. Cancer plan evaluation, including the creation of a:
366 tumor registry, data retrieval systems, and epidemiology of
367 cancer in the state and its relation to other areas.
368 2. Cancer prevention.
369 3. Cancer detection.
370 4. Cancer treatments patient management: treatment,
371 rehabilitation, terminal care, and other patient-oriented
372 activities.
373 5. Support services for cancer patients and caregivers
374 education: lay and professional.
375 6. Unproven methods of Cancer education for laypersons and
376 professionals therapy: quackery and unorthodox therapies.
377 7. Other cancer-control-related topics Investigator
378 initiated project research.
379 (n)(l) In order to implement in whole or in part the
380 Florida Cancer Plan, the council may shall recommend to the
381 Board of Governors or the State Surgeon General the awarding of
382 grants and contracts to qualified profit or nonprofit
383 associations or governmental agencies in order to plan,
384 establish, or conduct programs in cancer control or prevention
385 and, cancer education or and training, and cancer research.
386 (o) The council shall have input into the prioritization
387 and implementation of statewide programs and the allocation of
388 resources in the department’s comprehensive cancer control
389 program, consistent with the Florida Cancer Plan.
390 (p)(m) If funds are specifically appropriated by the
391 Legislature, the council shall develop or purchase standardized
392 written summaries, written in layperson’s terms and in language
393 easily understood by the average adult patient, informing
394 citizens and professionals on cancer prevention, detection,
395 treatment, and survivorship actual and high-risk breast cancer
396 patients, prostate cancer patients, and men who are considering
397 prostate cancer screening of the medically viable treatment
398 alternatives available to them in the effective management of
399 breast cancer and prostate cancer; describing such treatment
400 alternatives; and explaining the relative advantages,
401 disadvantages, and risks associated therewith. The breast cancer
402 summary, upon its completion, shall be printed in the form of a
403 pamphlet or booklet and made continuously available to
404 physicians and surgeons in this state for their use in
405 accordance with s. 458.324 and to osteopathic physicians in this
406 state for their use in accordance with s. 459.0125. The council
407 shall periodically update both summaries to reflect current
408 standards of medical practice in the treatment of breast cancer
409 and prostate cancer. The council shall develop and implement
410 educational programs and position statements, including
411 distribution of the summaries developed or purchased under this
412 paragraph, to inform citizen groups, associations, government
413 officials, and voluntary organizations about cancer-related
414 matters early detection and treatment of breast cancer and
415 prostate cancer.
416 (q)(n) The council may recommend to shall have the
417 responsibility to advise the Board of Governors and the State
418 Surgeon General, the Governor, the President of the Senate, and
419 the Speaker of the House of Representatives on methods of
420 enforcing and implementing laws already enacted and concerned
421 with cancer control, research, and education.
422 (r)(o) The council may recommend to the Board of Governors
423 or the State Surgeon General rules not inconsistent with law as
424 it may deem necessary for the performance of its duties and the
425 proper administration of this section.
426 (s)(p) The council shall formulate and put into effect a
427 continuing educational program for the prevention of cancer and
428 its early diagnosis and disseminate to hospitals, cancer
429 patients, and the public information concerning the proper
430 treatment of cancer.
431 (t)(q) The council shall be physically located at the H.
432 Lee Moffitt Cancer Center and Research Institute, Inc., at the
433 University of South Florida.
434 (u)(r) By December 1 On February 15 of each year, the
435 council shall report its findings and recommendations to the
436 State Surgeon General, the Governor, the President of the
437 Senate, and the Speaker of the House of Representatives and to
438 the Legislature.
439 (5) RESPONSIBILITIES OF THE BOARD OF GOVERNORS, THE H. LEE
440 MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC., AND THE
441 STATE SURGEON GENERAL, AND THE DEPARTMENT OF HEALTH.—
442 (a) The Board of Governors or The State Surgeon General,
443 after consultation with the council, may shall award grants and
444 contracts to qualified nonprofit associations and governmental
445 agencies in order to plan, establish, or conduct programs in
446 cancer control or and prevention and, cancer education or and
447 training, and cancer research.
448 (b) The H. Lee Moffitt Cancer Center and Research
449 Institute, Inc., shall provide a full-time executive director to
450 coordinate, facilitate, and communicate the mission and
451 responsibilities of the council. Additional administrative
452 support, information, and other assistance shall be provided
453 such staff, information, and other assistance as reasonably
454 necessary for the completion of the responsibilities of the
455 council.
456 (c) The Department of Health Board of Governors or the
457 State Surgeon General, after consultation with the council, may
458 adopt rules necessary for the implementation of this section.
459 (d) The Florida Cancer Plan is established within the
460 Department of Health. The department must utilize the council in
461 developing the plan, prioritizing goals, allocating resources,
462 and approving the plan in its final form. The State Surgeon
463 General, after consultation with the council, shall make rules
464 specifying to what extent and on what terms and conditions
465 cancer patients of the state may receive financial aid for the
466 diagnosis and treatment of cancer in any hospital or clinic
467 selected. The department may furnish to citizens of this state
468 who are afflicted with cancer financial aid to the extent of the
469 appropriation provided for that purpose in a manner which in its
470 opinion will afford the greatest benefit to those afflicted and
471 may make arrangements with hospitals, laboratories, or clinics
472 to afford proper care and treatment for cancer patients in this
473 state.
474 (6) FLORIDA CANCER CONTROL AND RESEARCH FUND.—
475 (a) There is created the Florida Cancer Control and
476 Research Fund consisting of funds appropriated therefor from the
477 General Revenue Fund and any gifts, grants, or funds received
478 from other sources.
479 (b) The fund shall be used exclusively for grants and
480 contracts to qualified nonprofit associations or governmental
481 agencies for the purpose of cancer control or and prevention,
482 cancer education or and training, cancer research, and all
483 expenses incurred in connection with the administration of this
484 section and the programs funded through the grants and contracts
485 authorized by the State Board of Education or the State Surgeon
486 General.
487 Section 4. Subsection (1) and paragraph (a) of subsection
488 (2) of section 458.324, Florida Statutes, are amended to read:
489 458.324 Breast cancer; information on treatment
490 alternatives.—
491 (1) DEFINITION.—As used in this section, the term
492 “medically viable,” as applied to treatment alternatives, means
493 modes of treatment generally considered by the medical
494 profession to be within the scope of current, acceptable
495 standards, including treatment alternatives described in the
496 written summary prepared by the Florida Cancer Control and
497 Resource Research Advisory Council in accordance with s.
498 1004.435(4)(p) 1004.435(4)(m).
499 (2) COMMUNICATION OF TREATMENT ALTERNATIVES.—Each physician
500 treating a patient who is, or in the judgment of the physician
501 is at high risk of being, diagnosed as having breast cancer
502 shall inform such patient of the medically viable treatment
503 alternatives available to such patient; shall describe such
504 treatment alternatives; and shall explain the relative
505 advantages, disadvantages, and risks associated with the
506 treatment alternatives to the extent deemed necessary to allow
507 the patient to make a prudent decision regarding such treatment
508 options. In compliance with this subsection:
509 (a) The physician may, in his or her discretion:
510 1. Orally communicate such information directly to the
511 patient or the patient’s legal representative;
512 2. Provide the patient or the patient’s legal
513 representative with a copy of the written summary prepared in
514 accordance with s. 1004.435(4)(p) 1004.435(4)(m) and express a
515 willingness to discuss the summary with the patient or the
516 patient’s legal representative; or
517 3. Both communicate such information directly and provide a
518 copy of the written summary to the patient or the patient’s
519 legal representative for further consideration and possible
520 later discussion.
521
522 Nothing in this subsection shall reduce other provisions of law
523 regarding informed consent.
524 Section 5. Subsection (1) and paragraph (a) of subsection
525 (2) of section 459.0125, Florida Statutes, are amended to read:
526 459.0125 Breast cancer; information on treatment
527 alternatives.—
528 (1) DEFINITION.—As used in this section, the term
529 “medically viable,” as applied to treatment alternatives, means
530 modes of treatment generally considered by the medical
531 profession to be within the scope of current, acceptable
532 standards, including treatment alternatives described in the
533 written summary prepared by the Florida Cancer Control and
534 Resource Research Advisory Council in accordance with s.
535 1004.435(4)(p) 1004.435(4)(m).
536 (2) COMMUNICATION OF TREATMENT ALTERNATIVES.—It is the
537 obligation of every physician treating a patient who is, or in
538 the judgment of the physician is at high risk of being,
539 diagnosed as having breast cancer to inform such patient of the
540 medically viable treatment alternatives available to such
541 patient; to describe such treatment alternatives; and to explain
542 the relative advantages, disadvantages, and risks associated
543 with the treatment alternatives to the extent deemed necessary
544 to allow the patient to make a prudent decision regarding such
545 treatment options. In compliance with this subsection:
546 (a) The physician may, in her or his discretion:
547 1. Orally communicate such information directly to the
548 patient or the patient’s legal representative;
549 2. Provide the patient or the patient’s legal
550 representative with a copy of the written summary prepared in
551 accordance with s. 1004.435(4)(p) 1004.435(4)(m) and express her
552 or his willingness to discuss the summary with the patient or
553 the patient’s legal representative; or
554 3. Both communicate such information directly and provide a
555 copy of the written summary to the patient or the patient’s
556 legal representative for further consideration and possible
557 later discussion.
558
559 Nothing in this subsection shall reduce other provisions of law
560 regarding informed consent.
561 Section 6. (1) The Legislature finds that Florida must
562 expand its graduate medical education to meet the medical needs
563 of its residents. The Association of American Medical Colleges
564 ranked Florida 43rd nationally in numbers of medical residents
565 per 100,000 population. Approximately 2,700 additional medical
566 residency positions are required in this state simply to meet
567 the national average per population. In accordance with these
568 findings, the Agency for Health Care Administration shall
569 establish a demonstration project by allowing prepaid managed
570 care organizations providing behavioral health services to
571 patients in Miami-Dade County to fund a residency program
572 sponsored by Florida International University and administered
573 by a federally qualified health center.
574 (2) The Agency for Health Care Administration shall
575 authorize managed care organizations providing behavioral health
576 services directly or indirectly to Medicaid patients in Miami
577 Dade County to allocate up to 1 percent of the medical loss
578 ratio to fund a new psychiatric graduate medical education
579 program located at a federally qualified health center and
580 sponsored by Florida International University Wertheim College
581 of Medicine. The university shall select a federally qualified
582 health center that has a large general psychiatric practice with
583 the capacity to implement a new psychiatry residency program and
584 a demonstrated commitment to establishing a new psychiatry
585 residency program.
586 (3) Payments pursuant to this section shall be made to
587 Florida International University for the design, development,
588 and operation of the psychiatric residency program and are
589 deemed to be payments for behavioral health services and not
590 administrative services. Any managed care organization
591 allocating funds under this section must enter into an agreement
592 with Florida International University making provision for
593 recurring annual payments to Florida International University of
594 up to 1 percent of the medical loss ratio for behavioral health
595 services provided to Medicaid patients in Miami-Dade County to
596 support the psychiatry residency program.
597 (4) Each January 1, beginning in 2014 and for the duration
598 of the demonstration project, the agency shall submit to the
599 Governor, the President of the Senate, and the Speaker of the
600 House of Representatives an annual report on the success and
601 outcomes achieved by the demonstration project, which must
602 include a recommendation as to whether the demonstration project
603 should be continued, terminated, or expanded.
604 Section 7. This act shall take effect July 1, 2012.
