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Budget Adds Health Contracts, Medicaid Changes

2020 florida legislature house
News Service of Florida
The Florida Channel
The proposed state budget contains tens of millions of dollars in new health care contracts and some changes to Florida's Medicaid managed care program.

A proposed $93.2 billion state budget cobbled together by lawmakers for the coming year contains tens of millions of dollars in new health-care contracts and some changes to Florida’s Medicaid managed-care program.

Lawmakers agreed to provide more than $57 million to the state Agency for Health Care Administration for two new contracts. Part of that funding --- $10 million --- would allow AHCA to hire a contractor to assist with the Canadian Prescription Drug Importation Program, which has been championed by Gov. Ron DeSantis.

The remaining $47 million is being targeted to a new Medicaid information-management system dubbed FX, which is short for Florida Health Care Connection System. It has been a priority for agency Secretary Mary Mayhew, who wants the system to integrate data across the various agencies that support Medicaid programs, such as the Agency for Persons with Disabilities and the departments of Health and Children and Family Services.

Lawmakers authorized AHCA to use $3.2 million of that funding to hire a private provider to assist with the contract. The agency must work with a steering committee to help guide its decisions related to the FX procurement, a requirement included in a budget “implementing” bill (HB 5003).

The House and Senate are slated to vote Thursday on the proposed 2020-2021 budget and the implementing bill. The budget and implementing bill will have a one-year shelf life, expiring on June 30, 2021. The spending plan totals $93.2 billion, with $39.3 billion directed to health and human services.

The health and human-services portion of the budget also includes smaller contracts for agencies. For instance, lawmakers agreed to allocate $250,000 to the Department of Elder Affairs to contract with a vendor to conduct a cybersecurity risk assessment of the state’s elderly population as well as the department’s cybersecurity “standing “

Lawmakers also agreed to earmark $250,000 for the Information Clearinghouse on Developmental Disabilities to promote what is being called Bright Expectations, which provides information on developmental disabilities for pregnant women, health care providers, parents and families.

Budget writers also made several changes to the Medicaid managed-care program for the long-term care system and the broader “managed medical assistance” system.

The legislative session included some debate about whether the state should change laws regarding a process that assigns people to specific managed-care plans if they don’t choose plans.

The House initially floated a proposal that would have required AHCA, “when temporarily necessary,” to allow preferential treatment in the assignment of Medicaid beneficiaries to managed-care plans.

Ultimately, though, lawmakers included a never-before-seen change involving some of the most-expensive patients in the program: dual eligible patients, or those who are in both Medicaid and Medicare.

Lawmakers agreed to automatically assign dual eligible people into Medicaid managed-care plans that have a “collaboration and coordination agreement” with the people’s Medicare Advantage plans.

In other changes to the managed-care program, lawmakers authorized AHCA to establish what is being called the managed care “home health performance incentive program” for long-term care plans and managed medical assistance plans. The goal of the program is to ensure that Medicaid beneficiaries have access to all covered and authorized home health services. If not, AHCA is authorized to withhold a portion of payments to the managed-care plans.

Lawmakers also agreed to require certain hospitals and medical faculty plans to make good-faith efforts and offer to contract with each Medicaid  managed-care plan in their regions --- and in some instances the entire state --- or lose access to supplemental Medicaid payments.

Safety Net Hospital Alliance of Florida CEO Justin Senior said that is better than an initial House proposal.

“The mandatory contracting language now requires hospitals to make a good-faith offer to enter into a contract with the Medicaid HMOs, as opposed to forcing them to enter into contracts no matter what,” Senior said in a statement to The News Service of Florida. “This should hopefully stop HMOs from making unreasonable demands. This is definitely an improvement, as all of our critical-care hospitals are ready and willing to provide the state’s best care to the state’s most vulnerable.”