Senate Bill 190 (2020) — Medicaid school-based services
SB 190
Florida Bills
Florida Senate - 2020 SB 190 By Senator Montford 3-00173-20 2020190__ Page 1 of 5 CODING: Words stricken are deletions; words underlined are additions. A bill to be entitled 1
An act relating to Medicaid school-based services; 2 amending s. 409.9071, F.S.; revising applicable 3 provisions for the reimbursement of school-based 4 services by the Agency for Health Care Administration 5 to certain school districts; deleting a requirement 6 specifying the use of certified state and local 7 education funds for school-based services; conforming 8 a provision to changes made by the act; deleting an 9 obsolete provision; amending s. 409.9072, F.S.; 10 revising a requirement for the agency’s reimbursement 11 of school-based services to certain charter and 12 private schools; conforming a provision to changes 13 made by the act; amending s. 409.908, F.S.; specifying 14 the federal agency that may waive certain school-based 15 provider qualifications; providing an effective date. 16 17 Be It Enacted by the Legislature of the State of Florida: 18 19
Section 1. Subsection (1), paragraph (
b) of subsection (2), 20 and subsection (6) of
section 409.9071, Florida Statutes, are 21 amended to read: 22 409.9071 Medicaid provider agreements for school districts 23 certifying state match.— 24
(1) The agency shall reimburse school-based services as 25 provided in ss. 409.908(21) and 1011.70 former s. 236.0812 26 pursuant to the rehabilitative services option provided under 42 27 U.S.C. s. 1396d(a)(13). For purposes of this section, billing 28 agent consulting services are shall be considered billing agent 29
Florida Senate - 2020 SB 190 3-00173-20 2020190__ Page 2 of 5 CODING: Words stricken are deletions; words underlined are additions. services, as that term is used in s. 409.913(10), and, as such, 30 payments to such persons may shall not be based on amounts for 31 which they bill nor based on the amount a provider receives from 32 the Medicaid program. This provision may shall not restrict 33 privatization of Medicaid school-based services.
Subject to any 34 limitations provided for in the General Appropriations Act, the 35 agency, in compliance with appropriate federal authorization, 36 shall develop policies and procedures and shall allow for 37 certification of state and local education funds that which have 38 been provided for school-based services as specified in s. 39 1011.70 and authorized by a physician’s order where required by 40 federal Medicaid law. Any state or local funds certified 41 pursuant to this
section shall be for children with specified 42 disabilities who are eligible for both Medicaid and part B or 43 part H of the Individuals with Disabilities Education Act 44 (IDEA), or the exceptional student education program, or who 45 have an individualized educational plan. 46
(2) School districts that wish to enroll as Medicaid 47 providers and that certify state match in order to receive 48 federal Medicaid reimbursements for services, pursuant to 49 subsection (1), shall agree to: 50 (
b) Develop and maintain the financial and other student 51 individual education plan records needed to document the 52 appropriate use of state and federal Medicaid funds. 53
(6) Retroactive reimbursements for services as specified in 54 former s. 236.0812 as of July 1, 1996, including reimbursement 55 for the 1995-1996 and 1996-1997 school years, are subject to 56 federal approval. 57
Section 2. Subsection (1) and paragraph (
b) of subsection 58
Florida Senate - 2020 SB 190 3-00173-20 2020190__ Page 3 of 5 CODING: Words stricken are deletions; words underlined are additions. (2) of
section 409.9072, Florida Statutes, are amended to read: 59 409.9072 Medicaid provider agreements for charter schools 60 and private schools.— 61
(1) Subject to a specific appropriation by the Legislature, 62 the agency shall reimburse private schools as defined in s. 63 1002.01 and schools designated as charter schools under s. 64 1002.33 which are Medicaid providers for school-based services 65 pursuant to the rehabilitative services option provided under 42 66 U.S.C. s. 1396d(a)(13) to children younger than 21 years of age 67 with specified disabilities who are eligible for both Medicaid 68 and part B or part H of the Individuals with Disabilities 69 Education Act (IDEA) or the exceptional student education 70 program, or who have an individualized educational plan. 71
(2) Schools that wish to enroll as Medicaid providers and 72 receive Medicaid reimbursement under this
section must apply to 73 the agency for a provider agreement and must agree to: 74 (
b) Develop and maintain the financial and student 75 individual education plan records needed to document the 76 appropriate use of state and federal Medicaid funds. 77
Section 3. Subsection (21) of
section 409.908, Florida 78 Statutes, is amended to read: 79 409.908 Reimbursement of Medicaid providers.—Subject to 80 specific appropriations, the agency shall reimburse Medicaid 81 providers, in accordance with state and federal law, according 82 to methodologies set forth in the rules of the agency and in 83 policy manuals and handbooks incorporated by reference therein. 84 These methodologies may include fee schedules, reimbursement 85 methods based on cost reporting, negotiated fees, competitive 86 bidding pursuant to s. 287.057, and other mechanisms the agency 87
Florida Senate - 2020 SB 190 3-00173-20 2020190__ Page 4 of 5 CODING: Words stricken are deletions; words underlined are additions. considers efficient and effective for purchasing services or 88 goods on behalf of recipients. If a provider is reimbursed based 89 on cost reporting and submits a cost report late and that cost 90 report would have been used to set a lower reimbursement rate 91 for a rate semester, then the provider’s rate for that semester 92 shall be retroactively calculated using the new cost report, and 93 full payment at the recalculated rate shall be effected 94 retroactively.
Medicare-granted extensions for filing cost 95 reports, if applicable, shall also apply to Medicaid cost 96 reports. Payment for Medicaid compensable services made on 97 behalf of Medicaid eligible persons is subject to the 98 availability of moneys and any limitations or directions 99 provided for in the General Appropriations Act or
chapter 216. 100 Further, nothing in this
section shall be construed to prevent 101 or limit the agency from adjusting fees, reimbursement rates, 102 lengths of stay, number of visits, or number of services, or 103 making any other adjustments necessary to comply with the 104 availability of moneys and any limitations or directions 105 provided for in the General Appropriations Act, provided the 106 adjustment is consistent with legislative intent. 107
(21) The agency shall reimburse school districts that which 108 certify the state match pursuant to ss. 409.9071 and 1011.70 for 109 the federal portion of the school district’s allowable costs to 110 deliver the services, based on the reimbursement schedule. The 111 school district shall determine the costs for delivering 112 services as authorized in ss. 409.9071 and 1011.70 for which the 113 state match will be certified. Reimbursement of school-based 114 providers is contingent on such providers being enrolled as 115 Medicaid providers and meeting the qualifications contained in 116
Florida Senate - 2020 SB 190 3-00173-20 2020190__ Page 5 of 5 CODING: Words stricken are deletions; words underlined are additions. 42 C.F.R. s. 440.110, unless otherwise waived by the United 117 States Department of Health and Human Services federal Health 118 Care Financing Administration.
Speech therapy providers who are 119 certified through the Department of Education pursuant to rule 120 6A-4.0176, Florida Administrative Code, are eligible for 121 reimbursement for services that are provided on school premises. 122 Any employee of the school district who has been fingerprinted 123 and has received a criminal background check in accordance with 124 Department of Education rules and guidelines is shall be exempt 125 from any agency requirements relating to criminal background 126 checks. 127