Bill Text: FL S1520 | 2013 | Regular Session | Enrolled
Bill Title: Medicaid
Spectrum: Committee Bill
Status: (Passed) 2013-05-20 - Chapter No. 2013-48, companion bill(s) passed, see CS/CS/HB 939 (Ch. 2013-150), SB 1500 (Ch. 2013-40) [S1520 Detail]
Download: Florida-2013-S1520-Enrolled.html
ENROLLED 2013 Legislature SB 1520, 1st Engrossed 20131520er 1 2 An act relating to Medicaid; repealing s. 381.0403, 3 F.S., relating to the Community Hospital Education 4 Act; amending s. 395.602, F.S.; providing that certain 5 rural hospitals remain rural hospitals under specified 6 circumstances; amending s. 409.905, F.S.; requiring 7 the Agency for Health Care Administration to implement 8 a prospective payment system for inpatient hospital 9 services using diagnosis-related groups (DRGs); 10 deleting provisions directing the agency to develop a 11 plan to convert hospital reimbursement for inpatient 12 services to a prospective payment system; requiring 13 hospital reimbursement for outpatient services to be 14 based on allowable costs; providing that adjustments 15 may not be made after a certain date; providing for 16 the reconciliation of errors in source data or 17 calculations; amending s. 409.908, F.S.; revising 18 exceptions to limitations on hospital reimbursement 19 for inpatient services; providing parameters for 20 submission of letters of agreement by local 21 governmental entities to the agency relating to funds 22 for special payments; providing that base rate 23 reimbursement under a diagnosis-related group 24 methodology shall be established in the General 25 Appropriations Act; creating s. 409.909, F.S.; 26 establishing the Statewide Medicaid Residency Program; 27 providing the purposes of the program; providing 28 definitions; providing a formula and limitations for 29 allocating funds to participating hospitals; 30 authorizing the agency to adopt rules; amending s. 31 409.910, F.S.; revising provisions relating to 32 responsibility for Medicaid payments in settlement 33 proceedings; providing procedures for a recipient to 34 contest the amount payable to the agency; amending s. 35 409.911, F.S.; updating references to data used for 36 calculations in the disproportionate share program; 37 amending s. 409.9118, F.S.; amending parameters for 38 the disproportionate share program for specialty 39 hospitals; limiting reimbursement to tuberculosis 40 services provided under contract with the Department 41 of Health; amending s. 409.9122, F.S.; providing that 42 certain mandatory managed care provisions that apply 43 to a Medicaid recipient diagnosed with HIV/AIDS apply 44 only to a recipient who failed to choose a managed 45 care option; amending s. 409.915, F.S.; specifying the 46 total contribution for certain years and specifying 47 the method for determining the amount in the following 48 years; revising the method for calculating each 49 county’s contribution; providing tables for 50 calculating county contributions; requiring the Agency 51 for Health Care Administration to annually report the 52 status of county billings to the Legislature; 53 authorizing the Department of Revenue to withhold 54 county distributions for failure to remit Medicaid 55 contributions; deleting provisions specifying the care 56 and services that counties must participate in, 57 obsolete bond provisions, and a process for refund 58 requests; specifying the method for calculating each 59 county’s contribution for the 2013-2014 fiscal year; 60 requiring the agency to submit an annual report to the 61 Governor, the Legislature, and the Florida Association 62 of Counties which includes information necessary to 63 comprehensively evaluate the cost and utilization of 64 health services by Medicaid enrollees; providing for 65 the repeal and replacement of specified proviso in the 66 2013-2014 General Appropriations Act; providing an 67 effective date. 68 69 Be It Enacted by the Legislature of the State of Florida: 70 71 Section 1. Section 381.0403, Florida Statutes, is repealed. 72 Section 2. Paragraph (e) of subsection (2) of section 73 395.602, Florida Statutes, is amended to read: 74 395.602 Rural hospitals.— 75 (2) DEFINITIONS.—As used in this part: 76 (e) “Rural hospital” means an acute care hospital licensed 77 under this chapter, having 100 or fewer licensed beds and an 78 emergency room, which is: 79 1. The sole provider within a county with a population 80 density of no greater than 100 persons per square mile; 81 2. An acute care hospital, in a county with a population 82 density of no greater than 100 persons per square mile, which is 83 at least 30 minutes of travel time, on normally traveled roads 84 under normal traffic conditions, from any other acute care 85 hospital within the same county; 86 3. A hospital supported by a tax district or subdistrict 87 whose boundaries encompass a population of 100 persons or fewer 88 per square mile; 89 4. A hospital in a constitutional charter county with a 90 population of over 1 million persons that has imposed a local 91 option health service tax pursuant to law and in an area that 92 was directly impacted by a catastrophic event on August 24, 93 1992, for which the Governor of Florida declared a state of 94 emergency pursuant to chapter 125, and has 120 beds or less that 95 serves an agricultural community with an emergency room 96 utilization of no less than 20,000 visits and a Medicaid 97 inpatient utilization rate greater than 15 percent; 98 5. A hospital with a service area that has a population of 99 100 persons or fewer per square mile. As used in this 100 subparagraph, the term “service area” means the fewest number of 101 zip codes that account for 75 percent of the hospital’s 102 discharges for the most recent 5-year period, based on 103 information available from the hospital inpatient discharge 104 database in the Florida Center for Health Information and Policy 105 Analysis at the agencyfor Health Care Administration; or 106 6. A hospital designated as a critical access hospital, as 107 defined in s. 408.07(15). 108 109 Population densities used in this paragraph must be based upon 110 the most recently completed United States census. A hospital 111 that received funds under s. 409.9116 for a quarter beginning no 112 later than July 1, 2002, is deemed to have been and shall 113 continue to be a rural hospital from that date through June 30, 114 2015, if the hospital continues to have 100 or fewer licensed 115 beds and an emergency room, or meets the criteria of 116 subparagraph 4. An acute care hospital that has not previously 117 been designated as a rural hospital and that meets the criteria 118 of this paragraph shall be granted such designation upon 119 application, including supporting documentation, to the agency 120for Health Care Administration. A hospital that was licensed as 121 a rural hospital during the 2010-2011 or 2011-2012 fiscal year 122 shall continue to be a rural hospital from the date of 123 designation through June 30, 2015, if the hospital continues to 124 have 100 or fewer licensed beds and an emergency room. 125 Section 3. Paragraphs (c), (d), and (f) of subsection (5) 126 and subsection (6) of section 409.905, Florida Statutes, are 127 amended to read: 128 409.905 Mandatory Medicaid services.—The agency may make 129 payments for the following services, which are required of the 130 state by Title XIX of the Social Security Act, furnished by 131 Medicaid providers to recipients who are determined to be 132 eligible on the dates on which the services were provided. Any 133 service under this section shall be provided only when medically 134 necessary and in accordance with state and federal law. 135 Mandatory services rendered by providers in mobile units to 136 Medicaid recipients may be restricted by the agency. Nothing in 137 this section shall be construed to prevent or limit the agency 138 from adjusting fees, reimbursement rates, lengths of stay, 139 number of visits, number of services, or any other adjustments 140 necessary to comply with the availability of moneys and any 141 limitations or directions provided for in the General 142 Appropriations Act or chapter 216. 143 (5) HOSPITAL INPATIENT SERVICES.—The agency shall pay for 144 all covered services provided for the medical care and treatment 145 of a recipient who is admitted as an inpatient by a licensed 146 physician or dentist to a hospital licensed under part I of 147 chapter 395. However, the agency shall limit the payment for 148 inpatient hospital services for a Medicaid recipient 21 years of 149 age or older to 45 days or the number of days necessary to 150 comply with the General Appropriations Act. Effective August 1, 151 2012, the agency shall limit payment for hospital emergency 152 department visits for a nonpregnant Medicaid recipient 21 years 153 of age or older to six visits per fiscal year. 154 (c) The agency shall implement a prospective payment 155 methodology for establishingbasereimbursement rates for 156 inpatient hospital serviceseach hospital based on allowable157costs, as defined by the agency. Rates shall be calculated 158 annually and take effect July 1 of each yearbased on the most159recent complete and accurate cost report submitted by each160hospital. The methodology shall categorize each inpatient 161 admission into a diagnosis-related group and assign a relative 162 payment weight to the base rate according to the average 163 relative amount of hospital resources used to treat a patient in 164 a specific diagnosis-related group category. The agency may 165 adopt the most recent relative weights calculated and made 166 available by the Nationwide Inpatient Sample maintained by the 167 Agency for Healthcare Research and Quality or may adopt 168 alternative weights if the agency finds that Florida-specific 169 weights deviate with statistical significance from national 170 weights for high-volume diagnosis-related groups. The agency 171 shall establish a single, uniform base rate for all hospitals 172 unless specifically exempt pursuant to s. 409.908(1). 173 1. Adjustments may not be made to the rates after October 174 31 of the state fiscal year in which the rates take effect, 175 except for cases of insufficient collections of 176 intergovernmental transfers authorized under s. 409.908(1) or 177 the General Appropriations Act. In such cases, the agency shall 178 submit a budget amendment or amendments under chapter 216 179 requesting approval of rate reductions by amounts necessary for 180 the aggregate reduction to equal the dollar amount of 181 intergovernmental transfers not collected and the corresponding 182 federal match. Notwithstanding the $1 million limitation on 183 increases to an approved operating budget contained in ss. 184 216.181(11) and 216.292(3), a budget amendment exceeding that 185 dollar amount is subject to notice and objection procedures set 186 forth in s. 216.177. 187 2. Errors in source data or calculationscost reporting or188calculation of ratesdiscovered after October 31 must be 189 reconciled in a subsequent rate period. However, the agency may 190 not make any adjustment to a hospital’s reimbursementratemore 191 than 5 years after a hospital is notified of an audited rate 192 established by the agency. The prohibition against adjustments 193requirement that the agency may not make any adjustment to a194hospital’s reimbursement ratemore than 5 years after 195 notificationa hospital is notified of an audited rate196established by the agencyis remedial and applies to actions by 197 providers involving Medicaid claims for hospital services. 198 Hospital reimbursement isrates aresubject to such limits or 199 ceilings as may be established in law or described in the 200 agency’s hospital reimbursement plan. Specific exemptions to the 201 limits or ceilings may be provided in the General Appropriations 202 Act. 203 (d) The agency shall implement a comprehensive utilization 204 management program for hospital neonatal intensive care stays in 205 certain high-volume participating hospitals, select counties, or 206 statewide, and replace existing hospital inpatient utilization 207 management programs for neonatal intensive care admissions. The 208 program shall be designed to manage appropriate admissions and 209 dischargesthe lengths of stayfor children being treated in 210 neonatal intensive care units and must seekthe earliest211 medically appropriate discharge to the child’s home or other 212 less costly treatment setting. The agency may competitively bid 213 a contract for the selection of a qualified organization to 214 provide neonatal intensive care utilization management services. 215 The agency may seek federal waivers to implement this 216 initiative. 217(f) The agency shall develop a plan to convert Medicaid218inpatient hospital rates to a prospective payment system that219categorizes each case into diagnosis-related groups (DRG) and220assigns a payment weight based on the average resources used to221treat Medicaid patients in that DRG. To the extent possible, the222agency shall propose an adaptation of an existing prospective223payment system, such as the one used by Medicare, and shall224propose such adjustments as are necessary for the Medicaid225population and to maintain budget neutrality for inpatient226hospital expenditures.2271. The plan must:228a. Define and describe DRGs for inpatient hospital care229specific to Medicaid in this state;230b. Determine the use of resources needed for each DRG;231c. Apply current statewide levels of funding to DRGs based232on the associated resource value of DRGs. Current statewide233funding levels shall be calculated both with and without the use234of intergovernmental transfers;235d. Calculate the current number of services provided in the236Medicaid program based on DRGs defined under this subparagraph;237e. Estimate the number of cases in each DRG for future238years based on agency data and the official workload estimates239of the Social Services Estimating Conference;240f. Calculate the expected total Medicaid payments in the241current year for each hospital with a Medicaid provider242agreement, based on the DRGs and estimated workload;243g. Propose supplemental DRG payments to augment hospital244reimbursements based on patient acuity and individual hospital245characteristics, including classification as a children’s246hospital, rural hospital, trauma center, burn unit, and other247characteristics that could warrant higher reimbursements, while248maintaining budget neutrality; and249h. Estimate potential funding for each hospital with a250Medicaid provider agreement for DRGs defined pursuant to this251subparagraph and supplemental DRG payments using current funding252levels, calculated both with and without the use of253intergovernmental transfers.2542. The agency shall engage a consultant with expertise and255experience in the implementation of DRG systems for hospital256reimbursement to develop the DRG plan under subparagraph 1.2573. The agency shall submit the DRG plan, identifying all258steps necessary for the transition and any costs associated with259plan implementation, to the Governor, the President of the260Senate, and the Speaker of the House of Representatives no later261than January 1, 2013. The plan shall include a timeline262necessary to complete full implementation by July 1, 2013. If,263during implementation of this paragraph, the agency determines264that these timeframes might not be achievable, the agency shall265report to the Legislative Budget Commission the status of its266implementation efforts, the reasons the timeframes might not be267achievable, and proposals for new timeframes.268 (6) HOSPITAL OUTPATIENT SERVICES.— 269 (a) The agency shall pay for preventive, diagnostic, 270 therapeutic, or palliative care and other services provided to a 271 recipient in the outpatient portion of a hospital licensed under 272 part I of chapter 395, and provided under the direction of a 273 licensed physician or licensed dentist, except that payment for 274 such care and services is limited to $1,500 per state fiscal 275 year per recipient, unless an exception has been made by the 276 agency, and with the exception of a Medicaid recipient under age 277 21, in which case the only limitation is medical necessity. 278 (b) The agency shall implement a methodology for 279 establishing base reimbursement rates for outpatient services 280 for each hospital based on allowable costs, as defined by the 281 agency. Rates shall be calculated annually and take effect July 282 1 of each year based on the most recent complete and accurate 283 cost report submitted by each hospital. 284 1. Adjustments may not be made to the rates after October 285 31 of the state fiscal year in which the rates take effect, 286 except for cases of insufficient collections of 287 intergovernmental transfers authorized under s. 409.908(1) or 288 the General Appropriations Act. In such cases, the agency shall 289 submit a budget amendment or amendments under chapter 216 290 requesting approval of rate reductions by amounts necessary for 291 the aggregate reduction to equal the dollar amount of 292 intergovernmental transfers not collected and the corresponding 293 federal match. Notwithstanding the $1 million limitation on 294 increases to an approved operating budget under ss. 216.181(11) 295 and 216.292(3), a budget amendment exceeding that dollar amount 296 is subject to notice and objection procedures set forth in s. 297 216.177. 298 2. Errors in source data or calculations discovered after 299 October 31 must be reconciled in a subsequent rate period. 300 However, the agency may not make any adjustment to a hospital’s 301 reimbursement more than 5 years after a hospital is notified of 302 an audited rate established by the agency. The prohibition 303 against adjustments more than 5 years after notification is 304 remedial and applies to actions by providers involving Medicaid 305 claims for hospital services. Hospital reimbursement is subject 306 to such limits or ceilings as may be established in law or 307 described in the agency’s hospital reimbursement plan. Specific 308 exemptions to the limits or ceilings may be provided in the 309 General Appropriations Act. 310 Section 4. Paragraph (a) of subsection (1) and subsection 311 (23) of section 409.908, Florida Statutes, are amended to read: 312 409.908 Reimbursement of Medicaid providers.—Subject to 313 specific appropriations, the agency shall reimburse Medicaid 314 providers, in accordance with state and federal law, according 315 to methodologies set forth in the rules of the agency and in 316 policy manuals and handbooks incorporated by reference therein. 317 These methodologies may include fee schedules, reimbursement 318 methods based on cost reporting, negotiated fees, competitive 319 bidding pursuant to s. 287.057, and other mechanisms the agency 320 considers efficient and effective for purchasing services or 321 goods on behalf of recipients. If a provider is reimbursed based 322 on cost reporting and submits a cost report late and that cost 323 report would have been used to set a lower reimbursement rate 324 for a rate semester, then the provider’s rate for that semester 325 shall be retroactively calculated using the new cost report, and 326 full payment at the recalculated rate shall be effected 327 retroactively. Medicare-granted extensions for filing cost 328 reports, if applicable, shall also apply to Medicaid cost 329 reports. Payment for Medicaid compensable services made on 330 behalf of Medicaid eligible persons is subject to the 331 availability of moneys and any limitations or directions 332 provided for in the General Appropriations Act or chapter 216. 333 Further, nothing in this section shall be construed to prevent 334 or limit the agency from adjusting fees, reimbursement rates, 335 lengths of stay, number of visits, or number of services, or 336 making any other adjustments necessary to comply with the 337 availability of moneys and any limitations or directions 338 provided for in the General Appropriations Act, provided the 339 adjustment is consistent with legislative intent. 340 (1) Reimbursement to hospitals licensed under part I of 341 chapter 395 must be made prospectively or on the basis of 342 negotiation. 343 (a) Reimbursement for inpatient care is limited as provided 344forin s. 409.905(5), except as otherwise provided in this 345 subsection.for:346 1. If authorized by the General Appropriations Act, the 347 agency may modify reimbursement for specific types of services 348 or diagnoses, recipient ages, and hospital provider typesThe349raising of rate reimbursement caps, excluding rural hospitals. 350 2. The agency may establish an alternative methodology to 351 the DRG-based prospective payment system to set reimbursement 352 rates for: 353 a. State-owned psychiatric hospitals. 354 b. Newborn hearing screening services. 355 c. Transplant services for which the agency has established 356 a global fee. 357 d. Recipients who have tuberculosis that is resistant to 358 therapy who are in need of long-term, hospital-based treatment 359 pursuant to s. 392.62Recognition of the costs of graduate360medical education. 361 3. The agency shall modify reimbursement according to other 362 methodologies recognized in the General Appropriations Act. 363 364During the years funds are transferred from the Department of365Health, any reimbursement supported by such funds shall be366subject to certification by the Department of Health that the367hospital has complied with s.381.0403.The agency mayis368authorized toreceive funds from state entities, including, but 369 not limited to, the Department of Health, local governments, and 370 other local political subdivisions, for the purpose of making 371 special exception payments, including federal matching funds, 372 through the Medicaid inpatient reimbursement methodologies. 373 Funds receivedfrom state entities or local governmentsfor this 374 purpose shall be separately accounted for and mayshallnot be 375 commingled with other state or local funds in any manner. The 376 agency may certify all local governmental funds used as state 377 match under Title XIX of the Social Security Act, to the extent 378 and in the manner authorized underthat the identified local379health care provider that is otherwise entitled to and is380contracted to receive such local funds is the benefactor under381the state’s Medicaid program as determined underthe General 382 Appropriations Act and pursuant to an agreement between the 383 agencyfor Health Care Administrationand the local governmental 384 entity. In order for the agency to certify such local 385 governmental funds, a local governmental entity must submit a 386 final, executed letter of agreement to the agency, which must be 387 received by October 1 of each fiscal year and provide the total 388 amount of local governmental funds authorized by the entity for 389 that fiscal year under this paragraph, paragraph (b), or the 390 General Appropriations Act. The local governmental entity shall 391 use a certification form prescribed by the agency. At a minimum, 392 the certification form mustshallidentify the amount being 393 certified and describe the relationship between the certifying 394 local governmental entity and the local health care provider. 395 The agency shall prepare an annual statement of impact which 396 documents the specific activities undertaken during the previous 397 fiscal year pursuant to this paragraph, to be submitted to the 398 Legislature annually byno later thanJanuary 1, annually. 399 (23)(a) The agency shall establish rates at a level that 400 ensures no increase in statewide expenditures resulting from a 401 change in unit costs effective July 1, 2011. Reimbursement rates 402 shall be as provided in the General Appropriations Act. 403 (b) Base rate reimbursement under a diagnosis-related group 404 payment methodology shall be provided in the General 405 Appropriations Act. 406 (c)(b)This subsection applies to the following provider 407 types: 408 1. Inpatient hospitals. 409 2. Outpatient hospitals. 410 3. Nursing homes. 411 4. County health departments. 412 5. Community intermediate care facilities for the 413 developmentally disabled. 414 6. Prepaid health plans. 415 (d)(c)The agency shall apply the effect of this subsection 416 to the reimbursement rates for nursing home diversion programs. 417 Section 5. Section 409.909, Florida Statutes, is created to 418 read: 419 409.909 Statewide Medicaid Residency Program.— 420 (1) The Statewide Medicaid Residency Program is established 421 to improve the quality of care and access to care for Medicaid 422 recipients, expand graduate medical education on an equitable 423 basis, and increase the supply of highly trained physicians 424 statewide. The agency shall make payments to hospitals licensed 425 under part I of chapter 395 for graduate medical education 426 associated with the Medicaid program. This system of payments is 427 designed to generate federal matching funds under Medicaid and 428 distribute the resulting funds to participating hospitals on a 429 quarterly basis in each fiscal year for which an appropriation 430 is made. 431 (2) On or before September 15 of each year, the agency 432 shall calculate an allocation fraction to be used for 433 distributing funds to participating hospitals. On or before the 434 final business day of each quarter of a state fiscal year, the 435 agency shall distribute to each participating hospital one 436 fourth of that hospital’s annual allocation calculated under 437 subsection (4). The allocation fraction for each participating 438 hospital is based on the hospital’s number of full-time 439 equivalent residents and the amount of its Medicaid payments. As 440 used in this section, the term: 441 (a) “Full-time equivalent,” or “FTE,” means a resident who 442 is in his or her initial residency period, which is defined as 443 the minimum number of years of training required before the 444 resident may become eligible for board certification by the 445 American Osteopathic Association Bureau of Osteopathic 446 Specialists or the American Board of Medical Specialties in the 447 specialty in which he or she first began training, not to exceed 448 5 years. A resident training beyond the initial residency period 449 is counted as 0.5 FTE, unless his or her chosen specialty is in 450 general surgery or primary care, in which case the resident is 451 counted as 1.0 FTE. For the purposes of this section, primary 452 care specialties include: 453 1. Family medicine; 454 2. General internal medicine; 455 3. General pediatrics; 456 4. Preventive medicine; 457 5. Geriatric medicine; 458 6. Osteopathic general practice; 459 7. Obstetrics and gynecology; and 460 8. Emergency medicine. 461 (b) “Medicaid payments” means the estimated total payments 462 for reimbursing a hospital for direct inpatient services for the 463 fiscal year in which the allocation fraction is calculated based 464 on the hospital inpatient appropriation and the parameters for 465 the inpatient diagnosis-related group base rate, including 466 applicable intergovernmental transfers, specified in the General 467 Appropriations Act, as determined by the agency. 468 (c) “Resident” means a medical intern, fellow, or resident 469 enrolled in a program accredited by the Accreditation Council 470 for Graduate Medical Education, the American Association of 471 Colleges of Osteopathic Medicine, or the American Osteopathic 472 Association at the beginning of the state fiscal year during 473 which the allocation fraction is calculated, as reported by the 474 hospital to the agency. 475 (3) The agency shall use the following formula to calculate 476 a participating hospital’s allocation fraction: 477 478 HAF=[0.9 x (HFTE/TFTE)] + [0.1 x (HMP/TMP)] 479 480 Where: 481 HAF=A hospital’s allocation fraction. 482 HFTE=A hospital’s total number of FTE residents. 483 TFTE=The total FTE residents for all participating 484 hospitals. 485 HMP=A hospital’s Medicaid payments. 486 TMP=The total Medicaid payments for all participating 487 hospitals. 488 489 (4) A hospital’s annual allocation shall be calculated by 490 multiplying the funds appropriated for the Statewide Medicaid 491 Residency Program in the General Appropriations Act by that 492 hospital’s allocation fraction. If the calculation results in an 493 annual allocation that exceeds $50,000 per FTE resident, the 494 hospital’s annual allocation shall be reduced to a sum equaling 495 no more than $50,000 per FTE resident. The funds calculated for 496 that hospital in excess of $50,000 per FTE resident shall be 497 redistributed to participating hospitals whose annual allocation 498 does not exceed $50,000 per FTE resident, using the same 499 methodology and payment schedule specified in this section. 500 (5) The agency may adopt rules to administer this section. 501 Section 6. Subsection (17) of section 409.910, Florida 502 Statutes, is amended to read: 503 409.910 Responsibility for payments on behalf of Medicaid 504 eligible persons when other parties are liable.— 505 (17) A recipient or his or her legal representative or any 506 person representing, or acting as agent for, a recipient or the 507 recipient’s legal representative, who has notice, excluding 508 notice charged solely by reason of the recording of the lien 509 pursuant to paragraph (6)(c), or who has actual knowledge of the 510 agency’s rights to third-party benefits under this section, who 511 receives any third-party benefit or proceedstherefromfor a 512 covered illness or injury, mustis required either to pay the513agency, within 60 days after receipt of settlement proceeds, pay 514 the agency the full amount of the third-party benefits, but not 515 more thanin excess ofthe total medical assistance provided by 516 Medicaid, ortoplace the full amount of the third-party 517 benefits in an interest-bearingatrust account for the benefit 518 of the agency pending anjudicial oradministrative 519 determination of the agency’s right to the benefitsthereto. 520 Proof thatanysuch person had notice or knowledge that the 521 recipient had received medical assistance from Medicaid, and 522 that third-party benefits or proceedstherefromwere in any way 523 related to a covered illness or injury for which Medicaid had 524 provided medical assistance, and thatanysuch person knowingly 525 obtained possession or control of, or used, third-party benefits 526 or proceeds and failedeitherto pay the agency the full amount 527 required by this section or to hold the full amount of third 528 party benefits or proceeds in an interest-bearing trust account 529 pending anjudicial oradministrative determination, unless 530 adequately explained, gives rise to an inference that such 531 person knowingly failed to credit the state or its agent for 532 payments received from social security, insurance, or other 533 sources, pursuant to s. 414.39(4)(b), and acted with the intent 534 set forth in s. 812.014(1). 535 (a) A recipient may contest the amount designated as 536 recovered medical expense damages payable to the agency pursuant 537 to the formula specified in paragraph (11)(f) by filing a 538 petition under chapter 120 within 21 days after the date of 539 payment of funds to the agency or after the date of placing the 540 full amount of the third-party benefits in the trust account for 541 the benefit of the agency. The petition shall be filed with the 542 Division of Administrative Hearings. For purposes of chapter 543 120, the payment of funds to the agency or the placement of the 544 full amount of the third-party benefits in the trust account for 545 the benefit of the agency constitutes final agency action and 546 notice thereof. Final order authority for the proceedings 547 specified in this subsection rests with the Division of 548 Administrative Hearings. This procedure is the exclusive method 549 for challenging the amount of third-party benefits payable to 550 the agency. 551 1. In order to successfully challenge the amount payable to 552 the agency, the recipient must prove, by clear and convincing 553 evidence, that a lesser portion of the total recovery should be 554 allocated as reimbursement for past and future medical expenses 555 than the amount calculated by the agency pursuant to the formula 556 set forth in paragraph (11)(f) or that Medicaid provided a 557 lesser amount of medical assistance than that asserted by the 558 agency. 559 2. The agency’s provider processing system reports are 560 admissible as prima facie evidence in substantiating the 561 agency’s claim. 562 3. Venue for all administrative proceedings pursuant to 563 this subsection lies in Leon County, at the discretion of the 564 agency. Venue for all appellate proceedings arising from the 565 administrative proceeding outlined in this subsection lie at the 566 First District Court of Appeal in Leon County, at the discretion 567 of the agency. 568 4. Each party shall bear its own attorney fees and costs 569 for any administrative proceeding conducted pursuant to this 570 paragraph. 571 (b)(a)In cases of suspected criminal violations or 572 fraudulent activity, the agency may take any civil action 573 permitted at law or equity to recover the greatest possible 574 amount, including, without limitation, treble damages under ss. 575 772.11 and 812.035(7). 576 1.(b)The agency mayis authorized toinvestigate andto577 request appropriate officers or agencies of the state to 578 investigate suspected criminal violations or fraudulent activity 579 related to third-party benefits, including, without limitation, 580 ss. 414.39 and 812.014. Such requests may be directed, without 581 limitation, to the Medicaid Fraud Control Unit of the Office of 582 the Attorney General, or to any state attorney. Pursuant to s. 583 409.913, the Attorney General has primary responsibility to 584 investigate and control Medicaid fraud. 585 2.(c)In carrying out duties and responsibilities related 586 to Medicaid fraud control, the agency may subpoena witnesses or 587 materials within or outside the state and, through any duly 588 designated employee, administer oaths and affirmations and 589 collect evidence for possible use in either civil or criminal 590 judicial proceedings. 591 3.(d)All information obtained and documents prepared 592 pursuant to an investigation of a Medicaid recipient, the 593 recipient’s legal representative, or any other person relating 594 to an allegation of recipient fraud or theft is confidential and 595 exempt from s. 119.07(1): 596 a.1.Until such time as the agency takes final agency 597 action; 598 b.2.Until such time as the Department of Legal Affairs 599 refers the case for criminal prosecution; 600 c.3.Until such time as an indictment or criminal 601 information is filed by a state attorney in a criminal case; or 602 d.4.At all times if otherwise protected by law. 603 Section 7. Paragraph (a) of subsection (2) and paragraph 604 (d) of subsection (4) of section 409.911, Florida Statutes, are 605 amended to read: 606 409.911 Disproportionate share program.—Subject to specific 607 allocations established within the General Appropriations Act 608 and any limitations established pursuant to chapter 216, the 609 agency shall distribute, pursuant to this section, moneys to 610 hospitals providing a disproportionate share of Medicaid or 611 charity care services by making quarterly Medicaid payments as 612 required. Notwithstanding the provisions of s. 409.915, counties 613 are exempt from contributing toward the cost of this special 614 reimbursement for hospitals serving a disproportionate share of 615 low-income patients. 616 (2) The Agency for Health Care Administration shall use the 617 following actual audited data to determine the Medicaid days and 618 charity care to be used in calculating the disproportionate 619 share payment: 620 (a) The average of the2004,2005,and2006, and 2007 621 audited disproportionate share data to determine each hospital’s 622 Medicaid days and charity care for the 2013-20142012-2013state 623 fiscal year. 624 (4) The following formulas shall be used to pay 625 disproportionate share dollars to public hospitals: 626 (d) Any nonstate government owned or operated hospital 627 eligible for payments under this section on July 1, 2011, 628 remains eligible for payments during the 2013-20142012-2013629 state fiscal year. 630 Section 8. Subsection (2) of section 409.9118, Florida 631 Statutes, is amended to read: 632 409.9118 Disproportionate share program for specialty 633 hospitals.— The Agency for Health Care Administration shall 634 design and implement a system of making disproportionate share 635 payments to those hospitals licensed in accordance with part I 636 of chapter 395 as a specialty hospital which meet all 637 requirements listed in subsection (2). Notwithstanding s. 638 409.915, counties are exempt from contributing toward the cost 639 of this special reimbursement for patients. 640 (2) In order to receive payments under this section, a 641 hospital must be licensed in accordance with part I of chapter 642 395, to participate in the Florida Title XIX program, and meet 643 the following requirements: 644 (a) Be certified or certifiable to be a provider of Title 645 XVIII services. 646 (b) Receiveall of itsinpatient clients through referrals 647 or admissions from county public health departments, as defined 648 in chapter 154. 649 (c) Require a diagnosis for the control of active 650 tuberculosis or a history of noncompliance with prescribed drug 651 regimens for the treatment of tuberculosisa communicable652diseaseforalladmissions for inpatient treatment. 653 (d) Retain a contract with the Department of Health to 654 accept clients for admission and inpatient treatment pursuant to 655 s. 392.62. 656 Section 9. Paragraphs (b), (l), and (m) of subsection (2) 657 of section 409.9122, Florida Statutes, are amended, subsections 658 (3) through (21) of that section are renumbered as subsections 659 (4) through (22), respectively, and a new subsection (3) is 660 added to that section, to read: 661 409.9122 Mandatory Medicaid managed care enrollment; 662 programs and procedures.— 663 (2) 664 (b) A Medicaid recipient mayshallnot be enrolled in or 665 assigned to a managed care plan or MediPass unless the managed 666 care plan or MediPass has complied with the quality-of-care 667 standards specified in paragraphs (4)(a)(3)(a)and (b), 668 respectively. 669(l) If the Medicaid recipient is diagnosed with HIV/AIDS,670the agency shall assign the Medicaid recipient to a managed care671plan that is a health maintenance organization authorized under672chapter 641, is under contract with the agency on July 1, 2011,673and which offers a delivery system through a university-based674teaching and research-oriented organization that specializes in675providing health care services and treatment for individuals676diagnosed with HIV/AIDS.677 (l)(m)Notwithstandingthe provisions ofchapter 287, the 678 agency may, at its discretion,renew cost-effective contracts 679 for choice counseling services once or more for such periods as 680 the agency may decide. However, all such renewals may not 681 combine to exceed a total period longer than the term of the 682 original contract. 683 684 This subsection expires October 1, 2014. 685 (3) Notwithstanding s. 409.961, if a Medicaid recipient is 686 diagnosed with HIV/AIDS, the agency shall assign the recipient 687 to a managed care plan that is a health maintenance organization 688 authorized under chapter 641, that is under contract with the 689 agency as an HIV/AIDS specialty plan as of January 1, 2013, and 690 that offers a delivery system through a university-based 691 teaching and research-oriented organization that specializes in 692 providing health care services and treatment for individuals 693 diagnosed with HIV/AIDS. This subsection applies to recipients 694 who are subject to mandatory managed care enrollment and have 695 failed to choose a managed care option. 696 Section 10. Section 409.915, Florida Statutes, is amended 697 to read: 698 409.915 County contributions to Medicaid.—Although the 699 state is responsible for the full portion of the state share of 700 the matching funds required for the Medicaid program,in order701to acquire a certain portion of these funds,the state shall 702 charge the counties an annual contribution in order to acquire a 703 certain portion of these fundsfor certain items of care and704service as provided in this section. 705 (1) As used in this section, the term “state Medicaid 706 expenditures” means those expenditures used as matching funds 707 for the federal Medicaid program. 708 (2)(a) For the 2013-2014 state fiscal year, the total 709 amount of the counties’ annual contribution is $269.6 million. 710 (b) For the 2014-2015 state fiscal year, the total amount 711 of the counties’ annual contribution is $277 million. 712 (c) By March 15, 2015, and each year thereafter, the Social 713 Services Estimating Conference shall determine the percentage 714 change in state Medicaid expenditures by comparing expenditures 715 for the 2 most recent completed state fiscal years. 716 (d) For the 2015-2016 state fiscal year through the 2019 717 2020 state fiscal year, the total amount of the counties’ annual 718 contribution shall be the total contribution for the prior 719 fiscal year adjusted by 50 percent of the percentage change in 720 the state Medicaid expenditures as determined by the Social 721 Services Estimating Conference. 722 (e) For each fiscal year after the 2019-2020 state fiscal 723 year, the total amount of the counties’ annual contribution 724 shall be the total contribution for the prior fiscal year 725 adjusted by the percentage change in the state Medicaid 726 expenditures as determined by the Social Services Estimating 727 Conference. 728 (3)(a)1. The amount of each county’s annual contribution is 729 equal to the product of the amount determined under subsection 730 (2) multiplied by the sum of the percentages calculated in sub 731 subparagraphs a. and b.: 732 a. The enrollment weight provided in subparagraph 2. is 733 multiplied by a fraction, the numerator of which is the number 734 of the county’s Medicaid enrollees as of March 1 of each year, 735 and the denominator of which is the number of all counties’ 736 Medicaid enrollees as of March 1 of each year. The agency shall 737 calculate this amount for each county and provide the 738 information to the Department of Revenue by May 15 of each year. 739 b. The payment weight provided in subparagraph 2. is 740 multiplied by the percentage share of payments provided in 741 subparagraph 3. for each county. 742 2. The weights for each fiscal year are equal to: 743 744 FISCAL YEAR ENROLLMENT PAYMENT 745 2013-14 0% 100% 746 2014-15 0% 100% 747 2015-16 20% 80% 748 2016-17 40% 60% 749 2017-18 60% 40% 750 2018-19 80% 20% 751 2019-20+ 100% 0% 752 COUNTY SHARE OF PAYMENTS 753 Alachua 1.278% 754 Baker 0.116% 755 Bay 0.607% 756 Bradford 0.179% 757 Brevard 2.471% 758 Broward 9.228% 759 Calhoun 0.084% 760 Charlotte 0.578% 761 Citrus 0.663% 762 Clay 0.635% 763 Collier 1.161% 764 Columbia 0.557% 765 Dade (Miami-Dade) 18.853% 766 Desoto 0.167% 767 Dixie 0.098% 768 Duval 5.337% 769 Escambia 1.615% 770 Flagler 0.397% 771 Franklin 0.091% 772 Gadsden 0.239% 773 Gilchrist 0.078% 774 Glades 0.055% 775 Gulf 0.076% 776 Hamilton 0.075% 777 Hardee 0.110% 778 Hendry 0.163% 779 Hernando 0.862% 780 Highlands 0.468% 781 Hillsborough 6.953% 782 Holmes 0.101% 783 Indian River 0.397% 784 Jackson 0.219% 785 Jefferson 0.083% 786 Lafayette 0.014% 787 Lake 1.525% 788 Lee 2.512% 789 Leon 0.929% 790 Levy 0.256% 791 Liberty 0.050% 792 Madison 0.086% 793 Manatee 1.623% 794 Marion 1.630% 795 Martin 0.353% 796 Monroe 0.262% 797 Nassau 0.240% 798 Okaloosa 0.567% 799 Okeechobee 0.235% 800 Orange 6.682% 801 Osceola 1.613% 802 Palm Beach 5.899% 803 Pasco 2.392% 804 Pinellas 6.645% 805 Polk 3.643% 806 Putnam 0.417% 807 Saint Johns 0.459% 808 Saint Lucie 1.155% 809 Santa Rosa 0.462% 810 Sarasota 1.230% 811 Seminole 1.740% 812 Sumter 0.218% 813 Suwannee 0.252% 814 Taylor 0.103% 815 Union 0.075% 816 Volusia 2.298% 817 Wakulla 0.103% 818 Walton 0.229% 819 Washington 0.114% 820 821 (b)1. The Legislature intends to replace the county 822 percentage share provided in subparagraph (a)3. with percentage 823 shares based upon each county’s proportion of the total 824 statewide amount of county billings made under this section from 825 April 1, 2012, through March 31, 2013, for which the state 826 ultimately receives payment. 827 2. By February 1 of each year and continuing until a 828 certification is made under sub-subparagraph b., the agency 829 shall report to the President of the Senate and the Speaker of 830 the House of Representatives the status of the county billings 831 made under this section from April 1, 2012, through March 31, 832 2013, by county, including: 833 a. The amounts billed to each county which remain unpaid, 834 if any; and 835 b. A certification from the agency of a final accounting of 836 the amount of funds received by the state from such billings, by 837 county, upon the expiration of all appeal rights that counties 838 may have to contest such billings. 839 3. By March 15 of the state fiscal year in which the state 840 receives the certification provided for in sub-subparagraph 841 (b)2.b., the Social Services Estimating Conference shall 842 calculate each county’s percentage share of the total statewide 843 amount of county billings made under this section from April 1, 844 2012, through March 31, 2013, for which the state ultimately 845 receives payment. 846 4. Beginning in the state fiscal year following the receipt 847 by the state of the certification provided in sub-subparagraph 848 (b)2.b., each county’s percentage share under subparagraph (a)3. 849 shall be replaced by the percentage calculated under 850 subparagraph (b)3. 851 5. If the court invalidates the replacement of each 852 county’s share as provided in this paragraph, the county share 853 set forth in subparagraph (a)3. shall continue to apply. 854 (4) By June 1 of each year, the Department of Revenue shall 855 notify each county of its required annual contribution. Each 856 county shall pay its contribution, by check or electronic 857 transfer, in equal monthly installments to the department by the 858 5th day of each month. If a county fails to remit the payment by 859 the 5th day of the month, the department shall reduce the 860 monthly distribution of that county pursuant to s. 218.61 and, 861 if necessary, by the amount of the monthly installment pursuant 862 to s. 218.26. The payments and the amounts by which the 863 distributions are reduced shall be transferred to the General 864 Revenue Fund. 865(1) Each county shall participate in the following items of866care and service:867(a) For both health maintenance members and fee-for-service868beneficiaries, payments for inpatient hospitalization in excess869of 10 days, but not in excess of 45 days, with the exception of870pregnant women and children whose income is in excess of the871federal poverty level and who do not participate in the Medicaid872medically needy program, and for adult lung transplant services.873(b) For both health maintenance members and fee-for-service874beneficiaries, payments for nursing home or intermediate875facilities care in excess of $170 per month, with the exception876of skilled nursing care for children under age 21.877(2) A county’s participation must be 35 percent of the878total cost, or the applicable discounted cost paid by the state879for Medicaid recipients enrolled in health maintenance880organizations or prepaid health plans, of providing the items881listed in subsection (1), except that the payments for items882listed in paragraph (1)(b) may not exceed $55 per month per883person.884(3) Each county shall set aside sufficient funds to pay for885items of care and service provided to the county’s eligible886recipients for which county contributions are required,887regardless of where in the state the care or service is888rendered.889(4) Each county shall contribute its pro rata share of the890total county participation based upon statements rendered by the891agency. The agency shall render such statements monthly based on892each county’s eligible recipients. For purposes of this section,893each county’s eligible recipients shall be determined by the894recipient’s address information contained in the federally895approved Medicaid eligibility system within the Department of896Children and Family Services. A county may use the process897developed under subsection (10) to request a refund if it898determines that the statement rendered by the agency contains899errors.900 (5) In any county in which a special taxing district or 901 authority is located which benefitswill benefitfrom the 902 Medicaid programmedical assistance programs covered by this903section, the board of county commissioners may divide the 904 county’s financial responsibility for this purpose 905 proportionately, and each such district or authority must 906 furnish its share to the board of county commissioners in time 907 for the board to comply with subsection (4)(3). Any appeal of 908 the proration made by the board of county commissioners must be 909 made to the Department of Financial Services, which shallthen910 set the proportionate share forofeach party. 911(6) Counties are exempt from contributing toward the cost912of new exemptions on inpatient ceilings for statutory teaching913hospitals, specialty hospitals, and community hospital education914program hospitals that came into effect July 1, 2000, and for915special Medicaid payments that came into effect on or after July9161, 2000.917 (6)(7)(a) By August 1, 2012, the agency shall certify to 918 each county the amount of such county’s billings from November 919 1, 2001, through April 30, 2012, which remain unpaid. A county 920 may contest the amount certified by filing a petition under the 921 applicable provisions of chapter 120 on or before September 1, 922 2012. This procedure is the exclusive method to challenge the 923 amount certified. In order to successfully challenge the amount 924 certified, a county must show, by a preponderance of the 925 evidence, that a recipient was not an eligible recipient of that 926 county or that the amount certified was otherwise in error. 927 (b) By September 15, 2012, the agency shall certify to the 928 Department of Revenue: 929 1. For each county that files a petition on or before 930 September 1, 2012, the amount certified under paragraph (a); and 931 2. For each county that does not file a petition on or 932 before September 1, 2012, an amount equal to 85 percent of the 933 amount certified under paragraph (a). 934 (c) The filing of a petition under paragraph (a) doesshall935 not stay or stop the Department of Revenue from reducing 936 distributions in accordance with paragraph (b) and subsection 937 (7)(8). If a county that files a petition under paragraph (a) 938 is able to demonstrate that the amount certified should be 939 reduced, the agency shall notify the Department of Revenue of 940 the amount of the reduction. The Department of Revenue shall 941 adjust all future monthly distribution reductions under 942 subsection (7)(8)in a manner that results in the remaining 943 total distribution reduction being applied in equal monthly 944 amounts. 945 (7)(8)(a) Beginning with the October 2012 distribution, the 946 Department of Revenue shall reduce each county’s distributions 947 pursuant to s. 218.26 by one thirty-sixth of the amount 948 certified by the agency under subsection (6)(7)for that 949 county, minus any amount required under paragraph (b). Beginning 950 with the October 2013 distribution, the Department of Revenue 951 shall reduce each county’s distributions pursuant to s. 218.26 952 by one forty-eighth of two-thirds of the amount certified by the 953 agency under subsection (6)(7)for that county, minus any 954 amount required under paragraph (b). However, the amount of the 955 reduction may not exceed 50 percent of each county’s 956 distribution. If, after 60 months, the reductions for any county 957 do not equal the total amount initially certified by the agency, 958 the Department of Revenue shall continue to reduce such county’s 959 distribution by up to 50 percent until the total amount 960 certified is reached. The amounts by which the distributions are 961 reduced shall be transferred to the General Revenue Fund. 962 (b) As an assurance to holders of bonds issued before the 963 effective date of this act to which distributions made pursuant 964 to s. 218.26 are pledged, or bonds issued to refund such bonds 965 which mature no later than the bonds they refunded and which 966 result in a reduction of debt service payable in each fiscal 967 year, the amount available for distribution to a county shall 968 remain as provided by law and continue to be subject to any lien 969 or claim on behalf of the bondholders. The Department of Revenue 970 must ensure, based on information provided by an affected 971 county, that any reduction in amounts distributed pursuant to 972 paragraph (a) does not reduce the amount of distribution to a 973 county below the amount necessary for the timely payment of 974 principal and interest when due on the bonds and the amount 975 necessary to comply with any covenant under the bond resolution 976 or other documents relating to the issuance of the bonds. If a 977 reduction to a county’s monthly distribution must be decreased 978 in order to comply with this paragraph, the Department of 979 Revenue must notify the agency of the amount of the decrease and 980 the agency must send a bill for payment of such amount to the 981 affected county. 982(9)(a) Beginning May 1, 2012, and each month thereafter,983the agency shall certify to the Department of Revenue by the 7th984day of each month the amount of the monthly statement rendered985to each county pursuant to subsection (4). Beginning with the986May 2012 distribution, the Department of Revenue shall reduce987each county’s monthly distribution pursuant to s.218.61by the988amount certified by the agency minus any amount required under989paragraph (b). The amounts by which the distributions are990reduced shall be transferred to the General Revenue Fund.991(b) As an assurance to holders of bonds issued before the992effective date of this act to which distributions made pursuant993to s.218.61are pledged, or bonds issued to refund such bonds994which mature no later than the bonds they refunded and which995result in a reduction of debt service payable in each fiscal996year, the amount available for distribution to a county shall997remain as provided by law and continue to be subject to any lien998or claim on behalf of the bondholders. The Department of Revenue999must ensure, based on information provided by an affected1000county, that any reduction in amounts distributed pursuant to1001paragraph (a) does not reduce the amount of distribution to a1002county below the amount necessary for the timely payment of1003principal and interest when due on the bonds and the amount1004necessary to comply with any covenant under the bond resolution1005or other documents relating to the issuance of the bonds. If a1006reduction to a county’s monthly distribution must be decreased1007in order to comply with this paragraph, the Department of1008Revenue must notify the agency of the amount of the decrease and1009the agency must send a bill for payment of such amount to the1010affected county.1011(10) The agency, in consultation with the Department of1012Revenue and the Florida Association of Counties, shall develop a1013process for refund requests which:1014(a) Allows counties to submit to the agency written1015requests for refunds of any amounts by which the distributions1016were reduced as provided in subsection (9) and which set forth1017the reasons for the refund requests.1018(b) Requires the agency to make a determination as to1019whether a refund request is appropriate and should be approved,1020in which case the agency shall certify the amount of the refund1021to the department.1022(c) Requires the department to issue the refund for the1023certified amount to the county from the General Revenue Fund.1024The Department of Revenue may issue the refund in the form of a1025credit against reductions to be applied to subsequent monthly1026distributions.1027 (8)(11)Beginning in the 2013-2014 fiscal year and each 1028 year thereafter through the 2020-2021 fiscal year, the Chief 1029 Financial Officer shall transfer from the General Revenue Fund 1030 to the Lawton Chiles Endowment Fund an amount equal to the 1031 amounts transferred to the General Revenue Fund in the previous 1032 fiscal year pursuant to subsections (4) and (7)subsections (8)1033and (9), reduced by the amount of refunds paid pursuant to1034subsection (10),which are in excess of the official estimate 1035 for medical hospital fees for such previous fiscal year adopted 1036 by the Revenue Estimating Conference on January 12, 2012, as 1037 reflected in the conference’s workpapers. By July 20 of each 1038 year, the Office of Economic and Demographic Research shall 1039 certify the amount to be transferred to the Chief Financial 1040 Officer. Such transfers must be made before July 31 of each year 1041 until the total transfers for all years equal $350 million. If 1042In the event thatsuch transfers do not total $350 million by 1043 July 1, 2021, the Legislature shall provide for the transfer of 1044 amounts necessary to total $350 million. The Office of Economic 1045 and Demographic Research shall publish the official estimates 1046 reflected in the conference’s workpapers on its website. 1047 (9)(12)The agency may adopt rules to administer this 1048 section. 1049 Section 11. Notwithstanding s. 409.915(3) and (4), Florida 1050 Statutes, as amended by this act, the amount of each county’s 1051 contribution during the 2013-2014 state fiscal year shall be 1052 determined and provided to the Department of Revenue by the 1053 Agency for Health Care Administration by June 15, 2013. The 1054 Department of Revenue shall notify each county of its annual 1055 contribution by June 20, 2013. 1056 Section 12. The Agency for Health Care Administration shall 1057 submit a data report by March 1 of each year to the Governor, 1058 the President of the Senate, the Speaker of the House of 1059 Representatives, and the Florida Association of Counties which 1060 includes such information as may be necessary for 1061 comprehensively evaluating the cost and utilization of health 1062 services by Medicaid enrollees by service type in each county. 1063 This section is repealed December 31, 2015. 1064 Section 13. The paragraph following Specific Appropriation 1065 195 contained in SB 1500, if adopted during the 2013 Regular 1066 Session of the Florida Legislature, is repealed and replaced 1067 with the following upon SB 1500 becoming a law: 1068 1069 From the funds in Specific Appropriations 195, 197, 1070 198, 201, 203, 215, 219, 222, and 223, $677,722,971 1071 from the Medical Care Trust Fund is provided for 1072 increased reimbursement rates for primary care 1073 services provided to eligible Medicaid recipients. 1074 1075 Section 14. This act shall take effect July 1, 2013.