FDDC's Capitol Update for May 25, 2005

[Guest guest]

Good morning!

In this issue of the Capitol Update you'll find the final outcome of the bills Council staff has been watching. This issue of the Update is divided into two sections - the bills that passed and the ones that did not make it.

The session ended with a compromise version of the Senate and House Medicaid reform plans, outlined in SB 838.The conforming bill SB 404 is outlined in detail because of the pharmaceutical changes that will be implemented under Medicaid.

The final budget numbers are still being analyzed. We will report in an upcoming Capitol Update on the actual dollar amounts for government programs that are of interest to people with developmental disabilities and their families.

The Medicaid reform bill has two features that are important to our community. The first is a section that specifies that any managed care plan for individuals with a developmental disability must be crafted to meet the unique needs of those individuals.

The second are provisions for the Agency for Healthcare Administration (AHCA) to bring the application/waiver proposal back to the legislature for comment and review at least ten working days before submission of the application. If the application is approved, then the implementation plan will be brought back to the full legislature for its approval.

The bill also requires AHCA to post any waiver applications on its Internet website 30-days before submission to the federal government.

For the complete copy of this week's Capitol Update, please click here to read and/or download.

If you have any questions, comments or suggestions regarding this week's Capitol Update, please feel free to call or write to me and thanks once again for your interest in the work of the Florida Developmental Disabilities Council.

Margaret H. Determann, M.S.W.

Public Policy Coordinator

Florida Developmental Disabilities Council, Inc.

124 Marriott Drive, Suite 203

Tallahassee, FL 32301-2981

Phone:

Fax:

mailto:margaretd@...

www.fddc.org

Bills Passed

SB 838 Relating to Medicaid

(Peaden, Jr. Co-Sponsors Health Care Committee)

This bill is the Senate's Medicaid Reform Bill.

Please refer to FDDC's Medicaid Reform SB 838 Explained, which details the components of this bill.

CS/CS/SB 404 Relating to Health Care (Saunders)

This is a conforming bill for Health Care. It provides statutory changes necessary to conform to the General Appropriations Act for Fiscal Year 2005-2006.

Some of the provisions of particular interest to individuals with developmental disabilities and their families are as follows:

Delays the nursing home staffing increase form 2.6 to 2.9 hours of direct patient care per resident per day from July 1, 2005 until July 1, 2006

Restores Medicaid coverage for pregnant women with incomes between 150-185 percent of the federal poverty level, effective July 1, 2005.

Revises the Medicaid eligibility requirements for the Medicaid Aged and Disabled program (MEDS AD), effective January 1, 2006, by limiting coverage to those individuals who are age 65 or older or disabled, who are not eligible for Medicare or are eligible for Medicare and are currently under institutionalized care.

Restores Medicaid coverage for all services under the Medically Needy program, effective, July 1, 2005.

Restores Medicaid coverage for adult denture serves effective July 1, 2005.

Requires the Agency for Health Care Administration to post the preferred drug list on the agency's website.

Implements prescription drug safety requirements by authorizing the Pharmaceutical and Therapeutics Committee to review and/or place certain drugs on prior authorization.

Eliminates the exemption of the prior authorization requirements for mental health and drugs for nursing home recipients and other institutionalized individuals. The drugs will now be subject to the preferred drug list and prior authorization requirements.

Provides that the Medicaid preferred drug list include a list of cost effective therapeutic options with at least two products in eat therapeutic class.

Excludes antiretroviral agents from the preferred drug list.

Eliminates the exemption for the preferred drug list for mental health drugs.

Authorized the dispensing of 100-day maximum supplies of maintenance medications.

Eliminates the four brand name drug limit and the exception to the prior authorization requirements based on the treatment needs of the patient.

Authorizes the agency to implement the program of all-inclusive care for children (PACC) to provide in-home hospice-like support services to children diagnosed with life-threatening illness and enrolled in the Children's Medical Services network.

Allows Medicaid clients under chapter 393 F.S., who are excluded from the definition of employment and served by Adult Day Training Services under the Family and Supported Living waiver to be exempt for workers compensation purposes.

CS/CS/SB 404

05/06/05 SENATE Conference Committee Report received; Conference Committee Report adopted; Passed (Vote: 37 Yeas / 0 Nays); In Returning House Messages; Conference Committee Report received; Conference Committee Report adopted; Passed (Vote: 84 Yeas / 30 Nays); Senate Ordered engrossed, then enrolled

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