Text of FL H 1283 (2024)

HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 1 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S A bill to be entitled 1 An act relating to the health care; providing a short 2 title; repealing ss. 286.31, 286.311, and 381.00321, 3 F.S., relating to the prohibited use of state funds 4 for travel to another state for purpose of abortion 5 services, the prohibited use of state funds for sex- 6 reassignment prescriptions or procedures, and the 7 right of medical conscience of health care providers 8 and health care payors, respectively; creating s. 9 381.027, F.S.; providing a short title; defining 10 terms; requiring a covered entity to adopt a policy 11 relating to providing notice of its refused services 12 by a specified date; providing requirements for such 13 notice; requiring a covered entity to submit a 14 complete list of refused services to the Department of 15 Health by a specified date; requiring a covered entity 16 to notify the department within a specified period 17 after a change is made to such list; requiring a 18 covered entity to submit the list, along with its 19 application, if applying for certain state grants or 20 contracts; providing a civil penalty; requiring the 21 department to adopt rules; requiring the department to 22 publish and maintain on its website a current list of 23 covered entities and their refused services; requiring 24 the department to develop and administer a certain 25 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 2 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S public education and awareness program; providing 26 construction; providing for severability; amending s. 27 381.96, F.S.; revising the definition of the term 28 "eligible client" and defining the term "pregnancy 29 support services," rather than "pregnancy and 30 parenting support services"; revising department 31 duties and contract requirements to conform to changes 32 made by the act; repealing ss. 4, 6, and 7 of chapter 33 2023-21, Laws of Florida, relating to termination of 34 pregnancies, powers of the Agency for Health Care 35 Administration, and the use of telehealth to provide 36 services, respectively; amending s. 390.011, F.S.; 37 deleting the definition of the term "fatal fetal 38 abnormality"; amending s. 390.0111, F.S.; revising the 39 timeframe in which a physician may perform a 40 termination of pregnancy; revising exceptions; 41 repealing s. 395.3027, F.S., relating to patient 42 immigration status data collection in hospitals; 43 amending s. 409.905, F.S.; defining the terms "gender 44 identity" and "transgender individual"; requiring the 45 agency to provide Medicaid reimbursement for medically 46 necessary treatment for or related to gender dysphoria 47 or comparable or equivalent diagnoses; prohibiting the 48 agency from discriminating in its reimbursement on the 49 basis of a recipient's gender identity or that the 50 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 3 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S recipient is a transgender individual; amending s. 51 456.001, F.S.; deleting the definition of the terms 52 "sex" and "sex-reassignment prescriptions or 53 procedures"; repealing ss. 456.52 and 766.318, F.S., 54 relating to sex-reassignment prescriptions and 55 procedures and civil liability for provision of sex- 56 reassignment prescriptions or procedures to minors, 57 respectively; amending ss. 61.517, 61.534, 409.908, 58 409.913, 456.074, and 636.0145, F.S.; conforming 59 provisions and cross-references to changes made by the 60 act; providing an effective date. 61 62 Be It Enacted by the Legislature of the State of Florida: 63 64 Section 1. This act may be cited as the "Health Care 65 Freedom Act." 66 Section 2. Section 286.31, Florida Statutes, is repealed. 67 Section 3. Section 286.311, Florida Statutes, is repealed. 68 Section 4. Section 381.00321, Florida Statutes, is 69 repealed. 70 Section 5. Section 381.027, Florida Statutes, is created 71 to read: 72 381.027 Requirements for covered entities; notice of 73 refused services; department duties.— 74 (1) SHORT TITLE.—This section may be cited as the "Health 75 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 4 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S Care Transparency and Accessibility Act." 76 (2) DEFINITIONS.—As used in this section, the term: 77 (a) "Covered entity" means any health care facility that 78 uses, plans to use, or relies upon a denial of care provision to 79 refuse to provide a health care service, or referral for a 80 health care service, for any reason. The term does not include a 81 health care practitioner. 82 (b) "Denial of care provision" means any federal or state 83 law that purports or is asserted to allow a health care facility 84 to opt out of providing a health care service, or referral for a 85 health care service, including, but not limited to, ss. 86 381.0051(5), 390.0111(8), 483.918, and 765.1105; 42 U.S.C. ss. 87 18023(b)(4) and 18113; 42 U.S.C. s. 300a-7; 42 U.S.C. s. 238n; 88 42 U.S.C. s. 2000bb et seq.; s. 507(d) of the Departments of 89 Labor, Health and Human Services, and Education, and Related 90 Agencies Appropriations Act of 2019, Division B of Pub. L. No. 91 115-245; and 45 C.F.R. part 88. 92 (c) "Department" means the Department of Health. 93 (d) "Health care facility" has the same meaning as in s. 94 381.026(2). 95 (e) "Health care practitioner" has the same meaning as in 96 s. 456.001. 97 (f) "Health care services" has the same meaning as in s. 98 624.27(1). 99 (g) "Referral" has the same meaning as in s. 456.053(3). 100 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 5 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S (h) "Refused service" means a health care service that a 101 covered entity chooses not to provide, or not to provide a 102 referral for, based on one or more denials of care provisions. 103 The term includes health care services that the covered entity 104 selectively provides to some, but not all, patients based on 105 their identity, objections to a health care service, or other 106 nonmedical reasons. 107 (3) REQUIREMENTS FOR COVERED ENTITIES; PENALTY.— 108 (a) By October 1, 2024, each covered entity shall adopt a 109 policy for providing patients with a complete list of its 110 refused services. A covered entity shall: 111 1. Provide written notice to the patient or the patient's 112 representative which includes the complete list of its refused 113 services before any health care service is initiated. 114 a. In the case of an emergency, the covered entity must 115 promptly provide written notice after the patient is capable of 116 receiving such notice or when the patient's representative is 117 available. 118 b. The patient or patient's representative shall 119 acknowledge receipt of the written notice of refused services. 120 2. Retain all acknowledgements of receipt of the written 121 notice of refused services for a period of at least 3 years. 122 3. Provide a complete list of its refused services to any 123 person upon request. 124 (b) By October 1, 2024, a covered entity shall submit to 125 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 6 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S the department a complete list of its refused services. If any 126 change is made to the list, the covered entity must notify the 127 department within 30 days after making the change. 128 (c) If applying for any state grant or contract related to 129 providing a health care service, a covered entity must submit, 130 along with its application, a complete list of its refused 131 services. 132 (d) A covered entity that fails to comply with this 133 subsection is subject to a fine not exceeding $5,000 for each 134 day the covered entity is not in compliance. 135 (4) DEPARTMENT DUTIES.— 136 (a) The department shall adopt rules to implement this 137 section, which must include a process for receiving and 138 investigating complaints regarding covered entities that fail to 139 comply with this section. 140 (b) By January 1, 2025, the department shall publish and 141 maintain on its website a current list of covered entities and 142 the refused services for each covered entity. 143 (c) The department shall develop and administer a public 144 education and awareness program regarding the denial of health 145 care services, including how the denial of health care services 146 can negatively impact health care access and quality, how the 147 denial of health care services may be avoided, and how the 148 denial of health care services affects vulnerable people and 149 communities. 150 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 7 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S (5) CONSTRUCTION.— 151 (a) This section does not authorize denials of health care 152 services or discrimination in the provision of health care 153 services. 154 (b) This section does not limit any cause of action under 155 state or federal law, or limit any remedy in law or equity, 156 against a health care facility or health care practitioner. 157 (c) Compliance with this section does not reduce or limit 158 any potential liability for covered entities associated with the 159 refused services or any violations of state or federal law. 160 (d) Section 761.03 does not provide a claim relating to, 161 or a defense to a claim under, this section, or provide a basis 162 for challenging the application or enforcement of this section 163 or the use of funds associated with the application or 164 enforcement of this section. 165 (6) SEVERABILITY.—If any provision of this section or its 166 application to any person or circumstance is held invalid, the 167 invalidity does not affect other provisions or applications of 168 this section which can be given effect without the invalid 169 provision or application, and to this end the provisions of this 170 section are severable. 171 Section 6. Section 381.96, Florida Statutes, is amended to 172 read: 173 381.96 Pregnancy support and wellness services.— 174 (1) DEFINITIONS.—As used in this section, the term: 175 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 8 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S (a) "Department" means the Department of Health. 176 (b) "Eligible client" means any of the following: 177 1. a pregnant woman or a woman who suspects she is 178 pregnant, and the family of such woman, who voluntarily seeks 179 pregnancy support services and any woman who voluntarily seeks 180 wellness services. 181 2. A woman who has given birth in the previous 12 months 182 and her family. 183 3. A parent or parents or a legal guardian or legal 184 guardians, and the families of such parents and legal guardians, 185 for up to 12 months after the birth of a child or the adoption 186 of a child younger than 3 years of age. 187 (c) "Florida Pregnancy Care Network, Inc.," or "network" 188 means the not-for-profit statewide alliance of pregnancy support 189 organizations that provide pregnancy support and wellness 190 services through a comprehensive system of care to women and 191 their families. 192 (d) "Pregnancy and parenting support services" means 193 services that promote and encourage childbirth, including, but 194 not limited to: 195 1. Direct client services, such as pregnancy testing, 196 counseling, referral, training, and education for pregnant women 197 and their families. A woman and her family continue to be 198 eligible to receive direct client services for up to 12 months 199 after the birth of the child. 200 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 9 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S 2. Nonmedical material assistance that improves the 201 pregnancy or parenting situation of families, including, but not 202 limited to, clothing, car seats, cribs, formula, and diapers. 203 3. Counseling or mentoring, education materials, and 204 classes regarding pregnancy, parenting, adoption, life skills, 205 and employment readiness. 206 4. Network awareness activities, including a promotional 207 campaign to educate the public about the pregnancy support 208 services offered by the network and a website that provides 209 information on the location of providers in the user's area and 210 other available community resources. 211 3.5. Communication activities, including the operation and 212 maintenance of a hotline or call center with a single statewide 213 toll-free number that is available 24 hours a day for an 214 eligible client to obtain the location and contact information 215 for a pregnancy center located in the client's area. 216 (e) "Wellness services" means services or activities 217 intended to maintain and improve health or prevent illness and 218 injury, including, but not limited to, high blood pressure 219 screening, anemia testing, thyroid screening, cholesterol 220 screening, diabetes screening, and assistance with smoking 221 cessation. 222 (2) DEPARTMENT DUTIES.—The department shall contract with 223 the network for the management and delivery of pregnancy and 224 parenting support services and wellness services to eligible 225 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 10 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S clients. 226 (3) CONTRACT REQUIREMENTS.—The department contract shall 227 specify the contract deliverables, including financial reports 228 and other reports due to the department, timeframes for 229 achieving contractual obligations, and any other requirements 230 the department determines are necessary, such as staffing and 231 location requirements. The contract shall require the network 232 to: 233 (a) Establish, implement, and monitor a comprehensive 234 system of care through subcontractors to meet the pregnancy and 235 parenting support and wellness needs of eligible clients. 236 (b) Establish and manage subcontracts with a sufficient 237 number of providers to ensure the availability of pregnancy and 238 parenting support services and wellness services for eligible 239 clients, and maintain and manage the delivery of such services 240 throughout the contract period. 241 (c) Spend at least 90 85 percent of the contract funds on 242 pregnancy and parenting support services, excluding services 243 specified in subparagraph (1)(d)4., and wellness services. 244 (d) Offer wellness services through vouchers or other 245 appropriate arrangements that allow the purchase of services 246 from qualified health care providers. 247 (e) Require a background screening under s. 943.0542 for 248 all paid staff and volunteers of a subcontractor if such staff 249 or volunteers provide direct client services to an eligible 250 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 11 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S client who is a minor or an elderly person or who has a 251 disability. 252 (f) Annually monitor its subcontractors and specify the 253 sanctions that shall be imposed for noncompliance with the terms 254 of a subcontract. 255 (g) Subcontract only with providers that exclusively 256 promote and support childbirth. 257 (h) Ensure that informational materials provided to an 258 eligible client by a provider are current and accurate and cite 259 the reference source of any medical statement included in such 260 materials. 261 (i) Ensure that the department is provided with all 262 information necessary for the report required under subsection 263 (5). 264 (4) SERVICES.—Services provided pursuant to this section 265 must be provided in a noncoercive manner and may not include any 266 religious content. 267 (5) REPORT.—By July 1, 2024, and each year thereafter, the 268 department shall report to the Governor, the President of the 269 Senate, and the Speaker of the House of Representatives on the 270 amount and types of services provided by the network; the 271 expenditures for such services; and the number of, and 272 demographic information for, women, parents, and families served 273 by the network. 274 Section 7. Sections 4, 6, and 7 of chapter 2023-21, Laws 275 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 12 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S of Florida, are repealed. 276 Section 8. Subsection (6) of section 390.011, Florida 277 Statutes, is amended to read: 278 390.011 Definitions.—As used in this chapter, the term: 279 (6) "Fatal fetal abnormality" means a terminal condition 280 that, in reasonable medical judgment, regardless of the 281 provision of life-saving medical treatment, is incompatible with 282 life outside the womb and will result in death upon birth or 283 imminently thereafter. 284 Section 9. Subsection (1) of section 390.0111, Florida 285 Statutes, is amended to read: 286 390.0111 Termination of pregnancies.— 287 (1) TERMINATION IN THIRD TRIMESTER AFTER GESTATIONAL AGE 288 OF 15 WEEKS; WHEN ALLOWED.—A physician may not perform a 289 termination of pregnancy on any human being in the third 290 trimester of pregnancy if the physician determines the 291 gestational age of the fetus is more than 15 weeks unless one of 292 the following conditions is met: 293 (a) Two physicians certify in writing that, in reasonable 294 medical judgment, the termination of the pregnancy is necessary 295 to save the pregnant woman's life or avert a serious risk of 296 substantial and irreversible physical impairment of a major 297 bodily function of the pregnant woman other than a psychological 298 condition. 299 (b) The physician certifies in writing that, in reasonable 300 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 13 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S medical judgment, there is a medical necessity for legitimate 301 emergency medical procedures for termination of the pregnancy to 302 save the pregnant woman's life or avert a serious risk of 303 imminent substantial and irreversible physical impairment of a 304 major bodily function of the pregnant woman other than a 305 psychological condition, and another physician is not available 306 for consultation. 307 (c) The fetus has not achieved viability under s. 308 390.01112 and two physicians certify in writing that, in 309 reasonable medical judgment, the fetus has a fatal fetal 310 abnormality. 311 Section 10. Section 395.3027, Florida Statutes, is 312 repealed. 313 Section 11. Present subsections (4) through (12) of 314 section 409.905, Florida Statutes, are redesignated as 315 subsections (5) through (13), respectively, and a new subsection 316 (4) is added to that section, to read: 317 409.905 Mandatory Medicaid services.—The agency may make 318 payments for the following services, which are required of the 319 state by Title XIX of the Social Security Act, furnished by 320 Medicaid providers to recipients who are determined to be 321 eligible on the dates on which the services were provided. Any 322 service under this section shall be provided only when medically 323 necessary and in accordance with state and federal law. 324 Mandatory services rendered by providers in mobile units to 325 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 14 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S Medicaid recipients may be restricted by the agency. Nothing in 326 this section shall be construed to prevent or limit the agency 327 from adjusting fees, reimbursement rates, lengths of stay, 328 number of visits, number of services, or any other adjustments 329 necessary to comply with the availability of moneys and any 330 limitations or directions provided for in the General 331 Appropriations Act or chapter 216. 332 (4) GENDER-AFFIRMING CARE.— 333 (a) Definitions.—As used in this section, the term: 334 1. "Gender identity" means an individual's internal sense 335 of that individual's gender, regardless of the sex assigned to 336 that individual at birth. 337 2. "Transgender individual" means an individual who 338 identifies as a gender different from the sex assigned to that 339 individual at birth. 340 (b) Reimbursement.—The agency shall provide reimbursement 341 for medically necessary treatment for or related to gender 342 dysphoria as defined by the Diagnostic and Statistical Manual of 343 Mental Disorders, Fifth Edition, published by the American 344 Psychiatric Association or a comparable or equivalent diagnosis. 345 (c) Discrimination prohibited.—The agency may not 346 discriminate in its reimbursement of medically necessary 347 treatment on the basis of the recipient's gender identity or on 348 the basis that the recipient is a transgender individual. 349 Section 12. Subsections (8) and (9) of section 456.001, 350 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 15 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S Florida Statutes, are amended to read: 351 456.001 Definitions.—As used in this chapter, the term: 352 (8) "Sex" means the classification of a person as either 353 male or female based on the organization of the human body of 354 such person for a specific reproductive role, as indicated by 355 the person's sex chromosomes, naturally occurring sex hormones, 356 and internal and external genitalia present at birth. 357 (9)(a) "Sex-reassignment prescriptions or procedures" 358 means: 359 1. The prescription or administration of puberty blockers 360 for the purpose of attempting to stop or delay normal puberty in 361 order to affirm a person's perception of his or her sex if that 362 perception is inconsistent with the person's sex as defined in 363 subsection (8). 364 2. The prescription or administration of hormones or 365 hormone antagonists to affirm a person's perception of his or 366 her sex if that perception is inconsistent with the person's sex 367 as defined in subsection (8). 368 3. Any medical procedure, including a surgical procedure, 369 to affirm a person's perception of his or her sex if that 370 perception is inconsistent with the person's sex as defined in 371 subsection (8). 372 (b) The term does not include: 373 1. Treatment provided by a physician who, in his or her 374 good faith clinical judgment, performs procedures upon or 375 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 16 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S provides therapies to a minor born with a medically verifiable 376 genetic disorder of sexual development, including any of the 377 following: 378 a. External biological sex characteristics that are 379 unresolvably ambiguous. 380 b. A disorder of sexual development in which the physician 381 has determined through genetic or biochemical testing that the 382 patient does not have a normal sex chromosome structure, sex 383 steroid hormone production, or sex steroid hormone action for a 384 male or female, as applicable. 385 2. Prescriptions or procedures to treat an infection, an 386 injury, a disease, or a disorder that has been caused or 387 exacerbated by the performance of any sex-reassignment 388 prescription or procedure, regardless of whether such 389 prescription or procedure was performed in accordance with state 390 or federal law. 391 3. Prescriptions or procedures provided to a patient for 392 the treatment of a physical disorder, physical injury, or 393 physical illness that would, as certified by a physician 394 licensed under chapter 458 or chapter 459, place the individual 395 in imminent danger of death or impairment of a major bodily 396 function without the prescription or procedure. 397 Section 13. Section 456.52, Florida Statutes, is repealed. 398 Section 14. Section 766.318, Florida Statutes, is 399 repealed. 400 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 17 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S Section 15. Subsection (1) of section 61.517, Florida 401 Statutes, is amended to read: 402 61.517 Temporary emergency jurisdiction.— 403 (1) A court of this state has temporary emergency 404 jurisdiction if the child is present in this state and: 405 (a) The child has been abandoned; or 406 (b) It is necessary in an emergency to protect the child 407 because the child, or a sibling or parent of the child, is 408 subjected to or threatened with mistreatment or abuse; or 409 (c) It is necessary in an emergency to protect the child 410 because the child has been subjected to or is threatened with 411 being subjected to sex-reassignment prescriptions or procedures, 412 as defined in s. 456.001. 413 Section 16. Subsection (1) of section 61.534, Florida 414 Statutes, is amended to read: 415 61.534 Warrant to take physical custody of child.— 416 (1) Upon the filing of a petition seeking enforcement of a 417 child custody determination, the petitioner may file a verified 418 application for the issuance of a warrant to take physical 419 custody of the child if the child is likely to imminently suffer 420 serious physical harm or removal from this state. Serious 421 physical harm includes, but is not limited to, being subjected 422 to sex-reassignment prescriptions or procedures as defined in s. 423 456.001. 424 Section 17. Paragraph (a) of subsection (1) of section 425 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 18 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S 409.908, Florida Statutes, is amended to read: 426 409.908 Reimbursement of Medicaid providers.—Subject to 427 specific appropriations, the agency shall reimburse Medicaid 428 providers, in accordance with state and federal law, according 429 to methodologies set forth in the rules of the agency and in 430 policy manuals and handbooks incorporated by reference therein. 431 These methodologies may include fee schedules, reimbursement 432 methods based on cost reporting, negotiated fees, competitive 433 bidding pursuant to s. 287.057, and other mechanisms the agency 434 considers efficient and effective for purchasing services or 435 goods on behalf of recipients. If a provider is reimbursed based 436 on cost reporting and submits a cost report late and that cost 437 report would have been used to set a lower reimbursement rate 438 for a rate semester, then the provider's rate for that semester 439 shall be retroactively calculated using the new cost report, and 440 full payment at the recalculated rate shall be effected 441 retroactively. Medicare-granted extensions for filing cost 442 reports, if applicable, shall also apply to Medicaid cost 443 reports. Payment for Medicaid compensable services made on 444 behalf of Medicaid-eligible persons is subject to the 445 availability of moneys and any limitations or directions 446 provided for in the General Appropriations Act or chapter 216. 447 Further, nothing in this section shall be construed to prevent 448 or limit the agency from adjusting fees, reimbursement rates, 449 lengths of stay, number of visits, or number of services, or 450 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 19 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S making any other adjustments necessary to comply with the 451 availability of moneys and any limitations or directions 452 provided for in the General Appropriations Act, provided the 453 adjustment is consistent with legislative intent. 454 (1) Reimbursement to hospitals licensed under part I of 455 chapter 395 must be made prospectively or on the basis of 456 negotiation. 457 (a) Reimbursement for inpatient care is limited as 458 provided in s. 409.905(6) s. 409.905(5), except as otherwise 459 provided in this subsection. 460 1. If authorized by the General Appropriations Act, the 461 agency may modify reimbursement for specific types of services 462 or diagnoses, recipient ages, and hospital provider types. 463 2. The agency may establish an alternative methodology to 464 the DRG-based prospective payment system to set reimbursement 465 rates for: 466 a. State-owned psychiatric hospitals. 467 b. Newborn hearing screening services. 468 c. Transplant services for which the agency has 469 established a global fee. 470 d. Recipients who have tuberculosis that is resistant to 471 therapy who are in need of long-term, hospital-based treatment 472 pursuant to s. 392.62. 473 3. The agency shall modify reimbursement according to 474 other methodologies recognized in the General Appropriations 475 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 20 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S Act. 476 477 The agency may receive funds from state entities, including, but 478 not limited to, the Department of Health, local governments, and 479 other local political subdivisions, for the purpose of making 480 special exception payments, including federal matching funds, 481 through the Medicaid inpatient reimbursement methodologies. 482 Funds received for this purpose shall be separately accounted 483 for and may not be commingled with other state or local funds in 484 any manner. The agency may certify all local governmental funds 485 used as state match under Title XIX of the Social Security Act, 486 to the extent and in the manner authorized under the General 487 Appropriations Act and pursuant to an agreement between the 488 agency and the local governmental entity. In order for the 489 agency to certify such local governmental funds, a local 490 governmental entity must submit a final, executed letter of 491 agreement to the agency, which must be received by October 1 of 492 each fiscal year and provide the total amount of local 493 governmental funds authorized by the entity for that fiscal year 494 under this paragraph, paragraph (b), or the General 495 Appropriations Act. The local governmental entity shall use a 496 certification form prescribed by the agency. At a minimum, the 497 certification form must identify the amount being certified and 498 describe the relationship between the certifying local 499 governmental entity and the local health care provider. The 500 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 21 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S agency shall prepare an annual statement of impact which 501 documents the specific activities undertaken during the previous 502 fiscal year pursuant to this paragraph, to be submitted to the 503 Legislature annually by January 1. 504 Section 18. Subsection (36) of section 409.913, Florida 505 Statutes, is amended to read: 506 409.913 Oversight of the integrity of the Medicaid 507 program.—The agency shall operate a program to oversee the 508 activities of Florida Medicaid recipients, and providers and 509 their representatives, to ensure that fraudulent and abusive 510 behavior and neglect of recipients occur to the minimum extent 511 possible, and to recover overpayments and impose sanctions as 512 appropriate. Each January 15, the agency and the Medicaid Fraud 513 Control Unit of the Department of Legal Affairs shall submit a 514 report to the Legislature documenting the effectiveness of the 515 state's efforts to control Medicaid fraud and abuse and to 516 recover Medicaid overpayments during the previous fiscal year. 517 The report must describe the number of cases opened and 518 investigated each year; the sources of the cases opened; the 519 disposition of the cases closed each year; the amount of 520 overpayments alleged in preliminary and final audit letters; the 521 number and amount of fines or penalties imposed; any reductions 522 in overpayment amounts negotiated in settlement agreements or by 523 other means; the amount of final agency determinations of 524 overpayments; the amount deducted from federal claiming as a 525 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 22 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S result of overpayments; the amount of overpayments recovered 526 each year; the amount of cost of investigation recovered each 527 year; the average length of time to collect from the time the 528 case was opened until the overpayment is paid in full; the 529 amount determined as uncollectible and the portion of the 530 uncollectible amount subsequently reclaimed from the Federal 531 Government; the number of providers, by type, that are 532 terminated from participation in the Medicaid program as a 533 result of fraud and abuse; and all costs associated with 534 discovering and prosecuting cases of Medicaid overpayments and 535 making recoveries in such cases. The report must also document 536 actions taken to prevent overpayments and the number of 537 providers prevented from enrolling in or reenrolling in the 538 Medicaid program as a result of documented Medicaid fraud and 539 abuse and must include policy recommendations necessary to 540 prevent or recover overpayments and changes necessary to prevent 541 and detect Medicaid fraud. All policy recommendations in the 542 report must include a detailed fiscal analysis, including, but 543 not limited to, implementation costs, estimated savings to the 544 Medicaid program, and the return on investment. The agency must 545 submit the policy recommendations and fiscal analyses in the 546 report to the appropriate estimating conference, pursuant to s. 547 216.137, by February 15 of each year. The agency and the 548 Medicaid Fraud Control Unit of the Department of Legal Affairs 549 each must include detailed unit-specific performance standards, 550 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 23 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S benchmarks, and metrics in the report, including projected cost 551 savings to the state Medicaid program during the following 552 fiscal year. 553 (36) The agency may provide to a sample of Medicaid 554 recipients or their representatives through the distribution of 555 explanations of benefits information about services reimbursed 556 by the Medicaid program for goods and services to such 557 recipients, including information on how to report inappropriate 558 or incorrect billing to the agency or other law enforcement 559 entities for review or investigation, information on how to 560 report criminal Medicaid fraud to the Medicaid Fraud Control 561 Unit's toll-free hotline number, and information about the 562 rewards available under s. 409.9203. The explanation of benefits 563 may not be mailed for Medicaid independent laboratory services 564 as described in s. 409.905(8) s. 409.905(7) or for Medicaid 565 certified match services as described in ss. 409.9071 and 566 1011.70. 567 Section 19. Paragraph (c) of subsection (5) of section 568 456.074, Florida Statutes, is amended to read: 569 456.074 Certain health care practitioners; immediate 570 suspension of license.— 571 (5) The department shall issue an emergency order 572 suspending the license of any health care practitioner who is 573 arrested for committing or attempting, soliciting, or conspiring 574 to commit any act that would constitute a violation of any of 575 HB 1283 2024 CODING: Words stricken are deletions; words underlined are additions. hb1283-00 Page 24 of 24 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S the following criminal offenses in this state or similar 576 offenses in another jurisdiction: 577 (c) Section 456.52(5)(b), relating to prescribing, 578 administering, or performing sex-reassignment prescriptions or 579 procedures for a patient younger than 18 years of age. 580 Section 20. Section 636.0145, Florida Statutes, is amended 581 to read: 582 636.0145 Certain entities contracting with Medicaid.—An 583 entity that is providing comprehensive inpatient and outpatient 584 mental health care services to certain Medicaid recipients in 585 Hillsborough, Highlands, Hardee, Manatee, and Polk Counties 586 through a capitated, prepaid arrangement pursuant to the federal 587 waiver provided for in s. 409.905(6) s. 409.905(5) must become 588 licensed under this chapter by December 31, 1998. Any entity 589 licensed under this chapter which provides services solely to 590 Medicaid recipients under a contract with Medicaid is exempt 591 from ss. 636.017, 636.018, 636.022, 636.028, 636.034, and 592 636.066(1). 593 Section 21. This act shall take effect July 1, 2024. 594