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ENROLLED HB 5001, ENGROSSED 1 2024 LEGISLATURE ______________________________________________________________________________ SECTION 3 - HUMAN SERVICES 212 SPECIAL CATEGORIES OTHER FEE FOR SERVICE FROM GENERAL REVENUE FUND . . . . . 169,689,863 FROM HEALTH CARE TRUST FUND . . . . 4,840,597 FROM GRANTS AND DONATIONS TRUST FUND . . . . . . . . . . . . . . . 1,743,862 FROM MEDICAL CARE TRUST FUND . . . . 305,515,555 FROM REFUGEE ASSISTANCE TRUST FUND . 33,654,820 Funds in Specific Appropriation 212 are for the inclusion of freestanding dialysis clinics in the Medicaid program. The Agency for Health Care Administration shall limit payment to $125.00 per visit for each dialysis treatment. Freestanding dialysis facilities may obtain, administer and submit claims directly to the Medicaid program for End-Stage Renal Disease pharmaceuticals subject to coverage and limitations policy. All pharmaceutical claims for this purpose must include National Drug Codes (NDC) to permit the invoicing for federal and/or state supplemental rebates from manufacturers. Claims for drug products that do not include NDC information are not payable by Florida Medicaid unless the drug product is exempt from federal rebate requirements. From the funds in Specific Appropriation 212, the Agency for Health Care Administration shall work with dialysis providers, managed care organizations, and physicians to ensure that all Medicaid patients with End Stage Renal Disease (ESRD) are educated and assessed by their physician and dialysis provider to determine their suitability for all types of home modalities. Further, the agency shall consult with the dialysis community concerning suitable voluntary reporting to the state Medicaid program on members’ home modality suitability. From the funds in Specific Appropriation 212, the Agency for Health Care Administration shall apply a recurring methodology to establish clinic services rates taking into consideration the reductions imposed on or after October 1, 2008, in the following manner: (1) the agency shall divide the total amount of each recurring reduction imposed by the number of visits originally used in the rate calculation for each rate setting period on or after October 1, 2008, which will yield a rate reduction per diem for each rate period; (2) the agency shall multiply the resulting rate reduction per diem for each rate setting period on or after October 1, 2008, by the projected number of visits used in establishing the current budget estimate which will yield the total current reduction amount to be applied to current rates; and (3) in the event the total current reduction amount is greater than the historical reduction amount, the agency shall hold the rate reduction to the historical reduction amount. From the funds in Specific Appropriations 212 and 215, $400,000 from the Grants and Donations Trust Fund and $538,306 from the Medical Care Trust Fund are provided to buy back clinic services rate adjustments, effective on or after July 1, 2008, and are contingent on the nonfederal share being provided through grants and donations from state, county or other governmental funds. Authority is granted to buy back rate reductions up to, but not higher than, the amounts available under the authority appropriated in this Specific Appropriation. In the event that the funds are not available in the Grants and Donations Trust Fund, the State of Florida is not obligated to continue reimbursements at the higher amount. From the funds in Specific Appropriations 212 and 227, $19,329,084 from the Grants and Donations Trust Fund and $26,012,422 from the Medical Care Trust Fund are provided to buy back hospice rate reductions, effective on or after January 1, 2008, and are contingent on the nonfederal share being provided through nursing home quality assessments. Authority is granted to buy back rate reductions up to, but no higher than, the amounts available under the budgeted authority in this Specific Appropriation. In the event that the funds are not available in the Grants and Donations Trust Fund, the State of Florida is not obligated to continue reimbursements at the higher amount. From the funds in Specific Appropriation 212, $24,990,000 from the Medical Care Trust Fund is provided for the Florida Assertive Community Treatment (FACT) Team Services as a Medicaid state plan covered service. Medicaid coverage for the FACT Team Services is contingent on the availability of state matching funds of $10,653,237 from the Medical Care Trust Fund being provided in Specific Appropriation 384. 74