HB 1811 (2004) -  Medicaid

General Bill by Health Care (CO-SPONSORS) Farkas; Hasner; Holloway
Medicaid: Adds criminal violations to the list of specified crimes within the jurisdiction of the Office of Statewide Prosecution; includes the Medicaid Fraud Control Unit in the Agency for Health Care Administration’s local coordinating workgroups for identifying unlicensed assisted living facilities; gives the Medicaid Fraud Control Unit authority to enter and inspect facilities; requires a Medicaid applicant to agree to forfeiture of all entitlements under the Medicaid program upon a judicial or administrative finding of fraud within a specified period; authorizes the Agency for Health Care Administration to require a confirmation or second physician's opinion of the correct diagnosis for purposes of authorizing future services under the Medicaid program; authorizes the agency to impose mandatory enrollment in drug-therapy-management or disease-management programs for certain categories of recipients; requires that the agency and the Drug Utilization Review Board consult with the Department of Health; allows termination of practitioners from the Medicaid program; provides that Medicaid recipients may be required to participate in a provider lock-in program for a specified time; requires the agency to seek a federal waiver to terminate eligibility; requires the agency to conduct a study of electronic verification systems; authorizes the agency to use credentialing criteria; provides specified conditions for providers to submit claims to the Medicaid program; provides that claims may be denied if not properly submitted; provides that the agency may seek any remedy under law if a provider submits specified false or erroneous claims; provides that suspension or termination precludes participation in the Medicaid program; provides that the agency is required to report administrative sanctions; provides that the agency may withhold payment to a provider; provides that the agency may deny payments to terminated or suspended providers; authorizes the agency to implement amnesty programs for providers to voluntarily repay overpayments; authorizes the agency to adopt rules; provides for limiting, restricting, or suspending Medicaid eligibility of Medicaid recipients; authorizes the agency and the Medicaid Fraud Control Unit to review non-Medicaid-related records in order to determine reconciliation of a provider's records; authorizes the agency head or designee to limit, restrict, or suspend Medicaid eligibility; authorizes the agency to limit the number of prescription claims submitted by pharmacy providers; requires the agency to limit the allowable amount of prescriptions; requires the Office of Program Policy Analysis and Government Accountability to report to the Legislature on the agency's fraud and abuse prevention, deterrence, detection, and recovery efforts; revises and provides definitions; requires an additional statement on Medicaid cost reports; provides that a person who knowingly sells or attempts to sell legend drugs obtained through the Medicaid program commits a felony; providing that a person who knowingly purchases or attempts to purchase legend drugs obtained through the Medicaid program and intended for the use of another commits a felony; provides that a person who knowingly makes or conspires to make false representations for the purpose of obtaining goods or services from the Medicaid program commits a felony; provides specified criminal penalties depending on the value of the legend drugs or goods or services obtained from the Medicaid program; provides an additional ground under which a health care practitioner who prescribes medicinal drugs or controlled substances may be subject to discipline; authorizes the Department of Health to initiate a disciplinary investigation of prescribing practitioners; removes the requirement that the agency give pharmacists at least 1 week's notice prior to an audit; specifies an effective date for certain audit criteria; provides that the specified Medicaid audit procedures do not apply to any investigative audit conducted by the agency when the agency has reliable evidence that the claim that is the subject of the audit involves fraud, willful misrepresentation, or abuse under the Medicaid program; prohibits the accounting practice of extrapolation for calculating penalties for Medicaid audits; provides that a person who traffics in property paid for in whole or in part by the Medicaid program, or who knowingly finances, directs, or traffics in such property, commits a felony; provides specified criminal penalties depending on the value of the property; adds specified criminal violations to the list of crimes within the jurisdiction of the statewide grand jury; requires that proceeds collected under the Florida Contraband Forfeiture Act be deposited in the Department of Legal Affairs' Grants and Donations Trust Fund; provides an appropriation and authorizes positions.
Companion Bill passed CS/CS/SB 1064 Medicaid By Appropriations and Health, Aging, and Long-Term Care and Saunders
Effective Date: upon becoming a law
Last Event: Companion Bill passed, refer to CS/CS/SB 1064 on Friday, April 30, 2004 11:24 AM; HB Laid on Table

PCB committee actions:

  • PCB HC 04-01 recommended by:
    Health Care

Referred Committees and Committee Actions

House Referrals

Related Bills

Bill # Subject Relationship
Bill #: CS/CS/SB 1064 Subject: Medicaid Relationship: Similar
Bill #: SB 2876 Subject: Medicaid Relationship: Similar
Bill #: HB 1257 Subject: Medicaid Fraud Relationship: Compare
Bill #: HB 1843 Subject: Health Care Relationship: Compare
Bill #: CS/SB 1276 Subject: Health Care Relationship: Compare

Bill Text

Staff Analysis

Chamber Committee
Chamber: House Committee: Appropriations 4/28/2004 12:47:58 PM
Chamber: House Committee: Appropriations 4/23/2004 12:43:32 AM
Chamber: House Committee: Subcommittee on Health Appropriations 4/5/2004 12:24:28 PM
Chamber: House Committee: Subcommittee on Health Appropriations 4/1/2004 8:28:31 PM
Chamber: House Committee: Health Care 3/24/2004 11:18:30 AM

Vote History

(No Votes Recorded)

Bill History

Event Time Member Committee Ver.
Event: H Laid on Table, refer to CS/CS/SB 1064 Time: 04/30/2004 - 11:24 AM Member: Committee: Version:
Event: H Substituted CS/CS/SB 1064 Time: 04/30/2004 - 11:24 AM Member: Committee: Version:
Event: H Bill added to Third Reading Calendar Time: 04/29/2004 - 12:48 AM Member: Committee: Version:
Event: H Read 2nd time Time: 04/28/2004 - 9:20 PM Member: Committee: Version:
Event: H Bill added to Second Reading Calendar Time: 04/27/2004 - 11:03 AM Member: Committee: Version:
Event: H Bill released to House Calendar Time: 04/27/2004 - 11:03 AM Member: Committee: Version:
Event: H Recommendation: CS by Appropriations ; Pending Review of CS under Rule 6.3 Time: 04/27/2004 - 10:17 AM Member: Committee: Appropriations Version:
Event: H Bill released from committee Time: 04/27/2004 - 10:17 AM Member: Committee: Appropriations Version:
Event: H Bill passed referred committee Time: 04/27/2004 - 10:17 AM Member: Committee: Appropriations Version:
Event: H Bill added to Special Order Calendar (4/28/2004 1:01:36 AM) Time: 04/27/2004 - 1:07 AM Member: Committee: Version:
Event: H Bill added to Appropriations agenda Time: 04/22/2004 - 4:26 PM Member: Committee: Appropriations Version:
Event: H Bill added to Appropriations agenda Time: 04/19/2004 - 4:19 PM Member: Committee: Appropriations Version:
Event: H Bill now in Appropriations Time: 04/05/2004 - 12:22 PM Member: Committee: Appropriations Version:
Event: H Bill released from committee Time: 04/05/2004 - 12:22 PM Member: Committee: Subcommittee on Health Appropriations Version:
Event: H Bill Passed referred committee with amendment(s) Time: 04/05/2004 - 12:22 PM Member: Committee: Subcommittee on Health Appropriations Version:
Event: H Bill added to Subcommittee on Health Appropriations agenda Time: 03/31/2004 - 2:52 PM Member: Committee: Subcommittee on Health Appropriations Version:
Event: H Now in Subcommittee on Health Appropriations Time: 03/23/2004 - 7:04 PM Member: Committee: Subcommittee on Health Appropriations Version:
Event: H Bill referred to committee Time: 03/23/2004 - 7:04 PM Member: Committee: Appropriations Version:
Event: H Bill referred to committee Time: 03/23/2004 - 7:04 PM Member: Committee: Subcommittee on Health Appropriations Version:
Event: H 1st Reading Time: 03/22/2004 - 6:20 PM Member: Committee: Version:
Event: H Filed timely Time: 03/22/2004 - 10:23 AM Member: Committee: Health Care Version:

Statutes Referenced by this Bill

Statute Other Bill Citations
16.56 HB 865, HB 1197, HB 1257, HB 1505, HB 1995
394.9082 HB 1065, HB 1845
400.0077
400.408
400.434
409.9021
409.9065 HB 1065
409.9071 HB 1257
409.908 HB 189, HB 1065, HB 1843, HB 1905
409.91196 HB 1065
409.912 HB 27, HB 645, HB 721, HB 887, HB 1065, HB 1257, HB 1349, HB 1823, HB 1843, HB 1905
409.9122 HB 1065, HB 1349, HB 1843
409.913 HB 1257
409.9131 HB 1257
409.920
409.9201 HB 1257
430.608
456.072 HB 121 CS, HB 807 CS, HB 1921
465.188
636.0145 HB 1065
641.225 HB 1065
641.386 HB 1065
705.101 HB 523 CS
812.0191 HB 1257
895.02 HB 141 CS, HB 865, HB 1065, HB 1257
905.34 HB 865, HB 1257, HB 1505
921.0022 HB 71, HB 177 CS, HB 205, HB 221, HB 295, HB 379 CS, HB 527, HB 761, HB 811, HB 1065, HB 1147, HB 1243 CS, HB 1375, HB 1525, HB 1641 CS, HB 1713, HB 1815, HB 1893
932.701 HB 523 CS
932.703 HB 523 CS
932.7055 HB 101 CS, HB 523 CS