409.9125  Study of Medicaid alternative service networks.--

(1)  Within existing resources, the agency shall work with the Department of Insurance, the ¹Department of Health and Rehabilitative Services, the Department of Education, the Department of Elderly Affairs, and provider groups to study the feasibility of non-risk-bearing alternative service networks for Medicaid recipients. Such networks shall be organizations of providers who are affiliated for the purpose of serving special populations of Medicaid recipients who have chronic diseases or disabilities or who are in need of specialized services, including, but not limited to, mental health, substance abuse, developmental services, and long-term care.

(2)  The alternative service network study shall examine the feasibility of:

(a)  Using a primary care case management process and fee-for-service reimbursement arrangement.

(b)  Requiring MediPass providers and managed care plans to refer Medicaid patients to an alternative service network.

(c)  Developing appropriate case management, treatment plan, and utilization management protocols; practice guidelines; quality assurance and quality improvement standards; credentialing standards; methods of determining patient satisfaction; and methods of analyzing and reporting health outcomes.

(d)  Using the Children's Medical Services network as a model for the development of alternative service networks.

(3)  The agency shall submit an interim report to the Governor and the chairpersons of the appropriations and health care committees of each chamber of the Legislature by January 1, 1997, and a final report by January 1, 1998.

History.--s. 10, ch. 96-199.