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       CS for CS for SB 8                               First Engrossed
    1                        A bill to be entitled                      
    2         An act relating to Medicaid and public assistance
    3         fraud; creating s. 624.35, F.S.; providing a short
    4         title; creating s. 624.351, F.S.; providing
    5         legislative intent; establishing the Medicaid and
    6         Public Assistance Fraud Strike Force within the
    7         Department of Financial Services to coordinate efforts
    8         to eliminate Medicaid and public assistance fraud;
    9         providing for membership; providing for meetings;
   10         specifying duties; requiring an annual report to the
   11         Legislature and Governor; creating s. 624.352, F.S.;
   12         directing the Chief Financial Officer to prepare model
   13         interagency agreements that address Medicaid and
   14         public assistance fraud; specifying which agencies can
   15         be a party to such agreements; amending s. 16.59,
   16         F.S.; conforming provisions to changes made by the
   17         act; requiring the Divisions of Insurance Fraud and
   18         Public Assistance Fraud in the Department of Financial
   19         Services to be collocated with the Medicaid Fraud
   20         Control Unit if possible; requiring positions
   21         dedicated to Medicaid managed care fraud to be
   22         collocated with the Division of Insurance Fraud;
   23         amending s. 20.121, F.S.; establishing the Division of
   24         Public Assistance Fraud within the Department of
   25         Financial Services; amending ss. 411.01, 414.33, and
   26         414.39, F.S.; conforming provisions to changes made by
   27         the act; transferring, renumbering, and amending s.
   28         943.401, F.S.; directing the Department of Financial
   29         Services rather than the Department of Law Enforcement
   30         to investigate public assistance fraud; creating s.
   31         409.91212, F.S.; requiring Medicaid managed care plans
   32         to adopt an anti-fraud plan relating to the provision
   33         of health care services; requiring certain managed
   34         care plans to also establish an investigative unit or
   35         contract for the investigation of fraudulent or
   36         abusive activity; requiring an annual report;
   37         providing administrative penalties for noncompliance;
   38         authorizing the Agency for Health Care Administration
   39         to adopt rules; directing the Auditor General and the
   40         Office of Program Policy Analysis and Government
   41         Accountability to review the Medicaid fraud and abuse
   42         processes in the Agency for Health Care
   43         Administration; requiring a report to the Legislature
   44         and Governor by a certain date; establishing the
   45         Medicaid claims adjudication project in the Agency for
   46         Health Care Administration to decrease the incidence
   47         of inaccurate payments and to improve the efficiency
   48         of the Medicaid claims processing system; transferring
   49         activities relating to public assistance fraud from
   50         the Department of Law Enforcement to the Division of
   51         Public Assistance Fraud in the Department of Financial
   52         Services by a type two transfer; providing effective
   53         dates.
   55         WHEREAS, Florida’s Medicaid program is one of the largest
   56  in the country, serving approximately 2.7 million persons each
   57  month. The program provides health care benefits to families and
   58  individuals below certain income and resource levels. For the
   59  2008-2009 fiscal year, the Legislature appropriated $18.81
   60  billion to operate the Medicaid program which is funded from
   61  general revenue, trust funds that include federal matching
   62  funds, and other state funds, and
   63         WHEREAS, Medicaid fraud in Florida is epidemic, far
   64  reaching, and costs the state and the Federal Government
   65  billions of dollars annually. Medicaid fraud not only drives up
   66  the cost of health care and reduces the availability of funds to
   67  support needed services, but undermines the long-term solvency
   68  of both health care providers and the state’s Medicaid program,
   69  and
   70         WHEREAS, the state’s public assistance programs serve
   71  approximately 1.8 million Floridians each month by providing
   72  benefits for food, cash assistance for needy families, home
   73  health care for disabled adults, and grants to individuals and
   74  communities affected by natural disasters. For the 2008-2009
   75  fiscal year, the Legislature appropriated $626 million to
   76  operate public assistance programs, and
   77         WHEREAS, public assistance fraud costs taxpayers millions
   78  of dollars annually, which significantly and negatively impacts
   79  the various assistance programs by taking dollars that could be
   80  used to provide services for those people who have a legitimate
   81  need for assistance, and
   82         WHEREAS, both Medicaid and public assistance programs are
   83  vulnerable to fraudulent practices that can take many forms. For
   84  Medicaid, these practices range from providers who bill for
   85  services never rendered and who pay kickbacks to other providers
   86  for client referrals, to fraud occurring at the corporate level
   87  of a managed care organization. Fraudulent practices involving
   88  public assistance involve persons not disclosing material facts
   89  when obtaining assistance or not disclosing changes in
   90  circumstances while on public assistance, and
   91         WHEREAS, ridding the system of perpetrators who prey on the
   92  state’s Medicaid and public assistance programs helps reduce the
   93  state’s skyrocketing costs, makes more funds available for
   94  essential services, and improves the quality of care and the
   95  health status of our residents, and
   96         WHEREAS, aggressive and comprehensive measures are needed
   97  at the state level to investigate and prosecute Medicaid and
   98  public assistance fraud and to recover dollars stolen from these
   99  programs, and
  100         WHEREAS, new statewide initiatives and coordinated efforts
  101  are necessary to focus resources in order to aid law enforcement
  102  and investigative agencies in detecting and deterring this type
  103  of fraudulent activity, NOW, THEREFORE,
  105  Be It Enacted by the Legislature of the State of Florida:
  107         Section 1. Section 624.35, Florida Statutes, is created to
  108  read:
  109         624.35Short title.—Sections 624.35-624.352 may be cited as
  110  the “Medicaid and Public Assistance Fraud Strike Force Act.”
  111         Section 2. Section 624.351, Florida Statutes, is created to
  112  read:
  113         624.351Medicaid and Public Assistance Fraud Strike Force.—
  114         (1)LEGISLATIVE FINDINGS.—The Legislature finds that there
  115  is a need to develop and implement a statewide strategy to
  116  coordinate state and local agencies, law enforcement entities,
  117  and investigative units in order to increase the effectiveness
  118  of programs and initiatives dealing with the prevention,
  119  detection, and prosecution of Medicaid and public assistance
  120  fraud.
  121         (2) ESTABLISHMENT.—The Medicaid and Public Assistance Fraud
  122  Strike Force is created within the department to oversee and
  123  coordinate state and local efforts to eliminate Medicaid and
  124  public assistance fraud and to recover state and federal funds.
  125  The strike force shall serve in an advisory capacity and provide
  126  recommendations and policy alternatives to the Chief Financial
  127  Officer.
  128         (3)MEMBERSHIP.—The strike force shall consist of the
  129  following 11 members who may not designate anyone to serve in
  130  their place:
  131         (a)The Chief Financial Officer, who shall serve as chair.
  132         (b) The Attorney General, who shall serve as vice chair.
  133         (c) The executive director of the Department of Law
  134  Enforcement.
  135         (d) The Secretary of Health Care Administration.
  136         (e)The Secretary of Children and Family Services.
  137         (f)The State Surgeon General.
  138         (g) Five members appointed by the Chief Financial Officer,
  139  consisting of two sheriffs, two chiefs of police, and one state
  140  attorney. When making these appointments, the Chief Financial
  141  Officer shall consider representation by geography, population,
  142  ethnicity, and other relevant factors in order to ensure that
  143  the membership of the strike force is representative of the
  144  state as a whole.
  146         (a)The five members appointed by the Chief Financial
  147  Officer will serve 4-year terms; however, for the purpose of
  148  providing staggered terms, of the initial appointments, two
  149  members will be appointed to a 2-year term, two members will be
  150  appointed to a 3-year term, and one member will be appointed to
  151  a 4-year term. The remaining members are standing members of the
  152  strike force and may not serve beyond the time he or she holds
  153  the position that was the basis for strike force membership. A
  154  vacancy shall be filled in the same manner as the original
  155  appointment but only for the unexpired term.
  156         (b)The Legislature finds that the strike force serves a
  157  legitimate state, county, and municipal purpose and that service
  158  on the strike force is consistent with a member’s principal
  159  service in a public office or employment. Therefore membership
  160  on the strike force does not disqualify a member from holding
  161  any other public office or from being employed by a public
  162  entity, except that a member of the Legislature may not serve on
  163  the strike force.
  164         (c)Members of the strike force shall serve without
  165  compensation, but are entitled to reimbursement for per diem and
  166  travel expenses pursuant to s. 112.061. Reimbursements may be
  167  paid from appropriations provided to the department by the
  168  Legislature for the purposes of this section.
  169         (d)The Chief Financial Officer shall appoint a chief of
  170  staff for the strike force who must have experience, education,
  171  and expertise in the fields of law, prosecution, or fraud
  172  investigations and shall serve at the pleasure of the Chief
  173  Financial Officer. The department shall provide the strike force
  174  with staff necessary to assist the strike force in the
  175  performance of its duties.
  176         (5)MEETINGS.—The strike force shall hold its
  177  organizational session by March 1, 2011. Thereafter, the strike
  178  force shall meet at least four times per year. Additional
  179  meetings may be held if the chair determines that extraordinary
  180  circumstances require an additional meeting. Members may appear
  181  by electronic means. A majority of the members of the strike
  182  force constitutes a quorum.
  183         (6)STRIKE FORCE DUTIES.—The strike force shall provide
  184  advice and make recommendations, as necessary, to the Chief
  185  Financial Officer.
  186         (a) The strike force may advise the Chief Financial Officer
  187  on initiatives that include, but are not limited to:
  188         1. Conducting a census of local, state, and federal efforts
  189  to address Medicaid and public assistance fraud in this state,
  190  including fraud detection, prevention, and prosecution, in order
  191  to discern overlapping missions, maximize existing resources,
  192  and strengthen current programs.
  193         2. Developing a strategic plan for coordinating and
  194  targeting state and local resources for preventing and
  195  prosecuting Medicaid and public assistance fraud. The plan must
  196  identify methods to enhance multiagency efforts that contribute
  197  to achieving the state’s goal of eliminating Medicaid and public
  198  assistance fraud.
  199         3. Identifying methods to implement innovative technology
  200  and data sharing in order to detect and analyze Medicaid and
  201  public assistance fraud with speed and efficiency.
  202         4.Establishing a program to provide grants to state and
  203  local agencies that develop and implement effective Medicaid and
  204  public assistance fraud prevention, detection, and investigation
  205  programs, which are evaluated by the strike force and ranked by
  206  their potential to contribute to achieving the state’s goal of
  207  eliminating Medicaid and public assistance fraud. The grant
  208  program may also provide startup funding for new initiatives by
  209  local and state law enforcement or administrative agencies to
  210  combat Medicaid and public assistance fraud.
  211         5.Developing and promoting crime prevention services and
  212  educational programs that serve the public, including, but not
  213  limited to, a well-publicized rewards program for the
  214  apprehension and conviction of criminals who perpetrate Medicaid
  215  and public assistance fraud.
  216         6. Providing grants, contingent upon appropriation, for
  217  multiagency or state and local Medicaid and public assistance
  218  fraud efforts, which include, but are not limited to:
  219         a. Providing for a Medicaid and public assistance fraud
  220  prosecutor in the Office of the Statewide Prosecutor.
  221         b. Providing assistance to state attorneys for support
  222  services or equipment, or for the hiring of assistant state
  223  attorneys, as needed, to prosecute Medicaid and public
  224  assistance fraud cases.
  225         c.Providing assistance to judges for support services or
  226  for the hiring of senior judges, as needed, so that Medicaid and
  227  public assistance fraud cases can be heard expeditiously.
  228         (b)The strike force shall receive periodic reports from
  229  state agencies, law enforcement officers, investigators,
  230  prosecutors, and coordinating teams regarding Medicaid and
  231  public assistance criminal and civil investigations. Such
  232  reports may include discussions regarding significant factors
  233  and trends relevant to a statewide Medicaid and public
  234  assistance fraud strategy.
  235         (7)REPORTS.—The strike force shall annually prepare and
  236  submit a report on its activities and recommendations, by
  237  October 1, to the President of the Senate, the Speaker of the
  238  House of Representatives, the Governor, and the chairs of the
  239  House of Representatives and Senate committees that have
  240  substantive jurisdiction over Medicaid and public assistance
  241  fraud.
  242         Section 3. Section 624.352, Florida Statutes, is created to
  243  read:
  244         624.352Interagency agreements to detect and deter Medicaid
  245  and public assistance fraud.—
  246         (1) The Chief Financial Officer shall prepare model
  247  interagency agreements for the coordination of prevention,
  248  investigation, and prosecution of Medicaid and public assistance
  249  fraud to be known as “Strike Force” agreements. Parties to such
  250  agreements may include any agency that is headed by a Cabinet
  251  officer, the Governor, the Governor and Cabinet, a collegial
  252  body, or any federal, state, or local law enforcement agency.
  253         (2) The agreements must include, but are not limited to:
  254         (a) Establishing the agreement’s purpose, mission,
  255  authority, organizational structure, procedures, supervision,
  256  operations, deputations, funding, expenditures, property and
  257  equipment, reports and records, assets and forfeitures, media
  258  policy, liability, and duration.
  259         (b) Requiring that parties to an agreement have appropriate
  260  powers and authority relative to the purpose and mission of the
  261  agreement.
  262         Section 4. Section 16.59, Florida Statutes, is amended to
  263  read:
  264         16.59 Medicaid fraud control.—The Medicaid Fraud Control
  265  Unit There is created in the Department of Legal Affairs to the
  266  Medicaid Fraud Control Unit, which may investigate all
  267  violations of s. 409.920 and any criminal violations discovered
  268  during the course of those investigations. The Medicaid Fraud
  269  Control Unit may refer any criminal violation so uncovered to
  270  the appropriate prosecuting authority. The offices of the
  271  Medicaid Fraud Control Unit, and the offices of the Agency for
  272  Health Care Administration Medicaid program integrity program,
  273  and the Divisions of Insurance Fraud and Public Assistance Fraud
  274  within the Department of Financial Services shall, to the extent
  275  possible, be collocated; however, positions dedicated to
  276  Medicaid managed care fraud within the Medicaid Fraud Control
  277  Unit shall be collocated with the Division of Insurance Fraud.
  278  The Agency for Health Care Administration, and the Department of
  279  Legal Affairs, and the Divisions of Insurance Fraud and Public
  280  Assistance Fraud within the Department of Financial Services
  281  shall conduct joint training and other joint activities designed
  282  to increase communication and coordination in recovering
  283  overpayments.
  284         Section 5. Paragraph (o) is added to subsection (2) of
  285  section 20.121, Florida Statutes, to read:
  286         20.121 Department of Financial Services.—There is created a
  287  Department of Financial Services.
  288         (2) DIVISIONS.—The Department of Financial Services shall
  289  consist of the following divisions:
  290         (o) The Division of Public Assistance Fraud.
  291         Section 6. Paragraph (b) of subsection (7) of section
  292  411.01, Florida Statutes, is amended to read:
  293         411.01 School readiness programs; early learning
  294  coalitions.—
  295         (7) PARENTAL CHOICE.—
  296         (b) If it is determined that a provider has provided any
  297  cash to the beneficiary in return for receiving the purchase
  298  order, the early learning coalition or its fiscal agent shall
  299  refer the matter to the Department of Financial Services
  300  pursuant to s. 414.411 Division of Public Assistance Fraud for
  301  investigation.
  302         Section 7. Subsection (2) of section 414.33, Florida
  303  Statutes, is amended to read:
  304         414.33 Violations of food stamp program.—
  305         (2) In addition, the department shall establish procedures
  306  for referring to the Department of Law Enforcement any case that
  307  involves a suspected violation of federal or state law or rules
  308  governing the administration of the food stamp program to the
  309  Department of Financial Services pursuant to s. 414.411.
  310         Section 8. Subsection (9) of section 414.39, Florida
  311  Statutes, is amended to read:
  312         414.39 Fraud.—
  313         (9) All records relating to investigations of public
  314  assistance fraud in the custody of the department and the Agency
  315  for Health Care Administration are available for examination by
  316  the Department of Financial Services Law Enforcement pursuant to
  317  s. 414.411 943.401 and are admissible into evidence in
  318  proceedings brought under this section as business records
  319  within the meaning of s. 90.803(6).
  320         Section 9. Section 943.401, Florida Statutes, is
  321  transferred, renumbered as section 414.411, Florida Statutes,
  322  and amended to read:
  323         414.411 943.401 Public assistance fraud.—
  324         (1)(a) The Department of Financial Services Law Enforcement
  325  shall investigate all public assistance provided to residents of
  326  the state or provided to others by the state. In the course of
  327  such investigation the department of Law Enforcement shall
  328  examine all records, including electronic benefits transfer
  329  records and make inquiry of all persons who may have knowledge
  330  as to any irregularity incidental to the disbursement of public
  331  moneys, food stamps, or other items or benefits authorizations
  332  to recipients.
  333         (b) All public assistance recipients, as a condition
  334  precedent to qualification for public assistance received and as
  335  defined under the provisions of chapter 409, chapter 411, or
  336  this chapter 414, must shall first give in writing, to the
  337  Agency for Health Care Administration, the Department of Health,
  338  the Agency for Workforce Innovation, and the Department of
  339  Children and Family Services, as appropriate, and to the
  340  Department of Financial Services Law Enforcement, consent to
  341  make inquiry of past or present employers and records, financial
  342  or otherwise.
  343         (2) In the conduct of such investigation the Department of
  344  Financial Services Law Enforcement may employ persons having
  345  such qualifications as are useful in the performance of this
  346  duty.
  347         (3) The results of such investigation shall be reported by
  348  the Department of Financial Services Law Enforcement to the
  349  appropriate legislative committees, the Agency for Health Care
  350  Administration, the Department of Health, the Agency for
  351  Workforce Innovation, and the Department of Children and Family
  352  Services, and to such others as the department of Law
  353  Enforcement may determine.
  354         (4) The Department of Health and the Department of Children
  355  and Family Services shall report to the Department of Financial
  356  Services Law Enforcement the final disposition of all cases
  357  wherein action has been taken pursuant to s. 414.39, based upon
  358  information furnished by the Department of Financial Services
  359  Law Enforcement.
  360         (5) All lawful fees and expenses of officers and witnesses,
  361  expenses incident to taking testimony and transcripts of
  362  testimony and proceedings are a proper charge to the Department
  363  of Financial Services Law Enforcement.
  364         (6) The provisions of this section shall be liberally
  365  construed in order to carry out effectively the purposes of this
  366  section in the interest of protecting public moneys and other
  367  public property.
  368         Section 10. Section 409.91212, Florida Statutes, is created
  369  to read:
  370         409.91212 Medicaid managed care fraud.—
  371         (1) Each managed care plan, as defined in s. 409.920(1)(e),
  372  shall adopt an anti-fraud plan addressing the detection and
  373  prevention of overpayments, abuse, and fraud relating to the
  374  provision of and payment for Medicaid services and submit the
  375  plan to the Office of the Inspector General within the agency
  376  for approval. At a minimum, the anti-fraud plan must include:
  377         (a) A written description or chart outlining the
  378  organizational arrangement of the plan’s personnel who are
  379  responsible for the investigation and reporting of possible
  380  overpayment, abuse, or fraud;
  381         (b) A description of the plan’s procedures for detecting
  382  and investigating possible acts of fraud, abuse, and
  383  overpayment;
  384         (c) A description of the plan’s procedures for the
  385  mandatory reporting of possible overpayment, abuse, or fraud to
  386  the Office of the Inspector General within the agency;
  387         (d) A description of the plan’s program and procedures for
  388  educating and training personnel on how to detect and prevent
  389  fraud, abuse, and overpayment;
  390         (e) The name, address, telephone number, e-mail address,
  391  and fax number of the individual responsible for carrying out
  392  the anti-fraud plan; and
  393         (f) A summary of the results of the investigations of
  394  fraud, abuse, or overpayment which were conducted during the
  395  previous year by the managed care organization’s fraud
  396  investigative unit.
  397         (2) A managed care plan that provides Medicaid services
  398  shall:
  399         (a) Establish and maintain a fraud investigative unit to
  400  investigate possible acts of fraud, abuse, and overpayment; or
  401         (b) Contract for the investigation of possible fraudulent
  402  or abusive acts by Medicaid recipients, persons providing
  403  services to Medicaid recipients, or any other persons.
  404         (3) If a managed care plan contracts for the investigation
  405  of fraudulent claims and other types of program abuse by
  406  recipients or service providers, the managed care plan shall
  407  file the following with the Office of the Inspector General
  408  within the agency for approval before the plan executes any
  409  contracts for fraud and abuse prevention and detection:
  410         (a) A copy of the written contract between the plan and the
  411  contracting entity;
  412         (b) The names, addresses, telephone numbers, e-mail
  413  addresses, and fax numbers of the principals of the entity with
  414  which the managed care plan has contracted; and
  415         (c) A description of the qualifications of the principals
  416  of the entity with which the managed care plan has contracted.
  417         (4) On or before September 1 of each year, each managed
  418  care plan shall report to the Office of the Inspector General
  419  within the agency on its experience in implementing an anti
  420  fraud plan, as provided under subsection (1), and, if
  421  applicable, conducting or contracting for investigations of
  422  possible fraudulent or abusive acts as provided under this
  423  section for the prior state fiscal year. The report must
  424  include, at a minimum:
  425         (a) The dollar amount of losses and recoveries attributable
  426  to overpayment, abuse, and fraud.
  427         (b) The number of referrals to the Office of the Inspector
  428  General during the prior year.
  429         (5) If a managed care plan fails to timely submit a final
  430  acceptable anti-fraud plan, fails to timely submit its annual
  431  report, fails to implement its anti-fraud plan or investigative
  432  unit, if applicable, or otherwise refuses to comply with this
  433  section, the agency shall impose:
  434         (a) An administrative fine of $2,000 per calendar day for
  435  failure to submit an acceptable anti-fraud plan or report until
  436  the agency deems the managed care plan or report to be in
  437  compliance;
  438         (b) An administrative fine of not more than $10,000 for
  439  failure by a managed care plan to implement an anti-fraud plan
  440  or investigative unit, as applicable; or
  441         (c) The administrative fines pursuant to paragraphs (a) and
  442  (b).
  443         (6) Each managed care plan shall report all suspected or
  444  confirmed instances of provider or recipient fraud or abuse
  445  within 15 calendar days after detection to the Office of the
  446  Inspector General within the agency. At a minimum the report
  447  must contain the name of the provider or recipient, the Medicaid
  448  billing number or tax identification number, and a description
  449  of the fraudulent or abusive act. The Office of the Inspector
  450  General in the agency shall forward the report of suspected
  451  overpayment, abuse, or fraud to the appropriate investigative
  452  unit, including, but not limited to, the Bureau of Medicaid
  453  program integrity, the Medicaid fraud control unit, the Division
  454  of Public Assistance Fraud, the Division of Insurance Fraud, or
  455  the Department of Law Enforcement.
  456         (a) Failure to timely report shall result in an
  457  administrative fine of $1,000 per calendar day after the 15th
  458  day of detection.
  459         (b) Failure to timely report may result in additional
  460  administrative, civil, or criminal penalties.
  461         (7) The agency may adopt rules to administer this section.
  462         Section 11. Review of the Medicaid fraud and abuse
  463  processes.—
  464         (1)The Auditor General and the Office of Program Policy
  465  Analysis and Government Accountability shall review and evaluate
  466  the Agency for Health Care Administration’s Medicaid fraud and
  467  abuse systems, including the Medicaid program integrity program.
  468  The reviewers may access Medicaid-related information and data
  469  from the Attorney General’s Medicaid Fraud Control Unit, the
  470  Department of Health, the Department of Elderly Affairs, the
  471  Agency for Persons with Disabilities, and the Department of
  472  Children and Family Services, as necessary, to conduct the
  473  review. The review must include, but is not limited to:
  474         (a)An evaluation of current Medicaid policies and the
  475  Medicaid fiscal agent;
  476         (b)An analysis of the Medicaid fraud and abuse prevention
  477  and detection processes, including agency contracts, Medicaid
  478  databases, and internal control risk assessments;
  479         (c)A comprehensive evaluation of the effectiveness of the
  480  current laws, rules, and contractual requirements that govern
  481  Medicaid managed care entities;
  482         (d)An evaluation of the agency’s Medicaid managed care
  483  oversight processes;
  484         (e)Recommendations to improve the Medicaid claims
  485  adjudication process, to increase the overall efficiency of the
  486  Medicaid program, and to reduce Medicaid overpayments; and
  487         (f)Operational and legislative recommendations to improve
  488  the prevention and detection of fraud and abuse in the Medicaid
  489  managed care program.
  490         (2)The Auditor General’s Office and the Office of Program
  491  Policy Analysis and Government Accountability may contract with
  492  technical consultants to assist in the performance of the
  493  review. The Auditor General and the Office of Program Policy
  494  Analysis and Government Accountability shall report to the
  495  President of the Senate, the Speaker of the House of
  496  Representatives, and the Governor by December 1, 2011.
  497         Section 12. Medicaid claims adjudication project.—The
  498  Agency for Health Care Administration shall issue a competitive
  499  procurement pursuant to chapter 287, Florida Statutes, with a
  500  third-party vendor, at no cost to the state, to provide a real
  501  time, front-end database to augment the Medicaid fiscal agent
  502  program edits and claims adjudication process. The vendor shall
  503  provide an interface with the Medicaid fiscal agent to decrease
  504  inaccurate payment to Medicaid providers and improve the overall
  505  efficiency of the Medicaid claims-processing system.
  506         Section 13. All powers, duties, functions, records,
  507  offices, personnel, property, pending issues and existing
  508  contracts, administrative authority, administrative rules, and
  509  unexpended balances of appropriations, allocations, and other
  510  funds relating to public assistance fraud in the Department of
  511  Law Enforcement are transferred by a type two transfer, as
  512  defined in s. 20.06(2), Florida Statutes, to the Division of
  513  Public Assistance Fraud in the Department of Financial Services.
  514         Section 14. Except for sections 10 and 11 of this act and
  515  this section, which shall take effect upon this act becoming a
  516  law, this act shall take effect January 1, 2011.

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