HB 1059: Managed Care Plan Accountability

• Agency for Health Care Administration authorized to impose fines and other sanctions on managed care plans that willfully fail to comply with prompt payment requirements under sections 641.315, 641.3155, 641.513, and 409.982(5).

• Managed care plans must offer network contracts to nursing homes, hospices, and aging network service providers that previously participated in home and community-based waivers or Department of Elderly Affairs programs for the first 12 months of any contract period following procurement.

• Plans may exclude providers after 12 months of active participation for failure to meet quality or performance criteria, but must provide written notice at least 30 days before exclusion and report exclusion criteria to the agency.

• Enrolled Medicaid nursing homes and hospices must participate in all eligible plans selected by the agency in their region, except for plans from which they have been excluded.

• Agency for Health Care Administration must submit a compliance report to the Governor and Legislature by January 15, 2018, covering the period from program implementation through June 30, 2017, detailing monitoring actions and sanctions imposed.

• Effective date: July 1, 2017.