FL H0967

Creates section 409.9063, Florida Statutes, to establish Medicaid coverage for continuous glucose monitors (CGMs) defined as electronic sensors designed to measure glucose levels and remain active for at least 7 days

Requires the Agency for Health Care Administration to provide CGM coverage under the Medicaid pharmacy benefit for recipients diagnosed with Type 1 diabetes, Type 2 diabetes, gestational diabetes, or insulin-treatable diabetes who have been prescribed insulin and a CGM by a licensed health care practitioner

Includes coverage for necessary repairs and replacement parts for continuous glucose monitors

Mandates Medicaid recipients participate in follow-up care with their treating practitioner in person or via telehealth at least once every 6 months for the first 18 months after initial CGM prescription, then at least once every 12 months thereafter

Takes effect October 1, 2023, with the Agency for Health Care Administration required to seek federal approval if needed and include the rate impact in Medicaid managed medical assistance and long-term care managed care program rates