FL H1457

Agency for Health Care Administration must establish specific network requirements for each type of behavioral health provider, including community-based and residential providers, serving Medicaid enrollees.

Agency must conduct systematic and continuous testing of behavioral health provider networks to confirm accuracy, that providers are accepting enrollees, and that enrollees have timely access to services, with provider-specific data on access timeliness.

Managed care plans must collect and report Adult Core Set behavioral health measures beginning with 2025 calendar year data and must stratify reported measures by age, sex, race, ethnicity, primary language, and disability status beginning with 2026 data.

Agency must establish specific outcome performance measures to reduce crisis stabilization services use for children and adolescents who are high users, with plan-specific year-over-year improvement targets.

Agency must submit annual reports to Legislature beginning October 1, 2023, on Medicaid-enrolled children and adolescents who are highest users of crisis stabilization services, including performance data, network testing data, and enforcement actions taken.