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FL H0389

Bill

Status

Failed

6/16/2025

Primary Sponsor

Felicia Simone Robinson

Click for details

Origin

House of Representatives

2025 Regular Session

AI Summary

  • Medicaid managed care plan enrollees may receive care from out-of-network Medicaid providers if they cannot access an in-network provider in a timely manner consistent with reasonable access standards set by Agency for Health Care Administration (AHCA) rule
  • Enrollees may also use out-of-network Medicaid providers when another appropriate Medicaid provider is located closer to the enrollee's residence than any in-network provider
  • Managed care plans must reimburse nonparticipating Medicaid providers at the applicable Medicaid rate for services rendered under the plan
  • Amends sections 409.967 and 409.975, Florida Statutes, to add these out-of-network access requirements to both AHCA's contract standards and the managed medical assistance program's provider network rules
  • Effective date is July 1, 2025

Legislative Description

Managed Care Plan Network Access

Last Action

Died in Health Care Facilities & Systems Subcommittee

6/16/2025

Committee Referrals

Health Care Facilities & Systems Subcommittee2/12/2025

Full Bill Text

No bill text available