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FL S1478
Bill
AI Summary
- Prohibits Medicaid managed care organizations, managed care plans, and their subcontractors from referring Medicaid recipients for treatments or services to providers, subcontractors, or third-party entities in which they have any ownership interest or profit-sharing arrangement
- Authorizes the Agency for Health Care Administration (AHCA) to conduct reviews, investigations, analyses, audits, or any combination thereof to determine if managed care organizations or plans have violated this referral prohibition
- Violations are subject to existing Medicaid program integrity sanctions, including suspension for up to 1 year, termination for up to 20 years, and fines of up to $5,000 per violation
- Amends sections 409.913 and 409.967 of Florida Statutes governing Medicaid program integrity oversight and managed care plan accountability
- Effective date is July 1, 2025
Legislative Description
Patient Referrals by Medicaid Managed Care Organizations and Managed Care Plans
Last Action
Died in Health Policy
6/16/2025
Full Bill Text
No bill text available