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FL S1648

Bill

Status

Introduced

1/9/2026

Primary Sponsor

Ileana Garcia

Click for details

Origin

Senate

2026 Regular Session

AI Summary

  • Creates s. 409.9775, F.S., requiring Medicaid managed care plans to use a standardized credentialing process for applied behavior analysis (ABA) providers, notify providers of all deficiencies within 15 days, and complete initial credentialing within 60 days of a clean application
  • Prohibits managed care plans from imposing moratoria on ABA provider enrollment unless they demonstrate to the Agency for Health Care Administration that network adequacy is fully met and the moratorium is narrowly tailored, time-limited, and necessary for a documented compliance issue
  • Requires a minimum 120-day continuity-of-care period for recipients newly enrolled in a plan or transitioning providers, during which prior authorizations must be honored and may not be reduced due to administrative delays
  • Mandates that coverage and utilization decisions for ABA services be based on individualized medical necessity rather than age-based hour targets or incentive benchmarks, with reviews conducted by reviewers experienced in ABA and reauthorization cycles of no less than 90 days
  • Requires managed care plans to pay clean claims under prompt payment rules, provide code-specific explanations for denials or partial payments, maintain stable electronic portals, and offer providers a defined escalation pathway for credentialing, utilization, and claims issues — effective July 1, 2026

Legislative Description

Access to Applied Behavior Analysis Services

Last Action

Introduced

1/22/2026

Full Bill Text

No bill text available