Bill > H0389

This bill modifies Florida's Medicaid managed care regulations to improve patient access to healthcare providers. Specifically, the legislation allows Medicaid managed care plan enrollees to receive care from Medicaid providers outside their plan's network under two key circumstances: first, if they are unable to receive timely care from a participating provider according to established access standards, and second, if an alternative Medicaid provider is more geographically convenient to the patient's residence. When patients access care through these alternative providers, the managed care plans are required to reimburse the non-contracted Medicaid providers at the standard Medicaid rate for those services. The bill also requires managed care plans to maintain accurate electronic databases of their contracted providers, including detailed information such as licensure, location, hours of operation, and performance indicators. These databases must be publicly accessible and capable of comparing provider availability to network adequacy standards. The changes aim to enhance healthcare accessibility and flexibility for Medicaid enrollees by ensuring they can receive necessary medical services even when their primary managed care plan's network is limited. The provisions will take effect on July 1, 2025.

Health and Social Services

https://www.flsenate.gov/Session/Bill/2025/389