Bill > S0648

This bill establishes a new framework for Medicaid reimbursement of private duty nursing services in pediatric continuing care integrated communities, which are defined as groups of affiliated businesses providing coordinated care for medically fragile children under 21. The bill requires Medicaid managed care plans to reimburse home health agencies for private duty nursing services in community residential group homes at 100 percent of the "prevailing hourly rate" in their geographic area, and prohibits reducing reimbursement based on the number of Medicaid-eligible persons receiving services in the same dwelling space. The legislation defines key terms like "geographic area" (the region where the community is located) and "prevailing hourly rate" (the usual contracted hourly rate for nursing services in that area), and mandates that managed care plans and affiliated businesses negotiate rates at least annually. The Agency for Health Care Administration is required to seek federal approval for these changes within 30 days of the act's effective date and implement the changes upon receiving that approval. The bill aims to ensure fair and consistent reimbursement for private duty nursing services in specialized care settings for medically complex children.

https://www.flsenate.gov/Session/Bill/2026/648