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CS/CS/SB 1950 — Statewide Medicaid Managed Care Program
by Appropriations Committee; Health Policy Committee; and Senator Brodeur
This summary is provided for information only and does not represent the opinion of any Senator, Senate Officer, or Senate Office.
Prepared by: Health Policy Committee (HP)
The bill makes changes to the Statewide Medicaid Managed Care (SMMC) program in anticipation of the next competitive procurement of managed care plans for the 2025 plan year. The bill:
- Requires provider service networks (PSNs) to be reimbursed on a prepaid basis by removing the option for fee-for-service reimbursement.
- Authorizes the Agency for Health Care Administration (AHCA) to select eligible managed care plans to provide services through a single statewide procurement and deletes the requirement that the AHCA conduct separate and simultaneous procurements for each Medicaid region.
- Outlines a new regional structure for plan selection under the SMMC program’s Managed Medical Assistance (MMA) and Long-Term Care Managed Care (LTCMC) programs with a minimum and maximum number of plans designated for each region.
- The bill provides for nine regions named by letters (Regions A-I), rather than the 11 regions named by numbers (Regions 1-11) in preexisting law.
- Maintains the preexisting requirement for the AHCA to award a contract to at least one PSN in each of the nine regions under the MMA and LTCMC programs.
- Requires managed care plans to contract with Florida cancer hospitals that meet specified federal criteria as statewide essential providers and provides a payment rate for services provided by those hospitals without a contract.
- Revises MMA plan healthy behaviors program requirements to include tobacco cessation programs, rather than smoking cessation programs, and to clarify that substance abuse programs must include opioid abuse recovery.
- Authorizes an MMA Child Welfare Specialty Plan to serve a child in a permanent guardianship placement whose caregivers receive payments through the Guardianship Assistance Program.
- Deletes obsolete language.
- Requires the AHCA to amend existing SMMC contracts to implement specific provisions of the bill and directs the AHCA to implement the procurement-related provisions for the 2025 plan year.
If approved by the Governor, these provisions take effect July 1, 2022.
Vote: Senate 38-0; House 115-0