Florida Senate - 2023 SB 188
By Senator Polsky
30-00525-23 2023188__
1 A bill to be entitled
2 An act relating to Medicaid coverage of prescribed
3 food programs for disease treatment and prevention;
4 creating s. 409.90203, F.S.; defining terms; requiring
5 the Agency for Health Care Administration, in
6 conjunction with the Department of Health, to, by a
7 specified date, establish the Food Is Medicine Program
8 for a specified purpose, seek certain federal approval
9 and waivers for implementation of the program, and
10 adopt certain rules; providing requirements for the
11 rules; providing an effective date.
12
13 Be It Enacted by the Legislature of the State of Florida:
14
15 Section 1. Section 409.90203, Florida Statutes, is created
16 to read:
17 409.90203 Food Is Medicine Program; Medicaid coverage for
18 cost-reducing programs providing medically tailored groceries,
19 medically tailored meals, and produce prescriptions; federal
20 approval and waivers.—
21 (1) As used in this section, the term:
22 (a) “Medically tailored groceries” means family-sized sets
23 of fresh and healthful groceries, prescribed by a physician
24 licensed under chapter 458 or chapter 459 and purchased and
25 distributed with education and support to change eating habits,
26 which:
27 1. Are in a protocol standard selected by a dietitian or
28 nutritionist licensed under part X of chapter 468 as part of a
29 6-month intervention treatment program that includes, at a
30 minimum, behavioral health counseling, nutrition education, Food
31 Is Medicine functional medicine classes, anatomy of disease
32 classes, cooking classes, weekly menus and shopping lists,
33 grocery store tours, exercise classes, and supports for habit
34 changes, such as peer mentoring and health coaching, for a
35 Medicaid recipient diagnosed with a specific disease or
36 condition to effectively control and reverse the effects of such
37 disease or condition.
38 2. May be picked up at an event organized by the program or
39 by an entity under contract with the program or may be delivered
40 by the program or by an entity under contract with the program
41 to the residence of the Medicaid recipient.
42 3. May include healthful prepared ingredients, herbs,
43 spices, sauces, at-home lab tests, supplements, or telehealth
44 components.
45 (b) “Medically tailored meals” means meals that are:
46 1. Provided through a referral from a physician licensed
47 under chapter 458 or chapter 459;
48 2. Designed and approved by a dietitian or nutritionist
49 licensed under part X of chapter 468 to reflect appropriate
50 medical nutrition therapy based on the latest evidence-based
51 practice guidelines for a medical condition or disease that
52 requires the referral provided in subparagraph 1.;
53 3. Fully prepared by a Medicaid provider or by a person or
54 entity under contract with a Medicaid provider; and
55 4. Delivered to the residence of the Medicaid recipient
56 diagnosed with the medical condition or disease for which the
57 meals are designed to control or reverse the disease effects and
58 reduce high-cost health care utilization by the enrolled patient
59 while improving the quality of life and increasing the lifespan
60 of the patient.
61 (c) “Produce prescription” means a program prescribed by a
62 physician licensed under chapter 458 or chapter 459 to a
63 Medicaid recipient who has or is at risk for a diet-related
64 disease or condition, including, but not limited to, diabetes,
65 coronary heart disease, cancer, obesity, renal disease, asthma,
66 or dementia, which uses vouchers or a debit card for free or
67 discounted fresh produce to incentivize the Medicaid recipient
68 to purchase and consume fresh produce.
69 1. The voucher or debit card may be redeemed at a farm
70 store, a farm packing house, a mobile farmers’ market, or a
71 market as defined in s. 414.456; through delivery by a
72 supermarket or a grocery store; or through a Medicaid provider.
73 2. The fresh produce in the program must be in a protocol
74 standard selected by a dietitian or nutritionist licensed under
75 part X of chapter 468 as part of a treatment program that may
76 include behavioral health counseling, nutrition education, Food
77 Is Medicine functional medicine classes, anatomy of disease
78 classes, cooking classes, weekly menus and shopping lists,
79 grocery store tours, exercise classes, and supports for habit
80 changes, such as peer mentoring and health coaching, for a
81 Medicaid recipient diagnosed with a specific disease or
82 condition to effectively control and reverse the effects of such
83 disease or condition.
84 (2) By July 1, 2024, the Agency for Health Care
85 Administration, in conjunction with the Department of Health,
86 shall:
87 (a) Establish the Food Is Medicine Program to provide
88 Medicaid coverage for purchases and deliveries of prescribed
89 healthful foods in disease-specific protocols through medically
90 tailored groceries, medically tailored meals, and produce
91 prescriptions to meet the specific needs of Medicaid recipients
92 who have or who are at risk of a diet-related disease or
93 condition and who are either high-need patients or patients with
94 high-cost patient care or who have the highest health care
95 utilization. The program shall establish the impact of healthful
96 foods on the health outcomes of such Medicaid recipients and the
97 cost effectiveness of such evidence-based practices.
98 (b) Seek:
99 1. The program’s approval by the United States Secretary of
100 Health and Human Services under s. 1115 of the Social Security
101 Act, which gives the secretary the authority to approve
102 experimental, pilot, or demonstration projects that are likely
103 to assist in promoting the objectives of the Medicaid program.
104 2. Any federal waivers necessary for the implementation of
105 the program, including any waivers necessary to secure Title XIX
106 matching funds for the program. The federal waiver application
107 shall seek Medicaid matching funds for all general revenue,
108 family contributions, and local contributions.
109 (c) Adopt rules that provide for all of the following, at a
110 minimum:
111 1. The quality standards for and the number of medically
112 tailored meals delivered per week to an enrolled Medicaid
113 recipient.
114 2. The moneys allowed per enrolled Medicaid recipient for
115 medically tailored groceries or for produce prescriptions.
116 3. Notification to Medicaid providers and Medicaid
117 recipients of the availability of and requirements for medically
118 tailored meals, medically tailored groceries, and produce
119 prescriptions.
120 4. Methodology for:
121 a. Providing vouchers or debit cards to enrolled Medicaid
122 recipients for produce prescriptions.
123 b. Reimbursing Medicaid providers and other entities as
124 applicable for products, events, services, classes, or
125 activities provided under the Food Is Medicine Program by the
126 programs that use medically tailored groceries, medically
127 tailored meals, and produce prescription models.
128 Section 2. This act shall take effect July 1, 2023.