Florida Senate - 2023 CS for SB 988
By the Committee on Health Policy; and Senator Burton
588-02516-23 2023988c1
1 A bill to be entitled
2 An act relating to Medicaid coverage of continuous
3 glucose monitors; creating s. 409.9063, F.S.; defining
4 the term “continuous glucose monitor”; requiring the
5 Agency for Health Care Administration, subject to the
6 availability of funds and certain limitations and
7 directions, to provide coverage for continuous glucose
8 monitors for certain Medicaid recipients; providing
9 construction; providing requirements for Medicaid
10 recipients to continue receiving coverage for their
11 continuous glucose monitors; requiring the agency to
12 seek federal approval for implementation of the act,
13 if needed; requiring the agency to include the rate
14 impact of the act in certain rates that become
15 effective on a specified date; providing an effective
16 date.
17
18 Be It Enacted by the Legislature of the State of Florida:
19
20 Section 1. Section 409.9063, Florida Statutes, is created
21 to read:
22 409.9063 Coverage of continuous glucose monitors for
23 Medicaid recipients.—
24 (1) As used in this section, the term “continuous glucose
25 monitor” means an instrument or a device designed for the
26 purpose of aiding in the treatment of diabetes by measuring
27 glucose levels on demand or at set intervals through a small,
28 electronic sensor that slightly penetrates a person’s skin when
29 applied and that is designed to remain in place and active for
30 at least 7 days.
31 (2) Subject to the availability of funds and subject to any
32 limitations or directions provided in the General Appropriations
33 Act, the agency must provide coverage for a continuous glucose
34 monitor under the Medicaid pharmacy benefit for the treatment of
35 a Medicaid recipient if:
36 (a) The recipient has been diagnosed by his or her primary
37 care physician, or another licensed health care practitioner
38 authorized to make such diagnosis, with Type 1 diabetes, Type 2
39 diabetes, gestational diabetes, or any other type of diabetes
40 that may be treated with insulin; and
41 (b) A health care practitioner with the applicable
42 prescribing authority has prescribed insulin to treat the
43 recipient’s diabetes and a continuous glucose monitor to assist
44 the recipient and practitioner in managing the recipient’s
45 diabetes.
46 (3) Coverage under this section includes the cost of any
47 necessary repairs or replacement parts for the continuous
48 glucose monitor.
49 (4) To qualify for continued coverage under this section,
50 the Medicaid recipient must participate in follow-up care with
51 his or her treating health care practitioner, in person or
52 through telehealth, at least once every 6 months during the
53 first 18 months after the first prescription of the continuous
54 glucose monitor for the recipient has been issued under this
55 section, to assess the efficacy of using the monitor for
56 treatment of his or her diabetes. After the first 18 months,
57 such follow-up care must occur at least once every 12 months.
58 (5) The agency shall seek federal approval, if needed, for
59 the implementation of this section.
60 Section 2. The Agency for Health Care Administration shall
61 include the rate impact of this act in the Medicaid managed
62 medical assistance program and long-term care managed care
63 program rates, as applicable, that take effect on October 1,
64 2023.
65 Section 3. This act shall take effect October 1, 2023.