Florida Senate - 2026                                    SB 1470
       
       
        
       By Senator Bernard
       
       
       
       
       
       24-01110A-26                                          20261470__
    1                        A bill to be entitled                      
    2         An act relating to behavioral health intervention
    3         services; creating s. 409.9206, F.S.; providing
    4         legislative findings and purpose; defining terms;
    5         authorizing, contingent upon an appropriation, the
    6         state Medicaid plan to fund a demonstration pilot
    7         program in a specified region for specified purposes;
    8         authorizing Medicaid managed assistance providers to
    9         offer specified intervention services to certain
   10         participants under the pilot program; providing
   11         requirements for the pilot program; requiring the
   12         state Medicaid plan to prepare and submit a specified
   13         report to the Legislature as soon as practicable after
   14         the expiration of the pilot program; requiring the
   15         state Medicaid plain to consider certain factors when
   16         paying certain capitation rates; providing for future
   17         expiration of the pilot program; providing an
   18         effective date.
   19          
   20  Be It Enacted by the Legislature of the State of Florida:
   21  
   22         Section 1. Section 409.9206, Florida Statutes, is created
   23  to read:
   24         409.9206De-risking disease behavioral health intervention
   25  services pilot program.—
   26         (1)LEGISLATIVE FINDING; PURPOSE.—
   27         (a)The Legislature finds that under federal Medicaid
   28  managed care regulations 42 C.F.R. s. 438.3(e)(2) and 42 C.F.R.
   29  s. 438.16, the Agency for Health Care Administration may approve
   30  de-risking disease behavioral health intervention services.
   31         (b)The purpose of this section is to authorize the state
   32  Medicaid plan to fund a demonstration pilot program that shall
   33  provide a de-risking disease behavioral health intervention
   34  services management plan to recipients of the state Medicaid
   35  plan in Region G, which consists of Indian River, Martin,
   36  Okeechobee, Palm Beach, and St. Lucie Counties.
   37         (2)DEFINITIONS.—As used in this section, the term:
   38         (a)“De-risking disease behavioral health intervention
   39  services” means the following set of five concurrent self
   40  management services and medical nutrition supports demonstrated
   41  in scientific research to improve behavioral health and chronic
   42  disease outcomes:
   43         1.Behavioral health counseling provided by a licensed
   44  clinical social worker for lifestyle modifications for patients
   45  diagnosed with depression and uncontrolled diabetes mellitus.
   46         2.Medical nutrition therapy provided by a registered
   47  dietitian nutritionist for diet and lifestyle modifications for
   48  patients diagnosed with depression and uncontrolled diabetes
   49  mellitus.
   50         3.Biomarker health tracking, nudging, and reporting using
   51  devices approved by the Florida Medicaid Diabetic Supply
   52  Services Coverage Policy to monitor HbA1C, blood sugar glucose,
   53  oxygen, heart rate, lipids, weight, body mass index, blood
   54  pressure, and other biomarkers.
   55         4.Medical disease nutrition education designed for
   56  depression and uncontrolled diabetes mellitus which is evidence
   57  based.
   58         5.Medical nutrition supports that are evidence-based
   59  lifestyle modification services for patients diagnosed with
   60  depression and uncontrolled diabetes mellitus, including, but
   61  not limited to, clinical nutrition groceries, home-delivered
   62  medically tailored meals, produce prescriptions, or other
   63  evidence-based, medically necessary nutrition interventions
   64  demonstrated to be cost effective by scientific research
   65  studies.
   66         (b)“Participant” means a Medicaid recipient and his or her
   67  family participating in the pilot program.
   68         (c)“Pilot program” means the demonstration pilot program
   69  established under this section.
   70         (3)PILOT PROGRAM.—Contingent upon an appropriation, the
   71  state Medicaid plan may fund a demonstration pilot program to
   72  provide de-risking disease behavioral health intervention
   73  services to eligible Medicaid recipients in Region G, which
   74  consists of Indian River, Martin, Okeechobee, Palm Beach, and
   75  St. Lucie Counties.
   76         (a)Under the pilot program, Medicaid managed assistance
   77  providers may offer de-risking disease behavioral health
   78  intervention services:
   79         1.In lieu of services specified in the state Medicaid plan
   80  to a Medicaid recipient who is diagnosed with both:
   81         a.Depression or anxiety; and
   82         b.Diabetes mellitus, obesity, or coronary heart disease.
   83         2.As a disease management plan to 1,000 participants in
   84  Region G.
   85         (b)The design, evaluation, and outcome measures of the
   86  pilot program must be developed from a research evaluation
   87  conducted by nutrition scientists at the Tufts University
   88  Friedman School of Nutrition Science and Policy, a qualified and
   89  accredited academic institution specializing in nutrition, and
   90  program implementation experts at the Florida Health and
   91  Nutrition Coalition.
   92         (c)The pilot program shall:
   93         1.Be designed to provide de-risking disease behavioral
   94  health intervention services, diabetic supply services, chronic
   95  disease self-management and education services, and medical
   96  nutrition supports coverage in lieu of services specified in the
   97  state Medicaid plan.
   98         2.Collect data, including, but not limited to, the rate by
   99  which pilot program participants, and their families, comply
  100  with de-risking disease behavioral health intervention services;
  101  health outcomes and biomarkers associated with the participants
  102  and their families; and overall impact of the pilot program on
  103  participant diagnosis, chronic health condition, and disease
  104  symptoms.
  105         3.Include measures to review and assess data, including
  106  health outcomes and biomarkers, and the impact on participants
  107  and their families to evaluate the overall impact of the pilot
  108  program on disease management.
  109         (4)ANNUAL REPORT.—The state Medicaid plan shall:
  110         (a)As soon as practicable after the expiration of the
  111  pilot program, prepare and submit to the President of the Senate
  112  and the Speaker of the House of Representatives a report on the
  113  number of times during the preceding year the de-risking disease
  114  behavioral health intervention services were used in Indian
  115  River, Martin, Okeechobee, Palm Beach, and St. Lucie Counties, a
  116  summary of the data the state Medicaid plan collected, and
  117  recommendations for any legislative action.
  118         (b)Consider the actual cost, measurable goals and health
  119  outcomes met, and participant adherence to the de-risking
  120  disease behavioral health intervention services when paying the
  121  capitation rates for that managed care organization under the
  122  contract.
  123         (5)EXPIRATION.—
  124         (a)The pilot program shall expire August 31, 2030.
  125         (b)This section expires September 1, 2031.
  126         Section 2. This act shall take effect July 1, 2026.