The bill amends sections 409.967 and 409.975 of the Florida Statutes to enhance access to care for enrollees in Medicaid managed care plans. It requires the Agency for Health Care Administration to include specific contract requirements that ensure managed care plans maintain adequate provider networks. Notably, the bill allows enrollees to seek care from Medicaid providers not under contract with their plan if they cannot receive timely care from participating providers or if a more accessible provider is available. In such cases, the plans are mandated to reimburse these nonparticipating providers at the applicable Medicaid rates.

Additionally, the bill emphasizes the importance of maintaining accurate and complete electronic databases of contracted providers, which must be accessible to both the agency and the public. It also requires managed care plans to submit quarterly reports on enrollee assignments to primary care providers and mandates that plans publish their drug formularies online. The effective date for this act is set for July 1, 2025.

Statutes affected:
H 389 Filed: 409.967