This bill establishes a new section, 409.9073, in the Florida Statutes to streamline the Medicaid provider credentialing process. It mandates that Medicaid managed care organizations (MCOs) operating in Florida after July 1, 2025, require their providers to meet specific accreditation standards. The bill outlines the procedures for provider enrollment, requiring the Agency for Health Care Administration to enroll providers within 60 days of receiving a clean application. It also introduces a single credentialing application process through a web-based portal managed by credentialing verification organizations, which must complete their review and provide recommendations within 30 days of receiving a clean application.
Additionally, the bill specifies that once a provider's credentialing application is approved, their claims will be eligible for payment retroactively to the date of approval. It prohibits MCOs from requiring providers to appeal or resubmit clean claims submitted during the credentialing process. The legislation encourages relevant licensing boards to electronically share licensure information with the agency and credentialing organizations, and it allows the agency to adopt rules to facilitate the implementation of these provisions. The act is set to take effect on July 1, 2025.