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 operating in Florida after July 1, 2025, require their providers to meet specific accreditation standards. The bill outlines the definition of a "clean application" for both credentialing and enrollment, and it sets a 60-day timeframe for the Agency for Health Care Administration to enroll providers after receiving a clean application. Additionally, it requires credentialing verification organizations to implement a single web-based credentialing application and perform necessary verifications within specified timeframes.
The legislation also stipulates that once a provider's credentialing application is approved, their claims will be eligible for payment retroactively to the date of approval. It prohibits Medicaid managed care organizations from requiring providers to appeal or resubmit clean claims submitted during the credentialing process. Furthermore, the bill 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.