The bill establishes new requirements for health care providers seeking to participate in Medicaid managed care organizations in Florida by creating a new section, 409.9663, in the Florida Statutes. It mandates that providers must enroll with the Agency for Health Care Administration, be credentialed, and enter into contracts with Medicaid managed care organizations. The bill outlines specific definitions, such as "clean credentialing application" and "credentialing verification organization," and sets forth timelines for enrollment and credentialing processes. For instance, the agency is required to enroll providers within 60 days of receiving a clean provider enrollment application, and credentialing verification organizations must recommend or refuse to recommend providers within 30 days of receiving a clean credentialing application.
Additionally, the bill prohibits Medicaid managed care organizations from imposing certain requirements related to clean claims during the credentialing process and ensures that claims become eligible for payment based on the credentialing application date. It encourages cooperation between licensing boards and the agency, and allows the agency to adopt rules to implement these provisions effectively. The act is set to take effect on July 1, 2025.