The bill establishes new regulations for applied behavior analysis (ABA) services under the Medicaid program in Florida, specifically through the creation of section 409.9775 of the Florida Statutes. It defines key terms related to ABA services and mandates the Agency for Health Care Administration to consider various factors, such as credentialing delays and administrative bottlenecks, when assessing network adequacy. The bill requires Medicaid managed care plans to implement a standardized credentialing process, support workforce retention, and ensure timely communication regarding credentialing deficiencies. Additionally, it prohibits moratoriums on ABA service providers unless specific criteria are met and mandates a continuity-of-care period for recipients transitioning between providers.

Furthermore, the bill emphasizes that coverage and utilization decisions for ABA services must be based on individualized medical necessity rather than age-based benchmarks. It outlines requirements for claims payment, including prompt payment for clean claims and clear explanations for any denials. Managed care plans are also required to maintain stable electronic communication portals and provide a defined escalation pathway for providers facing issues related to credentialing and claims resolution. The bill aims to enhance access to ABA services, reduce administrative barriers, and ensure that recipients receive necessary care without unnecessary delays or complications. The act is set to take effect on July 1, 2026.