House Bill 1453 proposes significant amendments to Florida's Medicaid program, primarily introducing mandatory work and community engagement requirements for able-bodied adults aged 18 to 64 to obtain and maintain coverage. The bill establishes a new section, 409.9041, detailing these requirements while allowing for exceptions for vulnerable populations. It also empowers the Agency for Health Care Administration (AHCA) to conduct retrospective reviews and audits of emergency medical services claims, seek federal approval for the new requirements, and develop a compliance process. Additionally, the bill aims to enhance the efficiency and oversight of the Medicaid program by maintaining cost-effective purchasing practices, expanding coverage for home- and community-based behavioral health services, and creating a Medicaid preferred drug list.

Furthermore, the bill includes provisions to improve the management of Medicaid prescription drug programs, such as ensuring facilities are reimbursed at no less than the actual acquisition cost of drugs and establishing a drug therapy management process for recipients with high prescription needs. It mandates annual reporting on Medicaid fraud control efforts and expands the definition of "overpayment" to include amounts improperly paid due to fraud and abuse. The bill also introduces new contract requirements for managed care plans, emphasizing program integrity and transparency, and establishes a pilot program to assess dental care availability for children and disabled populations. Overall, HB 1453 seeks to improve accountability, quality of care, and the sustainability of Florida's Medicaid system.

Statutes affected:
H 1453 Filed: 409.904, 409.91195, 409.912, 409.91196, 627.42392