The bill establishes the Joint Legislative Committee on Medicaid Oversight to enhance the transparency and efficiency of Florida's Medicaid program. Comprising ten members—five from the Senate and five from the House of Representatives—the committee will evaluate the program's financing, quality of care, and administrative functions. It will have the authority to access relevant records, compel testimony from state officials, and submit periodic reports and recommendations to the Legislature. Additionally, the bill amends various sections of the Florida Statutes concerning Medicaid managed care plans, including encounter data reporting and medical loss ratios, while requiring the Agency for Health Care Administration (AHCA) to notify the committee of any changes to capitation rates.

The legislation also introduces new standards for provider networks, mandates electronic prior authorization requests, and emphasizes quality care through internal improvement systems and performance standards. It includes provisions for penalties for noncompliance, such as fines for failure to report encounter data. Furthermore, the bill modifies the savings rebate structure for managed care plans and enhances transparency for pharmacy benefit managers by prohibiting certain practices and requiring new reporting obligations. Most provisions are set to take effect on July 1, 2026, with some sections effective upon passage.

Statutes affected:
S 1760 Filed: 626.8827
S 1760 c1: 409.967, 626.8827
S 1760 c2: 409.967, 626.8827, 627.42392