The bill establishes the Joint Legislative Committee on Medicaid Oversight to ensure the Florida Medicaid program aligns with legislative intent and promotes transparency and efficiency in government spending. Comprising ten members—five from the Senate and five from the House of Representatives—the committee will evaluate various aspects of the Medicaid program, including financing and quality of care, and will have the authority to access relevant records and compel testimony. The Auditor General and the Agency for Health Care Administration must cooperate with the committee, including entering into a data-sharing agreement by July 1, 2026. The bill also amends several sections of the Florida Statutes to refine definitions related to Medicaid and revises encounter data reporting requirements for prepaid Medicaid plans.

Additionally, the bill introduces comprehensive reforms to managed care plans within the Medicaid program, focusing on improving access to care and accountability. It mandates that managed care plans establish specific standards for provider networks, maintain an electronic database of providers, and publish drug formularies online. The bill also imposes performance standards for managed care plans, introduces penalties for noncompliance, and revises the achieved savings rebate structure. Furthermore, it enhances accountability among pharmacy benefit managers by prohibiting certain practices and mandating a minimum dispensing fee. The act is set to take effect on July 1, 2026.

Statutes affected:
S 1760 Filed: 626.8827