This bill amends various sections of Florida Statutes concerning the Medicaid program and food assistance, introducing new provisions and modifying existing ones to enhance service delivery and management. It authorizes the Agency for Health Care Administration to conduct retrospective reviews and audits of Medicaid claims, particularly for emergency medical services, and requires the agency to seek federal approval for implementing mandatory work and community engagement requirements for able-bodied adults to maintain Medicaid coverage. Additionally, the bill specifies that Medicaid recipients aged 19 to 64 must meet these requirements unless they qualify for exemptions, outlines acceptable activities for compliance, and establishes outreach procedures for affected individuals.

Moreover, the bill revises the Medicaid Pharmaceutical and Therapeutics Committee's structure, expanding its responsibilities to include developing a preferred physician-administered drug list and a high-cost drug list. It mandates the agency to maintain cost-effective purchasing practices and outlines prior authorization processes for certain services and drugs. The bill also introduces new eligibility criteria for food assistance, requiring documentation of shelter or utility expenses and limiting eligibility to U.S. residents and specific lawful aliens. It aims to improve the efficiency and effectiveness of Medicaid services while ensuring compliance with state and federal regulations, with an effective date set for July 1, 2026.

Statutes affected:
S 1758 Filed: 409.904, 409.905, 409.91195, 409.912, 414.455, 409.91196