Florida HB 1453: State Medicaid Program

Bill Text

HB 1453 2026

CODING: Words stricken are deletions; words underlined are additions.
hb1453-00
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A bill to be entitled 1
An act relating to the state Medicaid program; 2
amending s. 409.904, F.S.; authorizing the Agency for 3
Health Care Administration to conduct retrospective 4
reviews and audits of certain claims under the state 5
Medicaid program for a specified purpose; creating s. 6
409.9041, F.S.; providing legislative findings; 7
requiring the agency, in coordination with the 8
Department of Children and Families, to implement 9
mandatory work and community engagement requirements 10
for able-bodied adults as a condition of obtaining and 11
maintaining Medicaid coverage; requiring the agency to 12
seek federal approval to implement such requirements 13
for certain populations; specifying populations that 14
are subject to such work and community engagement 15
requirements; providing exceptions; defining the term 16
"family caregiver"; specifying the types of activities 17
which may satisfy the work and community engagement 18
requirements; providing that a certain population is 19
required to engage in work or community engagement 20
activities only during standard school hours; 21
requiring persons eligible for Medicaid to demonstrate 22
compliance with the work and community engagement 23
requirements at specified times as a condition of 24
maintaining Medicaid coverage; requiring the agency to 25

HB 1453 2026

CODING: Words stricken are deletions; words underlined are additions.
hb1453-00
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develop a process for ensuring compliance with the 26
work and community engagement requirements; requiring 27
that such process align, to the extent possible, with 28
certain existing processes; requiring the department 29
to verify compliance with the work and community 30
engagement requirements at specified intervals; 31
requiring the agency, in coordination with the 32
department, to conduct outreach regarding 33
implementation of the work and community engagement 34
requirements; specifying requirements for such 35
outreach; specifying procedures in the event of 36
noncompliance; requiring the agency, in coordination 37
with the department, to notify a Medicaid recipient of 38
a finding of noncompliance and the impact to 39
eligibility for continued receipt of services; 40
specifying requirements for such notice; amending s. 41
409.905, F.S.; requiring the agency to maintain cost-42
effective purchasing practices in its coverage of 43
hospital inpatient services rendered to Medicaid 44
recipients; amending 409.906, F.S.; requiring the 45
agency to seek federal approval to implement a program 46
for expanded coverage of home- and community-based 47
behavioral health services for a specified population; 48
specifying the goal of the program; requiring the 49
agency to work in coordination with the department to 50

HB 1453 2026

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develop and implement the program upon federal 51
approval; amending s. 409.91195, F.S.; revising the 52
purpose of the Medicaid Pharmaceutical and 53
Therapeutics Committee to include creation of a 54
Medicaid preferred physician-administered drug list, a 55
Medicaid preferred product list, and a high-cost drug 56
list; requiring the agency to adopt such lists upon 57
recommendation of the committee; specifying the 58
frequency with which the committee must review such 59
lists for any recommended additions or deletions; 60
specifying parameters for such recommended additions 61
and deletions; providing that reimbursement for drugs 62
not included on such lists is subject to prior 63
authorization, with an exception; requiring the agency 64
to publish and disseminate such lists to all Medicaid 65
providers in the state by posting on the agency's 66
website or in other media; providing requirements for 67
public testimony related to proposed inclusions on or 68
exclusions from certain lists; requiring the committee 69
to consider certain factors when developing such 70
recommended additions and deletions; amending s. 71
409.912, F.S.; revising the components of the Medicaid 72
prescribed-drug spending-control program to include 73
the preferred physician-administered drug list, the 74
preferred product list, and the high-cost drug list; 75

HB 1453 2026

CODING: Words stricken are deletions; words underlined are additions.
hb1453-00
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providing requirements for such lists; providing that 76
the agency does not need to follow rulemaking 77
procedures of ch. 120, F.S., when posting updates to 78
such lists; establishing an alternative reimbursement 79
methodology for long-acting injectables administered 80
in a hospital facility