Florida SB 1648: Access to Applied Behavior Analysis Services

Bill Text

1648 
Access to Applied Behavior Analysis Services 
2026-01-09T08:59:44Z 
Requiring the Agency for Health Care Administration to consider certain factors when evaluating network adequacy for applied behavior analysis services under the Medicaid program; requiring Medicaid managed care plans to take reasonable steps to support workforce retention and recruitment; requiring managed care plans to notify providers of credentialing deficiencies in a specified manner and timeframe; prohibiting managed care plans from imposing a moratorium on applied behavior analysis services providers unless such providers can demonstrate specified criteria to the agency, etc. 
Original Filed Version 
2026 
S 
2026-07-01T00:00:00Z 
GB 
General Bill 
__ 

 Florida Senate - 2026 SB 1648 

 By Senator Garcia 

 36-01064-26 20261648__ 
 1 A bill to be entitled 
 2 An act relating to access to applied behavior analysis 
 3 services; creating s. 409.9775, F.S.; defining terms; 
 4 requiring the Agency for Health Care Administration to 
 5 consider certain factors when evaluating network 
 6 adequacy for applied behavior analysis services under 
 7 the Medicaid program; requiring Medicaid managed care 
 8 plans to take reasonable steps to support workforce 
 9 retention and recruitment; requiring managed care 
 10 plans to use a standardized, consolidated 
 11 credentialing process; prohibiting managed care plans 
 12 from requiring duplicative submission of identical 
 13 documents to multiple portals or entities; requiring 
 14 managed care plans to notify providers of 
 15 credentialing deficiencies in a specified manner and 
 16 timeframe; requiring that initial credentialing and 
 17 activation be completed within a specified timeframe; 
 18 prohibiting managed care plans from requiring a 
 19 provider to undergo the full credentialing process to 
 20 recredential under certain circumstances; prohibiting 
 21 managed care plans from imposing a moratorium on 
 22 applied behavior analysis services providers unless 
 23 such providers can demonstrate specified criteria to 
 24 the agency; if the agency approves a moratorium, 
 25 requiring managed care plans to provide certain notice 
 26 to providers and recipients and provide an exception 
 27 process for underserved or rural areas; prohibiting 
 28 the use of a moratorium to delay or deny continuity of 
 29 care for existing recipients; requiring managed care 
 30 plans to provide a specified continuity-of-care period 
 31 for certain recipients; providing requirements for 
 32 such period; requiring that coverage and utilization 
 33 decisions for applied behavior analysis services be 
 34 based on individualized medical necessity; prohibiting 
 35 the use of age-based hour targets or incentive 
 36 benchmarks for certain purposes; specifying 
 37 requirements for authorization and utilization review 
 38 decisions for applied behavior analysis services; 
 39 requiring managed care plans to pay clean claims for 
 40 applied behavior analysis services in accordance with 
 41 prompt payment requirements; requiring managed care 
 42 plans to provide an explanation of benefits in a 
 43 specified manner for any denial or partial payment; 
 44 prohibiting managed care plans from issuing recoupment 
 45 or overpayment demands based solely on certain 
 46 factors; requiring managed care plans to maintain 
 47 stable electronic portals capable of certain 
 48 functions; requiring that providers have access to a 
 49 defined escalation pathway for issues of 
 50 credentialing, utilization management, and claims 
 51 resolution; requiring that notices sent by managed 
 52 care plans be written in plain language and clearly 
 53 describe certain information; requiring managed care 
 54 plans to implement certain safeguards and maintain 
 55 certain procedures and transmission methods; requiring 
 56 the agency to amend managed care plan contracts as 
 57 needed to enforce specified provisions; authorizing 
 58 the agency to adopt rules; providing an effective 
 59 date. 
 60 
 61 WHEREAS, the Legislature finds that applied behavior 
 62 analysis services are a medically necessary benefit for Medicaid 
 63 recipients with autism spectrum disorder and other qualifying 
 64 conditions, and 
 65 WHEREAS, access to such services depends on adequate 
 66 provider networks, timely credentialing, clinically appropriate 
 67 utilization management, and prompt payment, and 
 68 WHEREAS, administrative barriers, including roster freezes, 
 69 duplicative credentialing requirements, inconsistent 
 70 authorization practices, and payment delays, can result in gaps 
 71 in care, regression, and harm to recipients and families, and 
 72 WHEREAS, it is the intent of the Legislature to ensure 
 73 continuity of care, workforce stability, administrative 
 74 transparency, and individualized, clinically driven 
 75 decisionmaking for applied behavior analysis services delivered 
 76 under the Medicaid progra