Florida SB 568: Death Penalty

Bill Text

568 
Managed Care Plans 
2025-11-18T09:33:37Z 
Revising Medicaid managed care contract requirements to prohibit managed care plans from reviewing certain prior authorization claims for medical necessity; requiring that managed care plans provide coverage for durable medical equipment and complex rehabilitation technology from a qualified provider, from within the provider network, of the enrollee’s choosing, etc. 
Original Filed Version 
2026 
S 
2026-07-01T00:00:00Z 
GB 
General Bill 
__ 

 Florida Senate - 2026 SB 568 

 By Senator Harrell 

 31-00890-26 2026568__ 
 1 A bill to be entitled 
 2 An act relating to managed care plans; amending s. 
 3 409.967, F.S.; revising Medicaid managed care contract 
 4 requirements to prohibit managed care plans from 
 5 reviewing certain prior authorization claims for 
 6 medical necessity; requiring that managed care plans 
 7 provide coverage for durable medical equipment and 
 8 complex rehabilitation technology from a qualified 
 9 provider, from within the provider network, of the 
 10 enrollee’s choosing; requiring the Agency for Health 
 11 Care Administration to adopt certain rules; providing 
 12 an effective date. 
 13 
 14 Be It Enacted by the Legislature of the State of Florida: 
 15 
 16 Section 1. Paragraphs (p) and (q) are added to subsection 
 17 (2) of section 409.967, Florida Statutes, to read: 
 18 409.967 Managed care plan accountability.— 
 19 (2) The agency shall establish such contract requirements 
 20 as are necessary for the operation of the statewide managed care 
 21 program. In addition to any other provisions the agency may deem 
 22 necessary, the contract must require: 
 23 (p) Prior authorization reviews.—For any claims in which a 
 24 Medicaid managed care plan has given prior authorization, 
 25 prepayment or postpayment review may not include review for 
 26 medical necessity for the previously approved equipment, 
 27 supplies, or services. 
 28 (q) Durable medical equipment.—Managed care plans, or their 
 29 subcontractors, shall provide coverage for durable medical 
 30 equipment or complex rehabilitation technology from any 
 31 qualified durable medical equipment or complex rehabilitation 
 32 technology provider within the provider network which the 
 33 enrollee chooses. The agency shall adopt rules to implement this 
 34 paragraph, including, but not limited to: 
 35 1. Authorizing enrollees to choose the provider, within the 
 36 provider network, from which they can receive eligible durable 
 37 medical equipment or complex rehabilitation technology. 
 38 2. Providing a procedure within the grievance resolution 
 39 process adopted under paragraph (h) for enrollees to file a 
 40 complaint if they believe they were not granted authority to 
 41 choose their provider from within the provider network, as 
 42 authorized under this paragraph. 
 43 Section 2. This act shall take effect July 1, 2026.