Florida HB 5301: Health Care

Bill Text

HB 5301 2026

CODING: Words stricken are deletions; words underlined are additions.
hb5301-00
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A bill to be entitled 1
An act relating to health care; repealing s. 381.4015, 2
F.S., relating to Florida health care innovation; 3
amending s. 409.908, F.S.; revising the payment 4
methodology for reimbursement of Medicaid providers; 5
amending s. 409.912, F.S.; revising Medicaid preferred 6
drug coverage guidelines; creating s. 409.9207, F.S.; 7
providing legislative intent; providing definitions; 8
creating the Eligibility Assistance Program within the 9
Department of Children and Families; providing program 10
requirements; requiring the department to be operated 11
by an independent contractor that shall be selected 12
based on specified criteria; amending s. 409.967, 13
F.S.; revising the maximum term for Medicaid managed 14
care contracts; requiring the agency to establish by 15
contract a quality withhold incentive for certain 16
purposes; providing requirements for such incentive; 17
removing obsolete provisions; amending s. 409.9855, 18
F.S.; providing Medicaid waiver funding requirements 19
for certain individuals; requiring the Agency for 20
Persons with Disabilities and the Agency for Health 21
Care Administration to reconcile funding amounts in a 22
specified manner; amending s. 409.91196, F.S.; 23
conforming a provision to changes made by the act; 24
providing an effective date. 25

HB 5301 2026

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Be It Enacted by the Legislature of the State of Florida: 27
28
Section 1. Section 381.4015, Florida Statutes, is 29
repealed. 30
Section 2. Paragraph (b) of subsection (2) of section 31
409.908, Florida Statutes, as amended by section 25 of chapter 32
2025-199, Laws of Florida, is amended to read: 33
409.908 Reimbursement of Medicaid providers.—Subject to 34
specific appropriations, the agency shall reimburse Medicaid 35
providers, in accordance with state and federal law, according 36
to methodologies set forth in the rules of the agency and in 37
policy manuals and handbooks incorporated by reference therein. 38
These methodologies may include fee schedules, reimbursement 39
methods based on cost reporting, negotiated fees, competitive 40
bidding pursuant to s. 287.057, and other mechanisms the agency 41
considers efficient and effective for purchasing services or 42
goods on behalf of recipients. If a provider is reimbursed based 43
on cost reporting and submits a cost report late and that cost 44
report would have been used to set a lower reimbursement rate 45
for a rate semester, then the provider's rate for that semester 46
shall be retroactively calculated using the new cost report, and 47
full payment at the recalculated rate shall be effected 48
retroactively. Medicare-granted extensions for filing cost 49
reports, if applicable, shall also apply to Medicaid cost 50

HB 5301 2026

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reports. Payment for Medicaid compensable services made on 51
behalf of Medicaid-eligible persons is subject to the 52
availability of moneys and any limitations or directions 53
provided for in the General Appropriations Act or chapter 216. 54
Further, nothing in this section shall be construed to prevent 55
or limit the agency from adjusting fees, reimbursement rates, 56
lengths of stay, number of visits, or number of services, or 57
making any other adjustments necessary to comply with the 58
availability of moneys and any limitations or directions 59
provided for in the General Appropriations Act, provided the 60
adjustment is consistent with legislative intent. 61
(2) 62
(b) Subject to any limitations or directions in the 63
General Appropriations Act, the agency shall establish and 64
implement a state Title XIX Long-Term Care Reimbursement Plan 65
for nursing home care in order to provide care and services in 66
conformance with the applicable state and federal laws, rules, 67
regulations, and quality and safety standards and to ensure that 68
individuals eligible for medical assistance have reasonable 69
geographic access to such care. 70
1. The agency shall amend the long-term care reimbursement 71
plan and cost reporting system to create direct care and 72
indirect care subcomponents of the patient care component of the 73
per diem rate. These two subcomponents together shall equal the 74
patient care component of the per diem rate. Separate prices 75

HB 5301 2026

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shall be calculated for each patient care subcomponent, 76
initially based on the September 2016 rate setting cost reports 77