Florida HB 531: Student Internships

Bill Text

HB 531 2026

CODING: Words stricken are deletions; words underlined are additions.
hb531-00
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S

A bill to be entitled 1
An act relating to managed care plans; amending s. 2
409.967, F.S.; revising Medicaid managed care contract 3
requirements to prohibit managed care plans from 4
reviewing certain prior authorization claims for 5
medical necessity; requiring that managed care plans 6
provide coverage for durable medical equipment and 7
complex rehabilitation technology from a qualified 8
provider, from within the provider network, of the 9
enrollee's choosing; requiring the Agency for Health 10
Care Administration to adopt certain rules; providing 11
an effective date. 12
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Be It Enacted by the Legislature of the State of Florida: 14
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Section 1. Paragraphs (p) and (q) are added to subsection 16
(2) of section 409.967, Florida Statutes, to read: 17
409.967 Managed care plan accountability.— 18
(2) The agency shall establish such contract requirements 19
as are necessary for the operation of the statewide managed care 20
program. In addition to any other provisions the agency may deem 21
necessary, the contract must require: 22
(p) Prior authorization reviews.—For any claims in which a 23
Medicaid managed care plan has given prior authorization, 24
prepayment or postpayment review may not include review for 25

HB 531 2026

CODING: Words stricken are deletions; words underlined are additions.
hb531-00
Page 2 of 2
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S

medical necessity for the previously approved equipment, 26
supplies, or services. 27
(q) Durable medical equipment.—Managed care plans, or 28
their subcontractors, shall provide coverage for durable medical 29
equipment or complex rehabilitation technology from any 30
qualified durable medical equipment or complex rehabilitation 31
technology provider within the provider network which the 32
enrollee chooses. The agency shall adopt rules to implement this 33
paragraph, including, but not limited to: 34
1. Authorizing enrollees to choose the provider, within 35
the provider network, from which they can receive eligible 36
durable medical equipment or complex rehabilitation technology. 37
2. Providing a procedure within the grievance resolution 38
process adopted under paragraph (h) for enrollees to file a 39
complaint if they believe they were not granted authority to 40
choose their provider from within the provider network, as 41
authorized under this paragraph. 42
Section 2. This act shall take effect July 1, 2026. 43