Florida 2022 Regular Session

Florida House Bill H0855 Compare Versions

Version 1 (Old)

Version 2 (New)

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2		-	~~ENROLLED~~
3		-	HB 855 2022 ~~Legislature~~
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	3	+	HB 855 2022
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7	7		CODING: Words stricken are deletions; words underlined are additions.
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10	10		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
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14		-	1
	14	+	A bill to be entitled 1
15	15		An act relating to managed care plan performance; 2
16	16		amending s. 409.967, F.S.; requiring managed care 3
17	17		plans to collect and report specified measures 4
18	18		beginning with a certain data reporting period; 5
19	19		requiring plans to stratify reported measures by 6
20	20		specified categories beginning with a certain data 7
21	21		reporting period; requiring a plan's performance to be 8
22	22		published on its website in a specified manner; 9
23	23		requiring the Agency for Health Care Administration to 10
24	24		use the measures to monitor plan performance; 11
25	25		providing an effective date. 12
26	26		13
27	27		Be It Enacted by the Legislature of the State of Florida: 14
28	28		15
29	29		Section 1. Paragraph (f) of subsection (2) of section 16
30	30		409.967, Florida Statut es, is amended to read: 17
31	31		409.967 Managed care plan accountability. — 18
32	32		(2) The agency shall establish such contract requirements 19
33	33		as are necessary for the operation of the statewide managed care 20
34	34		program. In addition to any other provisions the agency may de em 21
35	35		necessary, the contract must require: 22
36	36		(f) Continuous improvement. —The agency shall establish 23
37	37		specific performance standards and expected milestones or 24
38		-	~~ENROLLED~~
39		-	HB 855 2022 ~~Legislature~~
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	39	+	HB 855 2022
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46	46		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
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50	50		timelines for improving performance over the term of the 25
51	51		contract. 26
52	52		1. Each managed care plan shall establish an internal 27
53	53		health care quality improvement system, including enrollee 28
54	54		satisfaction and disenrollment surveys. The quality improvement 29
55	55		system must include incentives and disincentives for network 30
56	56		providers. 31
57	57		2. Each managed care plan must collect and report the 32
58	58		Healthcare Effectiveness Health Plan Employer Data and 33
59	59		Information Set (HEDIS) measures , the federal Core Set of 34
60	60		Children's Health Care Quality measures, and the federal Core 35
61	61		Set of Adult Health Care Quality Measures , as specified by the 36
62	62		agency. Each plan must collect and report the Adult Core Set 37
63	63		behavioral health measures beginning with data reports for the 38
64	64		2025 calendar year. Each plan must stratify reported measures by 39
65	65		age, sex, race, ethnicity, primary language, and whether the 40
66	66		enrollee received a Social Security Administration determination 41
67	67		of disability for purposes of Supplemental Security Income 42
68	68		beginning with data reports for the 2026 calendar year . A plan's 43
69	69		performance on these measures must be published on the plan's 44
70	70		website in a manner that allows recipients to reliably compare 45
71	71		the performance of plans. The agency shall use the HEDIS 46
72	72		measures as a tool to monitor plan performance. 47
73	73		3. Each managed care plan must be accredited by the 48
74	74		National Committee for Quality Assurance, the Joint Commission, 49
75		-	~~ENROLLED~~
76		-	HB 855 2022 ~~Legislature~~
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83	83		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
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87	87		or another nationally recognized accrediting body, or have 50
88	88		initiated the accreditation process, within 1 year after the 51
89	89		contract is executed. For any plan not accredited within 18 52
90	90		months after executing the contract, the agency shall sus pend 53
91	91		automatic assignment under ss. 409.977 and 409.984 s. 409.977 54
92	92		and 409.984. 55
93	93		4. By the end of the fourth year of the first contract 56
94	94		term, the agency shall issue a request for information to 57
95	95		determine whether cost savings could be achieved by contracti ng 58
96	96		for plan oversight and monitoring, including analysis of 59
97	97		encounter data, assessment of performance measures, and 60
98	98		compliance with other contractual requirements. 61
99	99		Section 2. This act shall take effect July 1, 2022. 62