The Florida Senate
HOUSE MESSAGE SUMMARY
Prepared By: The Professional Staff of the Committee on Health Policy
[2022s01950.hms.hp]
BILL: CS/CS/SB 1950 1
st
Engrossed
INTRODUCER: Appropriations Committee; Health Policy Committee and Senator Brodeur
SUBJECT: Statewide Medicaid Managed Care Program
DATE: March 7, 2022
I.Amendments Contained in Message:
House Amendment – 739505 (body with title)
II.Summary of Amendments Contained in Message:
House Amendment 739505 is a strike-all that replaces the contents of the Senate bill with those
of CS/HB 7047, along with several minor revisions in the House bill language. The House
amendment revises the Statewide Medicaid Managed Care (SMMC) program in anticipation of
the next procurement cycle, for plan year 2025, while making other changes to the program that
take effect in State Fiscal Year 2022-23. The amendment:
Consolidates the current 11 regions into eight and adjusts the minimum and maximum
numbers of plans with which the Agency for Health Care Administration (AHCA) is directed
to contract;
Creates requirements concerning the delivery of dental benefits;
Requires the AHCA to conduct a single statewide SMMC procurement, requires negotiation
and selection on a regional basis, and authorizes statewide contract awards if deemed the best
value for the state;
Prohibits the AHCA from auto-assigning recipients to a health plan having a regional market
share greater than 50 percent;
Realigns Regional Perinatal Intensive Care Centers from statewide to regional essential
providers;
Requires the AHCA to identify health plans that lack required contracts with essential
providers and apply contract financial enforcement measures on the plan in certain
circumstances and requires such a plan and the essential provider to enter into mediation to
seek a network contract;
Establishes requirements and timelines for such required mediations and the publishing of the
post-mediation report;
Allows health plans that fail to meet medical loss ratio (MLR) targets to make contributions
in support of specified types of medical education and have the dollar amount of those
contributions count as Medicaid medical expenses when MLRs and Achieved Savings
Rebates are calculated;
Includes all tobacco cessation, instead of smoking cessation, in the "healthy behaviors"
efforts that health plans are required to implement; BILL: CS/CS/SB 1950 1st Engrossed Page 2
Requires health plans to include opioid abuse recovery in alcohol and substance abuse
recovery as part of the "healthy behaviors" efforts;
Requires health plans to contract with Florida's nationally-designated cancer hospitals as
statewide essential providers and provides a payment rate for services provided out-of-
network;
Allows children in the child welfare Guardian Assistance Program to enroll in the child
welfare specialty plan as an alternative to a non-specialty plan;
Requires regular AHCA testing of plan network adequacy;
Provides times for the AHCA to implement specific provisions of the amendment; and
Deletes obsolete provisions and makes conforming changes to reflect the amendment's
provisions.