CS/HB 967 2023
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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 Medicaid coverage of continuous 2
glucose monitors; creating s. 409.9063, F.S.; defining 3
the term "continuous glucose monitor"; requiring the 4
Agency for Health Care Administration, subject to the 5
availability of funds and certain limitations and 6
directions, to provide coverage for continuous glucose 7
monitors for certain Medicaid recipients; providing 8
construction; providing requirements for Medi caid 9
recipients to continue receiving coverage for their 10
continuous glucose monitors; requiring the agency to 11
seek federal approval for implementation of the act, 12
if needed; requiring the agency to include the rate 13
impact of the act in certain rates that b ecome 14
effective on a specified date; providing an effective 15
date. 16
17
Be It Enacted by the Legislature of the State of Florida: 18
19
Section 1. Section 409.9063, Florida Statutes, is created 20
to read: 21
409.9063 Coverage of continuous glucose monitors for 22
Medicaid recipients. — 23
(1) As used in this section, the term "continuous glucose 24
monitor" means an instrument or a device designed for the 25
CS/HB 967 2023
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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
purpose of aiding in the treatment of diabetes by measuring 26
glucose levels on demand or at set intervals through a s mall, 27
electronic sensor that slightly penetrates a person's skin when 28
applied and that is designed to remain in place and active for 29
at least 7 days. 30
(2) Subject to the availability of funds and subject to 31
any limitations or directions provided in the Ge neral 32
Appropriations Act, the agency must provide coverage for a 33
continuous glucose monitor under the Medicaid pharmacy benefit 34
for the treatment of a Medicaid recipient if: 35
(a) The recipient has been diagnosed by his or her primary 36
care physician, or an other licensed health care practitioner 37
authorized to make such diagnosis, with Type 1 diabetes, Type 2 38
diabetes, gestational diabetes, or any other type of diabetes 39
that may be treated with insulin; and 40
(b) A health care practitioner with the applicable 41
prescribing authority has prescribed insulin to treat the 42
recipient's diabetes and a continuous glucose monitor to assist 43
the recipient and practitioner in managing the recipient's 44
diabetes. 45
(3) Coverage under this section includes the cost of any 46
necessary repairs or replacement parts for the continuous 47
glucose monitor. 48
(4) To qualify for continued coverage under this section, 49
the Medicaid recipient must participate in follow -up care with 50
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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
his or her treating health care practitioner, in person or 51
through telehealth, at least once every 6 months during the 52
first 18 months after the first prescription of the continuous 53
glucose monitor for the recipient has been issued under this 54
section, to assess the efficacy of using the monitor for 55
treatment of his or her diabetes. After the first 18 months, 56
such follow-up care must occur at least once every 12 months. 57
(5) The agency shall seek federal approval, if needed, for 58
the implementation of this section. 59
Section 2. The Agency for Health Care Administratio n shall 60
include the rate impact of this act in the Medicaid managed 61
medical assistance program and long -term care managed care 62
program rates, as applicable, that take effect on October 1, 63
2023. 64
Section 3. This act shall take effect October 1, 2023. 65