CS/HB 633 2025
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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 behavioral health managing 2
entities; amending s. 394.9082, F.S.; requiring the 3
Department of Children and Families to contract 4
biennially for specified functions; requiring the 5
department to contract for recommendations for certain 6
transparency improvements; requiring the department to 7
prepare and present to the Governor and Legislature a 8
specified final report by a specified date; requiring 9
managing entities to report required data to the 10
department in a standardized electronic format; 11
providing requirements for such format; requiring 12
managing entities to electronically submit to the 13
department certain documents in a specified format and 14
with specified metadata; requiring managing entities 15
to submit certain specific measures to the department; 16
requiring the department to post and maintain such 17
measures on its website by a specified date every 18
month; requiring managing entities to report each 19
measure using a standard methodology determined by the 20
department; providing requirements for such measures; 21
providing an effective date. 22
23
Be It Enacted by the Legislature of the State of Florida: 24
25
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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
Section 1. Subsection (7) of section 394.9082, Florida 26
Statutes, is amended, paragraph (n) is added to subsection (3), 27
and paragraphs (v) and (w) are added to subsection (5) of that 28
section, to read: 29
394.9082 Behavioral health managing entities. — 30
(3) DEPARTMENT DUTIES. —The department shall: 31
(n)1. Contract for all of the following: 32
a. Biennial operational and financial audits of each 33
managing entity to include all of the following: 34
(I) A review of business practices, personnel, financial 35
records, related parties, compensation, and other areas as 36
determined by the department. 37
(II) The services administered, the method of provider 38
payment, expenditures, outcomes, and other information as 39
determined by the department. 40
(III) Referral patterns, including managing entity 41
referral volume; provider referra l assignments; services 42
referred; length of time to obtain services; and key referral 43
performance measures. 44
(IV) Provider network adequacy and provider network 45
participation in the department's available bed platform, the 46
Opioid Data Management System, t he Agency for Health Care 47
Administration Event Notification Service, and other department 48
required provider data submissions. 49
(V) Audits of each managing entity's expenditures and 50
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claims. Such an audit must do both of the following: 51
(A) Compare service s administered through each managing 52
entity, the outcomes of each managing entity's expenditures, 53
each managing entity's Medicaid expenditures for behavioral 54
health services, and any other information as determined by the 55
department. 56
(B) Analyze services funded by each managing entity 57
rendered to individuals who are also Medicaid beneficiaries to, 58
at a minimum, assess the extent to which managing entities are 59
funding services that are also available as covered services 60
under the Medicaid program. 61
b. Recommendations to improve transparency of system 62
performance, including, but not limited to, metrics and criteria 63
used to measure each managing entity's performance and patient 64
and system outcomes, and the format and method to be used to 65
collect and report necessary data and information. 66
2. Prepare a report of the information gathered in 67
subparagraph 1. and present the final report on or before 68
December 1, 2025, to the Governor, the President of the Senate, 69
and the Speaker of the House of Representatives . 70
(5) MANAGING ENTITY DUTIES. —A managing entity shall: 71
(v) Report all required data to the department in a 72
standardized electronic format to ensure interoperability and to 73
facilitate data analysis. The submission format must meet all of 74
the following criteria: 75
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1. Provider payments must be reported using a standardized 76
format for electronic data interchange that is used for health 77
care claims processing. 78
2. Information must be organized into discrete, machine -79
readable data elements that allow for eff icient processing and 80
integration with other datasets. 81
3. All data fields must comply with established protocols 82
as specified by the department. 83
4. The standardized format must be compatible with 84
automated systems to enable the downloading, parsing, an d 85
combining of data with other sources for analysis. 86
5. Submissions must pass validation checks to confirm 87
adherence to the required data structure and format before the 88
submission is accepted. 89
(w) Submit to the department all documents that are 90
required under contract for submission on a routine basis in an 91
electronic format that allows for accurate text recognition and 92
data extraction as specified by the department, which may 93
include, but is not limited to, Portable Document Format or 94
machine-readable text files. The documents must be accompanied 95
by metadata containing key information that ensures proper 96
organization, processing, and integration into the department's 97
systems. The required metadata must include, but is not limited 98
to, all of the followi ng elements: 99
1. A descriptive and unique name for the document, 100
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following any naming conventions prescribed by the department. 101
2. The date the document is uploaded. 102
3. A predefined classification indicating the nature or 103
category of the document. 104
4. Any relevant identifiers, such as application numbers, 105
case numbers, or tracking codes, as specified by the department. 106
5. The name, contact information, and any other required 107
identification number, which may include, but is not limited to, 108
a contract, license, or registration number, of the person or 109
organization submitting the document. 110
6. Any other metadata fields as prescribed by the 111
department to facilitate accurate processing and analysis. 112
(7) PERFORMANCE MEASUREMENT AND ACCOUNTABILITY. — 113
(a) Managing entities shall collect and submit data to the 114
department regarding persons served, outcomes of persons served, 115
costs of services provided through the department's contract, 116
and other data as required by the department. The department 117
shall evaluate managing entity performance and the overall 118
progress made by the managing entity, together with other 119
systems, in meeting the community's behavioral health needs, 120
based on consumer-centered outcome measures that reflect 121
national standards, if possible, that can be accurately 122
measured. The department shall work with managing entities to 123
establish performance standards, including, but not limited to: 124
1.(a) The extent to which individuals in the community 125
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receive services, including, but not limited to, parents or 126
caregivers involved in the child welfare system who need 127
behavioral health services. 128
2.(b) The improvement in the overall behavioral health of 129
a community. 130
3.(c) The improvement in functioning or progress in the 131
recovery of individuals serve d by the managing entity, as 132
determined using person -centered measures tailored to the 133
population. 134
4.(d) The success of strategies to: 135
a.1. Divert admissions from acute levels of care, jails, 136
prisons, and forensic facilities as measured by, at a minimu m, 137
the total number and percentage of clients who, during a 138
specified period, experience multiple admissions to acute levels 139
of care, jails, prisons, or forensic facilities; 140
b.2. Integrate behavioral health services with the child 141
welfare system; and 142
c.3. Address the housing needs of individuals being 143
released from public receiving facilities who are homeless. 144
5.(e) Consumer and family satisfaction. 145
6.(f) The level of engagement of key community 146
constituencies, such as law enforcement agencies, community -147
based care lead agencies, juvenile justice agencies, the courts, 148
school districts, local government entities, hospitals, and 149
other organizations, as appr opriate, for the geographical 150
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service area of the managing entity. 151
(b) Managing entities must submit specific measures to the 152
department regarding individual outcomes and system functioning, 153
which the department must post to, and maintain on, its website 154
by the 15th of every month. The posted measures must reflect 155
performance for the previous calendar month. Each managing 156
entity must report each measure using a standard methodology 157
determined by the department and submit the data to the 158
department by the deadline specified by the department. The 159
measures shall include data from individuals served by each 160
managing entity for services funded by the managing entity, to 161
the extent feasible and appropriate. The measures shall be 162
reported and posted stratified b y, at a minimum, whether the 163
individual is a child or an adult and whether the individual is 164
a Medicaid recipient. Such measures shall include, at a minimum, 165
all of the following: 166
1. The number and percentage of individuals who are high 167
utilizers of crisis behavioral health services. 168
2. The number and percentage of individuals referred to 169
outpatient behavioral health services after their discharge from 170
a receiving or treatment facility, an emergency department under 171
this chapter, or an inpatient or residential licensed service 172
component under chapter 397 and who begin receiving such 173
services within 7 days after discharge. 174
3. The average wait time for initial appointments for 175
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behavioral health services, categorized by the type of service. 176
4. The number and percentage of individuals with 177
significant behavioral health symptoms who are seeking urgent 178
but noncrisis acute care and who are scheduled to be seen by a 179
provider within 1 business day after initial contact with the 180
provider. 181
5. The number and percentage of emergency department 182
visits per capita for behavioral health -related issues. 183
6. The incidence of medication errors. 184
7. The number and percentage of adverse incidents, 185
including, but not limited to, self -harm, occurring during 186
inpatient and outpatient behavioral health services. 187
8. The number and percentage of individuals with co -188
occurring conditions who receive integrated care. 189
9. The number and percentage of individuals discharged 190
from a receiving or treatment facility under this ch apter or an 191
inpatient or residential licensed service component under 192
chapter 397 who successfully transition to ongoing services at 193
the appropriate level of care. 194
10. The rate of readmissions to emergency departments due 195
to behavioral health issues or t o crisis stabilization units, 196
addictions receiving facilities, or other inpatient levels of 197
care under this chapter and chapter 397 within 30 days after 198
discharge from inpatient or outpatient behavioral health 199
services. 200
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11. The average length of stay for inpatient behavioral 201
health services. 202
Section 2. This act shall take effect July 1, 2025. 203