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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; providing an exception; providing requirements 19
for such measures; requiring managing entities to 20
report each measure using a standard methodology 21
determined by the department; providing requirements 22
for such measures; providing that implementation of 23
specified requirements is contingent on certain 24
appropriations; providing an effective date. 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
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Be It Enacted by the Legislature of the State of Florida: 27
28
Section 1. Subsection (7) of section 394.9082, Florida 29
Statutes, is amended, paragraph (n) is added to subsection (3), 30
and paragraphs (v) and (w) a re added to subsection (5) of that 31
section, to read: 32
394.9082 Behavioral health managing entities. — 33
(3) DEPARTMENT DUTIES. —The department shall: 34
(n)1. Contract for all of the following: 35
a. Biennial operational and financial audits of each 36
managing entity to include all of the following: 37
(I) A review of business practices, personnel, financial 38
records, related parties, compensation, and other areas as 39
determined by the department. 40
(II) The services administered, the method of provider 41
payment, expenditures, outcomes, and other information as 42
determined by the department. 43
(III) Referral patterns, including managing entity 44
referral volume; provider referral assignments; services 45
referred; length of time to obtain services; and key referral 46
performance measures. 47
(IV) Provider network adequacy and provider network 48
participation in the department's available bed platform, the 49
Opioid Data Management System, the Agency for Health Care 50
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Administration Event Notification Service, and other department 51
required provider data submissions. 52
(V) Audits of each managing entity's expenditures and 53
claims. Such an audit must do both of the following: 54
(A) Compare services administered through each managing 55
entity, the outcomes of each managing entity's expenditu res, 56
each managing entity's expenditures for behavioral health 57
services, and any other information as determined by the 58
department. 59
(B) Analyze services funded by each managing entity 60
rendered to individuals who are also Medicaid beneficiaries to, 61
at a minimum, assess the extent to which managing entities are 62
funding services that are also available as covered services 63
under the Medicaid program. 64
b. Recommendations to improve transparency of system 65
performance, including, but not limited to, metrics and criteria 66
used to measure each managing entity's performance and patient 67
and system outcomes, and the format and method to be used to 68
collect and report necessary data and information. 69
2. Prepare a report of the information gathered in 70
subparagraph 1. and present the final report on or before 71
December 1, 2025, to the Governor, the President of the Senate, 72
and the Speaker of the House of Representatives. 73
(5) MANAGING ENTITY DUTIES. —A managing entity shall: 74
(v) Report all required data to the department in a 75
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standardized electronic format to ensure interoperability and to 76
facilitate data analysis. The submission format must meet all of 77
the following criteria: 78
1. Payments made to providers for services reported in a 79
format that reflects the client; the service provided; the date 80
the service is provided; the place where the service is 81
provided; the diagnosis, if available; and other information 82
typically reported in a standardized format for electronic data 83
interchange that is used for health care claims processing. 84
2. Information must be organized into discrete, machine -85
readable data elements that allow for efficient processing and 86
integration with other datasets. 87
3. All data fields must comply with established protocols 88
as specified by the department . 89
4. The standardized format must be compatible with 90
automated systems to enable the downloading, parsing, and 91
combining of data with other sources for analysis. 92
5. Submissions must pass validation checks to confirm 93
adherence to the required data struc ture and format before the 94
submission is accepted. 95
(w) Submit to the department all documents that are 96
required under contract for submission on a routine basis in an 97
electronic format that allows for accurate text recognition and 98
data extraction as spec ified by the department, which may 99
include, but is not limited to, Portable Document Format or 100
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machine-readable text files. The documents must be accompanied 101
by metadata containing key information that ensures proper 102
organization, processing, and integrati on into the department's 103
systems. The required metadata must include, but is not limited 104
to, all of the following elements: 105
1. A descriptive and unique name for the document, 106
following any naming conventions prescribed by the department. 107
2. The date the document is uploaded. 108
3. A predefined classification indicating the nature or 109
category of the document. 110
4. Any relevant identifiers, such as application numbers, 111
case numbers, or tracking codes, as specified by the department. 112
5. The name, contact information, and any other required 113
identification number, which may include, but is not limited to, 114
a contract, license, or registration number, of the person or 115
organization submitting the document. 116
6. Any other metadata fields as prescribed by the 117
department to facilitate accurate processing and analysis. 118
(7) PERFORMANCE MEASUREMENT AND ACCOUNTABILITY. — 119
(a) Managing entities shall collect and submit data to the 120
department regarding persons served, outcomes of persons served, 121
costs of services provi ded through the department's contract, 122
and other data as required by the department. The department 123
shall evaluate managing entity performance and the overall 124
progress made by the managing entity, together with other 125
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systems, in meeting the community's beh avioral health needs, 126
based on consumer-centered outcome measures that reflect 127
national standards, if possible, that can be accurately 128
measured. The department shall work with managing entities to 129
establish performance standards, including, but not limited to: 130
1.(a) The extent to which individuals in the community 131
receive services, including, but not limited to, parents or 132
caregivers involved in the child welfare system who need 133
behavioral health services. 134
2.(b) The improvement in the overall behavioral health of 135
a community. 136
3.(c) The improvement in functioning or progress in the 137
recovery of individuals served by the managing entity, as 138
determined using person -centered measures tailored to the 139
population. 140
4.(d) The success of strategies to: 141
a.1. Divert admissions from acute levels of care, jails, 142
prisons, and forensic facilities as measured by, at a minimum, 143
the total number and percentage of clients who, during a 144
specified period, experience multiple admissions to acute levels 145
of care, jails, pris ons, or forensic facilities; 146
b.2. Integrate behavioral health services with the child 147
welfare system; and 148
c.3. Address the housing needs of individuals being 149
released from public receiving facilities who are homeless. 150
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5.(e) Consumer and family satisfaction. 151
6.(f) The level of engagement of key community 152
constituencies, such as law enforcement agencies, community -153
based care lead agencies, juvenile justice agencies, the courts, 154
school districts, local government entities, h ospitals, and 155
other organizations, as appropriate, for the geographical 156
service area of the managing entity. 157
(b) Managing entities must submit specific measures to the 158
department regarding individual outcomes and system functioning, 159
which the department must post to, and maintain on, its website 160
by the 22nd of every month or if the 22nd day occurs on a 161
weekend or a holiday under s. 110.117(1), the report must be 162
posted before the conclusion of the next business day. The 163
posted measures must reflect perfor mance for the previous 164
calendar month, including year -to-date totals and annual trends. 165
Each managing entity must report each measure using a standard 166
methodology determined by the department and submit the data to 167
the department by the deadline specified by the department. The 168
measures shall include data from individuals served by each 169
managing entity for services funded by the managing entity, to 170
the extent feasible and appropriate. The measures shall be 171
reported and posted stratified by, at a minimum, wh ether the 172
individual is a child or an adult and whether the individual is 173
a Medicaid recipient. Such measures shall include, at a minimum, 174
all of the following: 175
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1. The number and percentage of individuals who are high 176
utilizers of crisis behavioral healt h services. 177
2. The number and percentage of individuals referred to 178
outpatient behavioral health services after their discharge from 179
a receiving or treatment facility, an emergency department under 180
this chapter, or an inpatient or residential licensed service 181
component under chapter 397 and who begin receiving such 182
services within 7 days after discharge. 183
3. The average wait time for initial appointments for 184
behavioral health services, categorized by the type of service. 185
4. The number and percentage of individuals with 186
significant behavioral health symptoms who are seeking urgent 187
but noncrisis acute care and who are scheduled to be seen by a 188
provider within 1 business day after initial contact with the 189
provider. 190
5. The number and percentage of emerg ency department 191
visits per capita for behavioral health -related issues. 192
6. The incidence of medication errors. 193
7. The number and percentage of adverse incidents, 194
including, but not limited to, self -harm, occurring during 195
inpatient and outpatient behavi oral health services. 196
8. The number and percentage of individuals with co -197
occurring conditions who receive integrated care. 198
9. The number and percentage of individuals discharged 199
from a receiving or treatment facility under this chapter or an 200
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inpatient or residential licensed service component under 201
chapter 397 who successfully transition to ongoing services at 202
the appropriate level of care. 203
10. The rate of readmissions to emergency departments due 204
to behavioral health issues or to crisis stabilizatio n units, 205
addictions receiving facilities, or other inpatient levels of 206
care under this chapter and chapter 397 within 30 days after 207
discharge from inpatient or outpatient behavioral health 208
services. 209
11. The average length of stay for inpatient behavioral 210
health services. 211
Section 2. This act shall be implemented to the extent of 212
available appropriations contained in the annual General 213
Appropriations Act for such purpose. 214
Section 3. This act shall take effect July 1, 2025. 215