CS/HB 815 2025
CODING: Words stricken are deletions; words underlined are additions.
hb815-01-c1
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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 patient referrals by Medicaid 2
managed care organizations and managed care plans; 3
requiring the Agency for Health Care Administration to 4
contract for an analysis of Medicaid managed care plan 5
referrals to affiliated organizations; providing 6
requirements; requiring a report; providing an 7
effective date. 8
9
Be It Enacted by the Legislature of the State of Florida: 10
11
Section 1. (1) The Agency for Health Care Administration 12
shall contract for an analysis of managed care plan referrals to 13
affiliated organizations. As used in this section, the term 14
"managed care plan" has the same meaning as in s. 409.962, 15
Florida Statutes. 16
(a) The contractor shall collect, compile, and analyze 17
data to determine the extent to which each managed care plan, 18
other than a provider service network as described in s. 19
409.912(1), Florida Statutes, or any of the managed care plan's 20
subcontractors, owns, has a cont rolling interest in, or has a 21
profit-sharing arrangement with, a service provider or provider 22
organization that provides services in the Statewide Medicaid 23
Managed Care program under contract with that managed care plan. 24
(b) The contractor shall collect, compile, and analyze 25
CS/HB 815 2025
CODING: Words stricken are deletions; words underlined are additions.
hb815-01-c1
Page 2 of 2
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
managed care plan data to determine the extent to which each 26
managed care plan refers or steers patients to service providers 27
or provider organizations which the managed care plan, or any of 28
its subcontractors, owns, has a controlling interest in, or has 29
a profit-sharing arrangement with. The analysis under this 30
paragraph must include a comparison of the cost of the services 31
provided under such referrals or steerage and the cost of such 32
services provided by other providers under contra ct with the 33
managed care plan or its subcontractor. 34
(2) By July 1, 2026, the agency shall submit a report on 35
the analyses required by subsection (1) to the Governor, the 36
President of the Senate, and the Speaker of the House of 37
Representatives. 38
Section 2. This act shall take effect July 1, 2025. 39