Florida H0531 amends Medicaid managed care contract requirements to prohibit reviews for medical necessity on previously approved equipment.

Florida H0531 amends Medicaid managed care contract requirements to prohibit managed care plans from reviewing certain prior authorization claims for medical necessity. It also mandates that managed care plans provide coverage for durable medical equipment and complex rehabilitation technology from a qualified provider within the provider network, chosen by the enrollee. The bill requires the Agency for Health Care Administration to adopt rules, including authorizing enrollees to choose their provider and providing a grievance resolution process for complaints.

Florida H0531 amends Medicaid managed care contract requirements to prohibit reviews for medical necessity on previously approved equipment.

Florida H0531 amends Medicaid managed care contract requirements to prohibit managed care plans from reviewing certain prior authorization claims for medical necessity. It also mandates that managed care plans provide coverage for durable medical equipment and complex rehabilitation technology from a qualified provider within the provider network, chosen by the enrollee. The bill requires the Agency for Health Care Administration to adopt rules, including authorizing enrollees to choose their provider and providing a grievance resolution process for complaints.