Florida S0568 amends Medicaid managed care contract requirements to prohibit reviews for medical necessity on previously approved claims and mandates.

Florida S0568 revises 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. The bill requires the Agency for Health Care Administration to adopt rules allowing enrollees to choose their provider and to establish a procedure within the grievance resolution process for enrollees to file a complaint if they believe they were.

Florida S0568 amends Medicaid managed care contract requirements to prohibit reviews for medical necessity on previously approved claims and mandates.

Florida S0568 revises 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. The bill requires the Agency for Health Care Administration to adopt rules allowing enrollees to choose their provider and to establish a procedure within the grievance resolution process for enrollees to file a complaint if they believe they were.