No. SB 1470
Filed under Healthcare.
Behavioral Health Intervention Services; Authorizing, contingent upon an appropriation, the state Medicaid plan to fund a demonstration pilot program in a specified region for specified purposes; authorizing Medicaid managed assistance providers to offer specified intervention services to certain participants under the pilot program; requiring the state Medicaid plain to consider certain factors when paying certain capitation rates, etc.
Plain English Summary
AI-GENERATEDA new Medicaid pilot would let managed care plans offer counseling, nutrition therapy, and biomarker tracking to patients with both a mental health diagnosis and diabetes, obesity, or heart disease. It only starts if the Legislature appropriates funding.
The pilot runs only in five counties -- Indian River, Martin, Okeechobee, Palm Beach, and St. Lucie -- and is capped at 1,000 participants. Enrolled patients get this alternative bundle instead of standard Medicaid-covered services.
Design and evaluation of the pilot must come from researchers at Tufts University's nutrition school and the Florida Health and Nutrition Coalition. The state must weigh cost and outcomes when paying the managed care organization.
The whole program automatically expires August 31, 2030, and the underlying law repeals itself a year later. The state must report to legislative leaders once, after the pilot ends, on how often it was used.
AIContingent on a legislative appropriation, the state Medicaid plan may fund a pilot letting managed care providers offer a five-part counseling, nutrition, and monitoring bundle to Medicaid recipients who have both a mental health diagnosis and diabetes, obesity, or heart disease.
AIProviders deliver the pilot's counseling, nutrition, and monitoring services in place of the treatments a recipient would otherwise get through the state Medicaid plan, rather than adding the bundle on top of standard coverage.
AIThe pilot operates only in Indian River, Martin, Okeechobee, Palm Beach, and St. Lucie counties, and is capped at 1,000 participants as a disease management plan, regardless of how many eligible recipients exist statewide.
AIWhen paying capitation rates to the managed care organization running the pilot, the state Medicaid plan must weigh actual cost, measurable goals and health outcomes met, and how well participants stuck with the program.
AIRather than letting a state agency or state university set the pilot's design and success measures, the law requires that they come from researchers at Tufts University's Friedman School of Nutrition Science and Policy, alongside the Florida Health and Nutrition Coalition.
AIThe pilot program itself ends August 31, 2030, and the entire new statute section is repealed a year later, on September 1, 2031, unless the Legislature acts again before then.