SESSION WATCH
Died SENATE · SESSION 2026

No. CS/CS/SB 1758

Public Assistance
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SPONSOR
Appropriations; Health Policy; Gaetz
FILED BY
Don Gaetz — District 1, Republican [search donations]
EFFECTIVE
7/1/2026
DIED IN
Messages

Filed under Healthcare.

PROVIDED SUMMARY

Public Assistance; Authorizing the Agency for Health Care Administration to conduct retrospective reviews and audits of certain claims under the state Medicaid program for a specified purpose; requiring the agency to seek federal approval to implement mandatory work and community engagement requirements for able-bodied adults as a condition of obtaining and maintaining Medicaid coverage; requiring the agency, in consultation with the Department of Children and Families, to develop a business plan to implement specified provisions; revising the purpose of the Medicaid Pharmaceutical and Therapeutics Committee to include creation of a Medicaid preferred physician-administered drug list, a Medicaid preferred product list, and a high-cost drug list; requiring the department to develop and implement a food assistance payment accuracy improvement plan for a specified purpose, etc.

Full bill text →

Plain English Summary

AI-GENERATED
Makes work a Medicaid requirement once federal approval arrives.

A new law requires Florida to seek federal permission for mandatory work rules for able-bodied Medicaid adults aged 19 to 64. They would need 80 hours a month of work, training, or school, with exemptions for parents of young children, veterans, and others.

Medicaid audits get broader teeth. Hospitals no longer must stop retrospective review once prior authorization starts, and overpayment findings can reach claims that already passed a utilization review or prior-authorization check.

Food assistance rules tighten too. The mandatory work-program age rises to 64, the child exemption drops to under 14, self-attestation alone can no longer prove shelter costs, and new EBT cards need photo ID.

The state also expands its Medicaid drug-list system to cover physician-administered drugs and high-cost drugs, and directs the agency to plan new home-based care for adults with serious mental illness.

KEY PROVISIONS
§ 1 New work and community engagement requirement for Medicaid adults majors. 409.9041

AIAdults 19 to 64 on Medicaid must complete about 80 hours a month of work, job training, or schooling to keep coverage, once the agency wins federal approval and the Legislature separately approves its business plan.

“Medicaid recipients between the ages of 19 and 64 years, inclusive, must meet the work or community engagement requirements of this section” bill text, line 205 →
§ 2 Retrospective review of hospital claims no longer must stop majors. 409.905

AIThe agency was required to stop retrospective review of hospital inpatient claims once it began requiring prior authorization for them. That mandatory stop is repealed, so review can continue indefinitely alongside prior authorization.

“the agency shall discontinue its hospital retrospective review program” bill text, line 360 →
§ 3 Overpayment definition now reaches prior-authorized claims majors. 409.913

AIMedicaid's definition of a recoverable overpayment is broadened to explicitly include payments for services that already went through a utilization review or prior-authorization process, so upfront approval no longer forecloses a later repayment demand.

“may include amounts paid for goods or services that were the subject of a utilization review or prior authorization process” bill text, line 964 →
§ 4 SNAP work-program age raised, child exemption narrowed majors. 414.455

AIFood-assistance recipients must join a mandatory work and training program up to age 64, not 59, and the exemption for parents now covers only those with children under 14 instead of under 18, pulling in parents of teenagers.

“who is 18 to 64 years of age, inclusive; who does not have children under the age of 14 in his or her home”
§ 5 Emergency Medicaid claims for noncitizens face new audits moderates. 409.904

AIThe agency may retroactively review and audit claims for emergency care given to people who qualify for Medicaid only because of a medical emergency, checking the emergency was real and treatment necessary, even after approving the service in advance.

“regardless of whether the provider obtained prior authorization for the services” bill text, line 168 →
§ 6 Immigration status and cost documentation required for food aid moderates. 414.321

AINew law limits food assistance to citizens, permanent residents, and other specified lawfully-present immigrants, and bars the department from accepting an applicant's word alone as proof of shelter or utility costs.

“prohibited from relying solely on an individual's self-attestation in determining shelter or utility expenses” bill text, line 1023 →
§ 7 New home-based care option planned for severe mental illness moderates. 409.906

AIThe agency must seek federal approval for a new optional Medicaid service offering expanded home- and community-based care for adults with serious mental illness who are heavy users of institutional treatment, but cannot launch it until the Legislature funds it.

“covers an expanded array of home- and community-based services for adults 18 years of age and older diagnosed with a serious mental illness” bill text, line 399 →
§ 8 New required drug and product lists for Medicaid formulary moderates. 409.91195

AIThe Pharmaceutical and Therapeutics Committee must build three new Medicaid lists beyond the existing preferred drug list, and the agency must adopt them; a drug or product left off a list can require prior authorization before Medicaid pays for it.

“a preferred physician-administered drug list, a preferred product list, and a high-cost drug list” bill text, line 444 →
TIMELINE
3/13/2026
Died in Messages
3/9/2026
In Messages
3/9/2026
CS passed; YEAS 26 NAYS 11 -SJ 688
3/9/2026
Read 3rd time -SJ 688
3/6/2026
Placed on 3rd reading -SJ 635
3/6/2026
Amendment(s) failed (122906, 821406) -SJ 635
3/6/2026
Read 2nd time -SJ 635
3/4/2026
CS/CS by Appropriations read 1st time
3/4/2026
Placed on Special Order Calendar, 03/06/26
3/4/2026
Placed on Calendar, on 2nd reading
3/4/2026
Pending reference review -under Rule 4.7(2) - (Committee Substitute)
3/2/2026
CS/CS by- Appropriations; YEAS 14 NAYS 4
2/25/2026
On Committee agenda-- Appropriations, 03/02/26, 12:00 pm, 110...
2/10/2026
CS by Health Policy read 1st time
2/4/2026
Now in Appropriations
2/4/2026
Pending reference review under Rule 4.7(2) - (Committee Substitute)
2/2/2026
CS by Health Policy; YEAS 8 NAYS 3
1/28/2026
On Committee agenda-- Health Policy, 02/02/26, 3:30 pm, 412 Knott Building
1/22/2026
Introduced
1/16/2026
Referred to Health Policy; Appropriations
1/13/2026
Filed
15 EARLIER →
STATUTES IT CHANGES
s. 409.904
+55 / −0
s. 409.9041
+1119 / −0
s. 409.905
+27 / −21
s. 409.906
+139 / −0
s. 409.91195
+122 / −12
s. 409.912
+585 / −21
STAFF ANALYSES