No. SB 736
Filed under Healthcare.
Medicaid Coverage of Blood Pressure Monitoring Devices; Defining the terms “blood pressure cuff” and “validated at-home blood pressure monitor”; requiring the Agency for Health Care Administration, subject to the availability of funds and certain limitations and directions, to provide coverage for validated at-home blood pressure monitors and blood pressure cuffs for certain Medicaid recipients; providing construction; providing requirements for Medicaid recipients to continue receiving coverage for their validated at-home blood pressure monitors and blood pressure cuffs, etc.
Plain English Summary
AI-GENERATEDRequires Florida Medicaid to cover validated at-home blood pressure monitors and blood pressure cuffs for recipients who are diagnosed with hypertension and have a prescription for the device, subject to available state funding.
Only devices listed on the American Medical Association's validated device registry qualify, and coverage includes the cost of necessary repairs or replacement parts for the monitor or its blood pressure cuff.
To keep the coverage, a recipient must see their treating practitioner -- in person or by telehealth -- at least every 6 months for 18 months, then at least every 12 months after that.
The coverage requirement only applies subject to available funds and to whatever limits the Legislature sets in the annual budget, so actual access could depend on yearly appropriations rather than being an unconditional guarantee.
AIThe state Medicaid agency must cover validated at-home blood pressure monitors and blood pressure cuffs under the Medicaid pharmacy benefit for a recipient who has been diagnosed with hypertension and has a prescription for the device, subject to available funding.
AITo qualify, a Medicaid recipient must be diagnosed with hypertension by a primary care physician or another authorized practitioner, and a prescriber must separately prescribe the validated at-home monitor to help manage that diagnosis.
AITo continue receiving coverage, a recipient must have follow-up care with the treating practitioner -- in person or by telehealth -- at least every 6 months for the first 18 months after the initial prescription, then at least every 12 months after that.
AIOnly a blood pressure monitor that has been validated for accuracy and appears on the American Medical Association's United States Blood Pressure Validated Device Listing counts as a covered device -- unlisted monitors do not qualify.
AIThe Medicaid coverage required by this section includes paying for necessary repairs or replacement parts for a recipient's validated at-home blood pressure monitor or blood pressure cuff, not just the initial device.
AIThe coverage requirement only applies subject to the availability of funds and to any limitations or directions the Legislature sets in the General Appropriations Act, so the Legislature can narrow or condition the mandate through the annual budget process.