THE BILL ITSELF
HB 781
Medicaid Coverage of Blood Pressure Monitors and Cuffs
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A bill to be entitled
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An act relating to Medicaid coverage of blood pressure
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monitors and cuffs; creating s. 409.90631, F.S.;
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defining the term "blood pressure monitor and cuff;"
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requiring the Agency for Health Care Administration to
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provide coverage for blood pressure monitors and cuffs
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under the Medicaid pharmacy benefit for certain
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persons; providing requirements for coverage;
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providing that coverage of blood pressure monitors and
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cuffs includes the cost of any necessary repairs or
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replacement parts; providing coverage qualification
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requirements for Medicaid recipients; requiring the
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agency to seek federal approval for implementation of
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coverage and to include the rate impact in the
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Medicaid managed medical assistance program and long-
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term care managed care program rates beginning on a
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specified date; providing an effective date.
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Be It Enacted by the Legislature of the State of Florida:
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Section 1. Section 409.90631, Florida Statutes, is created
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to read:
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409.90631 Coverage of blood pressure monitors and cuffs
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for Medicaid recipients.—
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(1) As used in this section, the term "blood pressure
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monitor and cuff" means a device designed for the purpose of
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aiding in the treatment of hypertension by measuring blood
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pressure levels through a validated blood pressure measurement
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device at home or elsewhere outside the clinic setting.
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(2) Subject to the availability of funds and subject to
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any limitations or directions provided in the General
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Appropriations Act, the agency must provide coverage for blood
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pressure monitors and cuffs under the Medicaid pharmacy benefit
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for the treatment of a Medicaid recipient if:
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(a) The recipient has been diagnosed by his or her primary
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care physician, or another licensed health care practitioner
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authorized to make such diagnosis, with hypertension that may be
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treated with medication; and
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(b) A health care practitioner with the applicable
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prescribing authority has prescribed medication to treat the
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recipient's hypertension and a validated blood pressure monitor
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and cuff to assist the recipient and practitioner in managing
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the recipient's hypertension.
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(3) Coverage under this section includes the cost of any
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necessary repairs or replacement parts for the blood pressure
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monitor and cuff.
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(4) To qualify for continued coverage under this section,
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the Medicaid recipient must participate in follow-up care with
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his or her treating health care practitioner, in person or
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through telehealth, at least once every 6 months during the
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first 18 months after the first prescription of the blood
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pressure monitor and cuff for the recipient has been issued
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under this section, to assess the efficacy of using the blood
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pressure monitor and cuff for treatment of his or her
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hypertension. After the first 18 months, such follow-up care
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must occur at least once every 12 months.
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(5) The agency shall seek federal approval, if needed, for
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the implementation of this section.
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Section 2. The Agency for Health Care Administration shall
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include the rate impact of this act in the Medicaid managed
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medical assistance program and long-term care managed care
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program rates, as applicable, that take effect on or after
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October 1, 2026.
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Section 3. This act shall take effect October 1, 2026.