No. HB 781
Filed under Healthcare.
Medicaid Coverage of Blood Pressure Monitors and Cuffs; Defines "blood pressure monitor & cuff;" requiring AHCA to provide coverage for blood pressure monitors & cuffs under Medicaid pharmacy benefit for certain persons; provides requirements for coverage; provides that coverage of blood pressure monitors & cuffs includes cost of any necessary repairs or replacement parts; provides coverage qualification requirements for Medicaid recipients; requires agency to seek federal approval for implementation of coverage & to include rate impact in Medicaid managed medical assistance program & long-term care managed care program rates beginning on specified date.
Plain English Summary
AI-GENERATEDMedicaid must cover home blood pressure monitors and cuffs, subject to available funding, for recipients diagnosed with medication-treatable hypertension whose practitioner has prescribed both the medication and the monitor to manage it.
Coverage includes repairs and replacement parts, but continuing it depends on the recipient attending follow-up visits at least every 6 months for 18 months, then every 12 months after that.
AHCA must seek federal approval to implement the benefit and must build its cost into Medicaid managed care and long-term care plan rates starting October 1, 2026.
AISubject to available funding, AHCA must cover blood pressure monitors and cuffs under the Medicaid pharmacy benefit for a recipient diagnosed with hypertension whose practitioner has prescribed both medication and the monitor to manage it.
AIA recipient qualifies only if a practitioner has diagnosed medication-treatable hypertension and a prescribing practitioner has separately prescribed both medication and a validated blood pressure monitor and cuff to manage it.
AIOnce a recipient qualifies, Medicaid coverage extends beyond the initial device to include the cost of any necessary repairs or replacement parts for the monitor and cuff.
AITo keep the coverage, a recipient must attend follow-up care at least every 6 months for the first 18 months after the first prescription, then at least every 12 months after that.
AIThe duty to cover blood pressure monitors applies only subject to available funds and any limits set in the General Appropriations Act, so the Legislature could scale back the benefit through the budget process.