No. HB 935
Filed under Healthcare.
Community Health Worker Services; Authorizes AHCA to pay for community health worker services as optional Medicaid service; specifies coverage requirements; defines "community health worker"; requires agency to adopt rules; authorizes agency to seek federal approval; adds community health worker services to list of Medicaid services authorized for reimbursement on fee-for-service basis; adds community health worker services to list of minimum benefits required to be covered by Medicaid managed care plans.
Plain English Summary
AI-GENERATEDFlorida Medicaid managed care plans must now cover community health worker services as a minimum benefit, and the same services are added to the list eligible for fee-for-service reimbursement outside managed care.
The state agency may also pay directly for community health worker services as a new optional Medicaid benefit, covering health promotion, wellness coaching, cultural mediation, interpretation, health system navigation, home visits, and care coordination.
A "community health worker" is defined broadly to include community health representatives, promotores de salud, and public or private community-based organizations, and the agency must adopt rules on which services qualify.
AICreates s. 409.906(30), letting the agency pay for community health worker services covering health promotion, cultural mediation, interpretation, health system navigation, home visits, transportation arranging, and care coordination. The same services are also added to the fee-for-service reimbursement list under s. 409.908(3)(c).
AIAdds community health worker services as a new paragraph (e) to the minimum benefits list in s. 409.973(1), which Medicaid managed care plans must cover for enrollees rather than merely being permitted to.
AIDefines a community health worker as a frontline public health worker addressing a community's health and social needs, and states the term also includes community health representatives, promotores de salud, and community-based organizations.
AIRequires the agency to adopt rules covering, at minimum, which services provided by community health workers are eligible for Medicaid payment, leaving the detailed scope of the new benefit to future rulemaking.