Florida legislation · 2026 Regular Session
Florida H531: Managed Care Plans
Status: Failed, March 13, 2026
Revises Medicaid managed care contract requirements to prohibit managed care plans from reviewing certain prior authorization claims for medical necessity; requires that managed care plans provide coverage for durable medical equipment & complex rehabilitation technology from qualified provider, from within provider network, of enrollee's choosing; requires AHCA to adopt certain rules.
What the bill says
An act relating to managed care plans; amending s. 409.967, F.S.; revising Medicaid managed care contract requirements to prohibit managed care plans from reviewing certain prior authorization claims for medical necessity; requiring that managed care plans provide coverage for durable medical equipment and complex rehabilitation technology from a qualified provider, from within the provider network, of the enrollee's choosing; requiring the Agency for Health Care Administration to adopt certain rules; providing an effective date.
From the introduced text, November 24, 2025:
A bill to be entitled An act relating to managed care plans; amending s. 409.967, F.S.; revising Medicaid managed care contract requirements to prohibit managed care plans from reviewing certain prior authorization claims for medical necessity; requiring that managed care plans provide coverage for durable medical equipment and complex rehabilitation technology from a qualified provider, from within the provider network, of the enrollee's choosing; requiring the Agency for Health Care Administration to adopt certain rules; providing an effective date. Be It Enacted by the Legislature of the State of Florida: Section 1. Paragraphs (p) and (q) are added to subsection (2) of section 409.967, Florida Statutes, to read: 409.967 Managed care plan accountability.-- (2) The agency shall establish such contract requirements as are necessary for the operation of the statewide managed care program. In addition to any other provisions the agency may deem necessary, the contract must require: (p) Prior authorization reviews.--For any claims in which a Medicaid managed care plan has given prior authorization, prepayment or postpayment review may not include review for words underlined are additions. hb531-00 FLORIDAHOUSEOFREPRESENTATIVES HB 531 2026 medical necessity for the previously approved equipment, supplies, or services. (q) Durable medical equipment.--Managed care plans, or their subcontractors, shall provide coverage for durable medical equipment or complex rehabilitation technology from any qualified durable medical equipment or …
Sponsors
- Webster Barnaby (R, HD-027) · primary sponsor
- Barnaby, Webster (R, HD-029) · primary sponsor
- Basabe, Fabián (R, HD-106) · primary sponsor
Latest actions
- : Died in Health Care Facilities & Systems Subcommittee
- : 1st Reading (Original Filed Version)
- : Now in Health Care Facilities & Systems Subcommittee
- : Referred to Health & Human Services Committee
- : Referred to Health Care Facilities & Systems Subcommittee
- : Filed
Common questions
- What is H531?
- H531 is a bill in the Florida Legislature (2026 Regular Session): Managed Care Plans.
- What does H531 do?
- In its own words: An act relating to managed care plans; amending s. 409.967, F.S.; revising Medicaid managed care contract requirements to prohibit managed care plans from reviewing certain prior authorization claims for medical necessity; requiring that managed care plans provide coverage for durable medical equipment and complex rehabilitation technology from a qualified provider, from within the provider network, of the enrollee's choosing; requiring the Agency for Health Care Administration to adopt certain rules; providing an effective date.
- What is the status of H531?
- Failed as of March 13, 2026. Latest action: Died in Health Care Facilities & Systems Subcommittee (March 13, 2026).
- Who sponsored H531?
- Webster Barnaby (R, HD-027), with 2 co-sponsors.
- Where is the official record for H531?
- On the Florida Legislature website: https://www.flsenate.gov/Session/Bill/2026/531
Source: official Florida record. Tracked by Delilah, AI for legislation across all 50 states and Congress.