Florida Medicaid Managed Care Legislation

Florida Medicaid Managed Care Legislation:

The Medicaid Managed Care Networks legislation has been filed in both chambers of the Florida Legislature. The House version is HB 625 and is sponsored by Representative Heather Fitzenhagen. The Senate version, SB 670 was filed by Senator Aaron Bean. It is important to note that neither bill has been referred to any committees yet. Yet this is a major step toward reform of the both Florida Statutes (409.975 and 409.967) that govern the Medicaid Managed Care Networks in Florida. It signifies that actions taken by independent community retail Pharmacists can make an impact and that their “voice” and opinions can be heard and make a difference. Through such organizations as The Florida Independent Pharmacy Network and others, the slow gears of legislative change have been set into motion. If passed by both Florida Chambers, the Act shall take effect July 1, 2017.

The heart of the Act relating to the Florida Medicaid Managed Care Networks is amending  Florida Statute 409.975 in prohibiting a managed care plan from excluding a pharmacy that meets the credentialing requirements and standards established by the Agency for Health Care Administration and that accepts the terms of the plan. Additionally, the amendment requires a managed care plan to offer the same rate of reimbursement to all pharmacies in the plan network. There are other additional modifications to Florida Statute 409.975 (both additions and deletions) and we recommend that you read both in their entirety as listed above.

This is a major victory for the independent community retail Pharmacies operating in Florida. It also shows that through a united and continuous effort the system works for both the small Pharmacy business entrepreneur as well as the large national Pharmacy chain stores.

As always, please contact us here at HCC if you have any questions regarding how these changes to the Florida Statutes affect your Pharmacy business. With over 27 years in the Pharmacy Consulting business, HCC can assist with expert advice in any area of your Pharmacy business or practice. We urge you to contact us today to see how our Pharmacy Consulting services can help. With a full-time staff of in-house Pharmacy Consultant specialists, HCC can answer any questions that you may have in all Pharmacy settings. Contact us online or call us today at 800-642-1652 for a free consultation.

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