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HB 935 2026
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hb935-00
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to community health worker services; 2
amending s. 409.906, F.S.; authorizing the Agency for 3
Health Care Administration to pay for community health 4
worker services as an optional Medicaid service; 5
specifying coverage requirements; defining the term 6
"community health worker"; requiring the agency to 7
adopt rules; authorizing the agency to seek federal 8
approval; amending s. 409.908, F.S.; adding community 9
health worker services to the list of Medicaid 10
services authorized for reimbursement on a fee-for-11
service basis; amending s. 409.973, F.S.; adding 12
community health worker services to the list of 13
minimum benefits required to be covered by Medicaid 14
managed care plans; providing an effective date. 15
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Be It Enacted by the Legislature of the State of Florida: 17
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Section 1. Subsection (30) is added section 409.906, 19
Florida Statutes, to read: 20
409.906 Optional Medicaid services.—Subject to specific 21
appropriations, the agency may make payments for services which 22
are optional to the state under Title XIX of the Social Security 23
Act and are furnished by Medicaid providers to recipients who 24
are determined to be eligible on the dates on which the services 25
HB 935 2026
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
were provided. Any optional service that is provided shall be 26
provided only when medically necessary and in accordance with 27
state and federal law. Optional services rendered by providers 28
in mobile units to Medicaid recipients may be restricted or 29
prohibited by the agency. Nothing in this section shall be 30
construed to prevent or limit the agency from adjusting fees, 31
reimbursement rates, lengths of stay, number of visits, or 32
number of services, or making any other adjustments necessary to 33
comply with the availability of moneys and any limitations or 34
directions provided for in the General Appropriations Act or 35
chapter 216. If necessary to safeguard the state's systems of 36
providing services to elderly and disabled persons and subject 37
to the notice and review provisions of s. 216.177, the Governor 38
may direct the Agency for Health Care Administration to amend 39
the Medicaid state plan to delete the optional Medicaid service 40
known as "Intermediate Care Facilities for the Developmentally 41
Disabled." Optional services may include: 42
(30) COMMUNITY HEALTH WORKERS.—The agency may pay for the 43
provision of community health worker services including, but not 44
limited to, health promotion, wellness coaching, and self-45
management education; cultural mediation; interpretation or 46
translation services; health system navigation; patient and 47
family advocacy; outreach before appointments, including 48
appointment reminders; outreach to ensure adherence to 49
treatments and medications; home visits; individual, community, 50
HB 935 2026
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
and environmental assessments; arranging transportation; making 51
connections to community resources or social services; and 52
providing care coordination and case management. 53
(a) As used in this subsection, the term "community health 54
worker" means a frontline public health worker who provides a 55
range of services addressing the health and social needs of the 56
community and is a trusted member of or has a close 57
understanding of the community he or she serves. The term 58
includes community health representatives, promotores de salud, 59
and public or private community-based organizations. 60
(b) The agency shall adopt rules that include, but are not 61
limited to, eligible services provided by community health 62
workers. 63
(c) The agency may seek federal approval necessary to 64
implement this subsection. 65
Section 2. Paragraphs (c) through (u) of subsection (3) of 66
section 409.908, Florida Statutes, are redesignated as 67
paragraphs (d) through (v), respectively, and a new paragraph 68
(c) is added to subsection (3) of that section, to read: 69
409.908 Reimbursement of Medicaid providers.—Subject to 70
specific appropriations, the agency shall reimburse Medicaid 71
providers, in accordance with state and federal law, according 72
to methodologies set forth in the rules of the agency and in 73
policy manuals and handbooks incorporated by reference therein. 74
These methodologies may include fee schedules, reimbursement 75
HB 935 2026
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
methods based on cost reporting, negotiated fees, competitive 76
bidding pursuant to s. 287.057, and other mechanisms the agency 77
considers efficient and effective for purchasing services or 78
goods on behalf of recipients. If a provider is reimbursed based 79
on cost reporting and submits a cost report late and that cost 80
report would have been used to set a lower reimbursement rate 81
for a rate semester, then the provider's rate for that semester 82
shall be retroactively calculated using the new cost report, and 83
full payment at the recalculated rate shall be effected 84
retroactively. Medicare-granted extensions for filing cost 85
reports, if applicable, shall also apply to Medicaid cost 86
reports. Payment for Medicaid compensable services made on 87
behalf of Medicaid-eligible persons is subject to the 88
availability of moneys and any limitations or directions 89
provided for in the General Appropriations Act or chapter 216. 90
Further, nothing in this section shall be construed to prevent 91
or limit the agency from adjusting fees, reimbursement rates, 92
lengths of stay, number of visits, or number of services, or 93
making any other adjustments necessary to comply with the 94
availability of moneys and any limitations or directions 95
provided for in the General Appropriations Act, provided the 96
adjustment is consistent with legislative intent. 97
(3) Subject to any limitations or directions provided for 98
in the General Appropriations Act, the following Medicaid 99
services and goods may be reimbursed on a fee-for-service basis. 100
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
For each allowable service or goods furnished in accordance with 101
Medicaid rules, policy manuals, handbooks, and state and federal 102
law, the payment shall be the amount billed by the provider, the 103
provider's usual and customary charge, or the maximum allowable 104
fee established by the agency, whichever amount is less, with 105
the exception of those services or goods for which the agency 106
makes payment using a methodology based on capitation rates, 107
average costs, or negotiated fees. 108
(c) Community health workers services. 109
Section 3. Paragraphs (e) through (cc) of subsection (1) 110
of section 409.973, Florida Statutes, are redesignated as 111
paragraphs (f) through (dd), respectively, and a new paragraph 112
(e) is added to subsection (1) of that section, to read: 113
409.973 Benefits.— 114
(1) MINIMUM BENEFITS.—Managed care plans shall cover, at a 115
minimum, the following services: 116
(e) Community health worker services. 117
Section 4. This act shall take effect July 1, 2026. 118