Parity for Nonnursing Services Under Long-term Managed Care Plans

Plain English Breakdown

Checked against official source text during the last sync.

Parity for Nonnursing Services Under Long-term Managed Care Plans

This bill requires the Agency for Health Care Administration to pay licensed providers at least as much as unlicensed providers for nonnursing services under Medicaid long-term managed care plans, starting January 1, 2027.

What This Bill Does

• Requires the agency to pay licensed providers the same or higher rate than unlicensed providers for nonnursing services from January 1, 2027.
• Allows the agency to adjust payment rates annually based on inflation and overhead costs.
• Directs the agency to request any necessary Medicaid waiver or state plan amendment within 30 days of the bill becoming law.

Who It Names or Affects

• Licensed providers who offer nonnursing services under Medicaid long-term managed care plans.
• Unlicensed providers and family caregivers providing similar services.
• The Agency for Health Care Administration in Florida.

Terms To Know

Medicaid

A government program that helps people with low income pay for medical costs.

Managed care plan

An insurance plan that manages health care services and payments to control costs.

Limits and Unknowns

• The bill does not specify how much more licensed providers will be paid compared to unlicensed providers.
• It is unclear if the rate adjustments for licensed providers will cover all necessary expenses or if additional funding will be needed.

Official Summary Text

Parity for Nonnursing Services Under Long-term Managed Care Plans; Beginning on a specified date, requiring the Agency for Health Care Administration to reimburse nonnursing services provided by licensed providers at the same rate or higher than the rate it reimburses unlicensed providers for such services under the Medicaid long-term managed care program; requiring the agency annually to adjust the rate for licensed providers, etc.

Current Bill Text

Florida Senate
-
2026

SB 38

By
Senator Sharief

35-00009-26 202638__
1 A bill to be entitled
2 An act relating to parity for nonnursing services
3 under long-term managed care plans; beginning on a
4 specified date, requiring the Agency for Health Care
5 Administration to reimburse nonnursing services
6 provided by licensed providers at the same rate or
7 higher than the rate it reimburses unlicensed
8 providers for such services under the Medicaid long
9 term managed care program; requiring the agency
10 annually to adjust the rate for licensed providers;
11 requiring the agency, within a specified timeframe, to
12 seek any Medicaid waiver or state plan amendment
13 necessary to implement the rate changes; providing an
14 effective date.
15
16 Be It Enacted by the Legislature of the State of Florida:
17
18 Section 1.
(1)

Beginning January 1, 2027, the
Agency for

19
Health Care Administration shall reimburse licensed providers

20
who provide nonnursing services, such as home health agencies

21
and nurse registries, participating in the Medicaid long-term

22
managed care program at a rate that is at least the same rate or

23
higher than the rate it reimburses unlicensed providers for such

24
services, such as family caregivers. The agency shall annually

25
adjust the rate for licensed providers to accommodate inflation

26
and overhead costs.

27
(2)

Within 30 days after the effective date of this act,

28
the agency shall request any Medicaid waiver or state plan

29
amendment necessary to implement these rate changes.

30 Section 2. This act shall take effect upon becoming a law.