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HB 815 Florida House · 2025 Regular Session

Patient Referrals by Medicaid Managed Care Organizations and Managed Care Plans

Summary
Patient Referrals by Medicaid Managed Care Organizations and Managed Care Plans; Requires AHCA to contract for analysis of Medicaid managed care plan referrals to affiliated organizations; provides requirements; requires report.
Issues: ✓ HealthcareSupports HealthcareMandates analysis of Medicaid managed care referrals to affiliated orgs for oversight, aiming to improve patient access and prevent conflicts of interest in healthcare delivery.85% confidence
Bill status died 1 of 4 stages cleared
Introduction
Feb 2025
Committee Review
Floor Vote
Governor
Introduced Feb 20, 2025 Last action Jun 16, 2025
Maddy AI version diff · 1 comparison

What changed between versions

H 815 Filed → H 815 c1 · 4 edits
MODERATE
This bill was amended to simplify its focus from a broad mandate for the Agency for Health Care Administration to conduct various reviews and investigations into Medicaid fraud to a specific requirement to contract for an analysis of referrals to affiliated organizations. The changes narrow the scope to require a comparative cost analysis of referrals versus other providers and establish a clear reporting deadline of July 1, 2026, replacing the previous vague language about conducting reviews and investigations.
Scope change
The bill's scope was narrowed from a broad mandate for general Medicaid fraud investigations and audits to a specific requirement for analyzing referrals to affiliated organizations with profit-sharing or controlling interests.
REQUIREMENT

Changed the Agency's obligation from conducting general reviews, investigations, and audits to specifically contracting for an analysis of referrals to affiliated organizations.

Added a requirement to compare the cost of services provided through referrals to affiliated organizations against the cost of services provided by other contracted providers.

TIMELINE

Established a specific deadline of July 1, 2026, for submitting the analysis report to state leadership.

ENFORCEMENT

Removed language authorizing the Agency to conduct reviews, investigations, and audits to determine violations and impose penalties.

Floor votes

How they voted

No floor votes recorded yet.
Full legislative history

Actions timeline

Total actions
16
Key actions
5
Committee
9
Apr 4, 2025
Lower · Passed
Now in Health & Human Services Committee
lower
Apr 4, 2025
Committee
Referred to Health & Human Services Committee
lower
Apr 3, 2025
Lower · Passed
Reported out of Health Care Facilities & Systems Subcommittee
lower
Apr 2, 2025
Lower · Passed
Favorable with CS by Health Care Facilities & Systems Subcommittee
lower
Mar 31, 2025
Lower · Passed
PCS added to Health Care Facilities & Systems Subcommittee agenda
lower
Feb 26, 2025
Lower · Passed
Now in Health Care Facilities & Systems Subcommittee
lower
Feb 26, 2025
Committee
Referred to Health & Human Services Committee
lower
Feb 26, 2025
Committee
Referred to Health Care Budget Subcommittee
lower
Feb 26, 2025
Committee
Referred to Health Care Facilities & Systems Subcommittee
lower
1 primary · 0 co-sponsors

Sponsors

Role
Legislator
Party
State
District
P
FB
Fabián Basabe
RRepublican
FL
106