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HB 855/ SB1258 creates a new system to measure Medicaid plan performance and increases transparency for Medicaid Recipients


This week, Representative Robin Bartleman (D-Weston) and Senator Shevrin Jones (D- Miami Gardens) have filed HB 855/SB 1258 - Managed Care Plan Performance. Last session, this same idea (HB 899) by Representative Bartleman passed through the House. 

“The COVID- 19 pandemic has revealed disparities that exist in our healthcare system”, said Representative Bartleman. “Yet without data, lawmakers can only guess where these disparities lie. HB 855 brings greater transparency, ensures that our State’s health care dollars are spent efficiently, and makes Florida’s Medicaid programs stronger and recipients healthier.”

“This legislation provides common sense reforms to the Florida Healthcare System”, says prime co- sponsor, Representative Nicholas Duran (D- Miami). “HB 855 will require transparency and accountability from Managed Care Plans in providing accessible and affordable healthcare in the State of Florida.”

Florida’s Medicaid program covers approximately 4.5 million low-income individuals and represents approximately one-third of the total 2020- 2021 state budget. While current law requires the Managed Medical Assistance Program (MMA), overseen by the Agency for Health Care Administration, to collect portions of the Adult and Child Core Set data, this bill expands these measures to include all Adult Core Set behavioral health measures. It also directs MMA plans to break down the data based on common indicators of health disparities including disability, race, age, primary language, ethnicity, and sex so that policy makers, providers, and Medicaid recipients can make better-informed decisions. 

AHCA and Medicaid Managed Care plans will then use this data to provide targeted services to Florida’s Managed Care Plan recipients. Recipients can then compare these reports to select the Medicaid Managed Care plan that best fits their needs.

“I am proud to work alongside Representative Bartleman on this bill to increase transparency for the millions of Floridians covered through Medicaid,” said Senator Jones. “Health care is a human right, and all Floridians deserve equal opportunities to achieve healthier outcomes, regardless of race, age, disability, or ethnicity. It’s time we take action to ensure Florida’s policymakers have access to the necessary data for making informed, meaningful decisions as we seek to eliminate health disparities in our communities.”