S 1470

Florida Senate - 2026  SB 1470
By Senator Bernard
24-01110A-26  20261470__
1A bill to be entitled
2An act relating to behavioral health intervention
3services; creating s. 409.9206, F.S.; providing
4legislative findings and purpose; defining terms;
5authorizing, contingent upon an appropriation, the
6state Medicaid plan to fund a demonstration pilot
7program in a specified region for specified purposes;
8authorizing Medicaid managed assistance providers to
9offer specified intervention services to certain
10participants under the pilot program; providing
11requirements for the pilot program; requiring the
12state Medicaid plan to prepare and submit a specified
13report to the Legislature as soon as practicable after
14the expiration of the pilot program; requiring the
15state Medicaid plain to consider certain factors when
16paying certain capitation rates; providing for future
17expiration of the pilot program; providing an
18effective date.
19
20Be It Enacted by the Legislature of the State of Florida:
21
22Section 1. Section 409.9206, Florida Statutes, is created
23to read:
24409.9206De-risking disease behavioral health intervention
25services pilot program.—
26(1)LEGISLATIVE FINDING; PURPOSE.—
27(a)The Legislature finds that under federal Medicaid
28managed care regulations 42 C.F.R. s. 438.3(e)(2) and 42 C.F.R.
29s. 438.16, the Agency for Health Care Administration may approve
30de-risking disease behavioral health intervention services.
31(b)The purpose of this section is to authorize the state
32Medicaid plan to fund a demonstration pilot program that shall
33provide a de-risking disease behavioral health intervention
34services management plan to recipients of the state Medicaid
35plan in Region G, which consists of Indian River, Martin,
36Okeechobee, Palm Beach, and St. Lucie Counties.
37(2)DEFINITIONS.—As used in this section, the term:
38(a)“De-risking disease behavioral health intervention
39services” means the following set of five concurrent self
40management services and medical nutrition supports demonstrated
41in scientific research to improve behavioral health and chronic
42disease outcomes:
431.Behavioral health counseling provided by a licensed
44clinical social worker for lifestyle modifications for patients
45diagnosed with depression and uncontrolled diabetes mellitus.
462.Medical nutrition therapy provided by a registered
47dietitian nutritionist for diet and lifestyle modifications for
48patients diagnosed with depression and uncontrolled diabetes
49mellitus.
503.Biomarker health tracking, nudging, and reporting using
51devices approved by the Florida Medicaid Diabetic Supply
52Services Coverage Policy to monitor HbA1C, blood sugar glucose,
53oxygen, heart rate, lipids, weight, body mass index, blood
54pressure, and other biomarkers.
554.Medical disease nutrition education designed for
56depression and uncontrolled diabetes mellitus which is evidence
57based.
585.Medical nutrition supports that are evidence-based
59lifestyle modification services for patients diagnosed with
60depression and uncontrolled diabetes mellitus, including, but
61not limited to, clinical nutrition groceries, home-delivered
62medically tailored meals, produce prescriptions, or other
63evidence-based, medically necessary nutrition interventions
64demonstrated to be cost effective by scientific research
65studies.
66(b)“Participant” means a Medicaid recipient and his or her
67family participating in the pilot program.
68(c)“Pilot program” means the demonstration pilot program
69established under this section.
70(3)PILOT PROGRAM.—Contingent upon an appropriation, the
71state Medicaid plan may fund a demonstration pilot program to
72provide de-risking disease behavioral health intervention
73services to eligible Medicaid recipients in Region G, which
74consists of Indian River, Martin, Okeechobee, Palm Beach, and
75St. Lucie Counties.
76(a)Under the pilot program, Medicaid managed assistance
77providers may offer de-risking disease behavioral health
78intervention services:
791.In lieu of services specified in the state Medicaid plan
80to a Medicaid recipient who is diagnosed with both:
81a.Depression or anxiety; and
82b.Diabetes mellitus, obesity, or coronary heart disease.
832.As a disease management plan to 1,000 participants in
84Region G.
85(b)The design, evaluation, and outcome measures of the
86pilot program must be developed from a research evaluation
87conducted by nutrition scientists at the Tufts University
88Friedman School of Nutrition Science and Policy, a qualified and
89accredited academic institution specializing in nutrition, and
90program implementation experts at the Florida Health and
91Nutrition Coalition.
92(c)The pilot program shall:
931.Be designed to provide de-risking disease behavioral
94health intervention services, diabetic supply services, chronic
95disease self-management and education services, and medical
96nutrition supports coverage in lieu of services specified in the
97state Medicaid plan.
982.Collect data, including, but not limited to, the rate by
99which pilot program participants, and their families, comply
100with de-risking disease behavioral health intervention services;
101health outcomes and biomarkers associated with the participants
102and their families; and overall impact of the pilot program on
103participant diagnosis, chronic health condition, and disease
104symptoms.
1053.Include measures to review and assess data, including
106health outcomes and biomarkers, and the impact on participants
107and their families to evaluate the overall impact of the pilot
108program on disease management.
109(4)ANNUAL REPORT.—The state Medicaid plan shall:
110(a)As soon as practicable after the expiration of the
111pilot program, prepare and submit to the President of the Senate
112and the Speaker of the House of Representatives a report on the
113number of times during the preceding year the de-risking disease
114behavioral health intervention services were used in Indian
115River, Martin, Okeechobee, Palm Beach, and St. Lucie Counties, a
116summary of the data the state Medicaid plan collected, and
117recommendations for any legislative action.
118(b)Consider the actual cost, measurable goals and health
119outcomes met, and participant adherence to the de-risking
120disease behavioral health intervention services when paying the
121capitation rates for that managed care organization under the
122contract.
123(5)EXPIRATION.—
124(a)The pilot program shall expire August 31, 2030.
125(b)This section expires September 1, 2031.
126Section 2. This act shall take effect July 1, 2026.