Florida Statutes 409.9745 – Managed care plan biomarker testing
Current as of: 2024 | Check for updates
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Terms Used In Florida Statutes 409.9745
- Agency: means the Agency for Health Care Administration. See Florida Statutes 409.962
- Managed care plan: means an eligible plan under contract with the agency to provide services in the Medicaid program. See Florida Statutes 409.962
- Medicaid: means the medical assistance program authorized by Title XIX of the Social Security Act, 42 U. See Florida Statutes 409.962
- recipient: means an individual who the department or, for Supplemental Security Income, the Social Security Administration determines is eligible pursuant to federal and state law to receive medical assistance and related services for which the agency may make payments under the Medicaid program. See Florida Statutes 409.962
- Screening: means the use of an information-collection tool to determine a priority score for placement on the wait list. See Florida Statutes 409.962
(1) A managed care plan must provide coverage for biomarker testing for recipients, as authorized under s. 409.906, at the same scope, duration, and frequency as the Medicaid program provides for other medically necessary treatments.
(2) A recipient and health care provider shall have access to a clear and convenient process to request authorization for biomarker testing as provided under this section. Such process shall be made readily accessible on the website of the managed care plan.
(3) This section does not require coverage of biomarker testing for screening purposes.
(4) The agency shall include the rate impact of this section in the applicable Medicaid managed medical assistance program and long-term care managed care program rates.