H1109: Health Care Provider Participation in Medicaid Managed Care Organizations

Legislative Summary

Requires that health care providers wanting to participate in Medicaid managed care organizations enroll with AHCA & be credentialed for & enter into contract with Medicaid managed care organizations; requires agency to enroll health care providers within specified timeframe; provides date of enrollment; requires health care providers to submit credentialing applications to credentialing verification organizations; provides requirements for contracts between agency & such organizations; provides requirements for contracts between Medicaid managed care organizations & health care providers; encouraging licensing boards to cooperate with agency & credentialing verification organizations; provides date on which providers' claims become eligible for payment; prohibits Medicaid managed care organizations from imposing certain requirements relating to clean claims within specified timeframe.