Florida Senate - 2026                                     SB 736
       
       
        
       By Senator Burgess
       
       
       
       
       
       23-00686A-26                                           2026736__
    1                        A bill to be entitled                      
    2         An act relating to Medicaid coverage of blood pressure
    3         monitoring devices; creating s. 409.9064, F.S.;
    4         defining the terms “blood pressure cuff” and
    5         “validated at-home blood pressure monitor”; requiring
    6         the Agency for Health Care Administration, subject to
    7         the availability of funds and certain limitations and
    8         directions, to provide coverage for validated at-home
    9         blood pressure monitors and blood pressure cuffs for
   10         certain Medicaid recipients; providing construction;
   11         providing requirements for Medicaid recipients to
   12         continue receiving coverage for their validated at
   13         home blood pressure monitors and blood pressure cuffs;
   14         requiring the agency to seek federal approval for
   15         implementation of the act, if needed; requiring the
   16         agency to include the rate impact of the act in
   17         certain rates that become effective on a specified
   18         date; providing an effective date.
   19          
   20  Be It Enacted by the Legislature of the State of Florida:
   21  
   22         Section 1. Section 409.9064, Florida Statutes, is created
   23  to read:
   24         409.9064 Coverage of blood pressure monitoring devices for
   25  Medicaid recipients.—
   26         (1)As used in this section, the term:
   27         (a)“Blood pressure cuff” means a blood pressure
   28  measurement accessory that is used with a validated at-home
   29  blood pressure monitor to measure blood pressure levels and that
   30  is obtained independently of a validated at-home blood pressure
   31  monitor in order to ensure proper size and fit for the patient.
   32         (b)Validated at-home blood pressure monitormeans a
   33  blood pressure measurement device that has been validated for
   34  accuracy and is listed in the United States Blood Pressure
   35  Validated Device Listing developed by the American Medical
   36  Association and is designed for the purpose of aiding in the
   37  treatment of hypertension by measuring blood pressure levels
   38  outside of the clinical setting.
   39         (2)Subject to the availability of funds and subject to any
   40  limitations or directions provided in the General Appropriations
   41  Act, the agency must provide coverage for validated at-home
   42  blood pressure monitors and blood pressure cuffs under the
   43  Medicaid pharmacy benefit for the treatment of a Medicaid
   44  recipient if:
   45         (a)The recipient has been diagnosed by his or her primary
   46  care physician, or another licensed health care practitioner
   47  authorized to make such diagnosis, with hypertension; and
   48         (b)A health care practitioner with the applicable
   49  prescribing authority has prescribed a validated at-home blood
   50  pressure monitor to assist the recipient and practitioner in
   51  managing the recipient’s condition.
   52         (3)Coverage under this section includes the cost of any
   53  necessary repairs or replacement parts for validated at-home
   54  blood pressure monitors and blood pressure cuffs.
   55         (4)To qualify for continued coverage under this section,
   56  the Medicaid recipient must participate in follow-up care with
   57  his or her treating health care practitioner, in person or
   58  through telehealth, at least once every 6 months during the
   59  first 18 months after the recipient’s first prescription for the
   60  validated at-home blood pressure monitor has been issued under
   61  this section, to assess the efficacy of using the monitor for
   62  treatment or management of his or her hypertension. After the
   63  first 18 months, such follow-up care must occur at least once
   64  every 12 months.
   65         (5)The agency shall seek federal approval, if needed, for
   66  the implementation of this section.
   67         Section 2. The Agency for Health Care Administration shall
   68  include the rate impact of this act in the Medicaid managed
   69  medical assistance program and long-term care managed care
   70  program rates, as applicable, which take effect on October 1,
   71  2026.
   72         Section 3. This act shall take effect October 1, 2026.