Hospitals must file non‑emergent care access plans; AHCA has approved most early submissions
Loading...
Summary
AHCA required hospitals with emergency departments to submit non‑emergent care access plans by July 1, 2025. Between July 1 and Sept. 30, AHCA received 83 plans, approved 63 and continued review of 20; plans must include patient education and coordination with Medicaid managed‑care plans via the state's HIE.
The Agency for Health Care Administration implemented a statutory requirement that hospitals with emergency departments submit non‑emergent care access plans (NECAPs) at initial licensure or renewal, AHCA Deputy Secretary Kimberly Smoak told the Senate Health Policy Committee. The NECAP requirement took effect July 1, 2025, and the agency has updated hospital licensure rules to require agency review and approval of the plans.
Smoak said AHCA received 83 NECAP submissions between July 1 and Sept. 30, 2025; 63 had been approved and 20 remained under review through the licensure process. She emphasized that the agency must review and approve plans rather than simply collect them.
The statute and AHCA rules require plans to ensure compliance with federal EMTALA obligations, educate patients about appropriate sites for care, and either provide or contract for alternatives (for example, urgent care centers, federally qualified health centers or physician offices). Smoak described examples AHCA reviewers saw in approved plans, including one hospital that assists discharged patients in making primary care appointments and another that sends a follow‑up text message three days after discharge with a localized link to community resources.
For Medicaid enrollees, the NECAP must include outreach to the patient's Medicaid managed‑care organization so plans can assign an in‑network primary care provider where appropriate. Smoak said most acute care hospitals in Florida share admit/transfer/discharge data through the state's Florida Health Information Exchange (HIE) and that AHCA has trained hospitals and managed‑care plans to use the HIE's event notification service (ENS) to coordinate assignments and referrals.
Committee members raised capacity and technical questions about the HIE vendor; Smoak said the state recently procured a new HIE vendor (Chris Shared Services) and that AHCA's engagement with hospitals and managed‑care organizations uncovered opportunities to better use existing ENS functionality.
Ending: AHCA reported routine implementation activity — rule updates, stakeholder outreach and plan reviews — and said it will continue training hospitals and managed‑care plans and to collect NECAP data through licensure renewals to evaluate outcomes.
