AHCA officials update Senate Health Policy Committee on 2024 health-law implementations

Brian Meyer, deputy secretary for Medicaid at the Agency for Health Care Administration (AHCA), and Kim Smoak, AHCA deputy secretary for health quality assurance, told the Senate Health Policy Committee that the agency is advancing multiple statutory changes enacted in 2024, including workforce incentives, hospital payment updates and new licensure and program frameworks.

Meyer said AHCA is pursuing federal authority where required and has already taken operational steps on several items. He told senators the agency plans to submit an 1115 demonstration waiver in spring 2025 to support the FRAME and TEACH workforce-related programs and that TEACH applications have been processed and payments issued.

The largest items discussed were workforce and graduate medical education. Meyer said Senate Bill 7016 (repeated in testimony as “Senate Bill 70 16”) directed expansion of the Florida Reimbursement Assistance for Medical Education (FRAME) and creation of the TEACH (training, education and clinical health) funding program. He said AHCA plans to request federal matching through an 1115 waiver and that the TEACH program has received applications and “issued almost 6,700,000.0 in payments.” AHCA expects TEACH rulemaking to conclude in fall 2025 and a legislatively required TEACH report due 12/01/2025.

Meyer also described implementation steps for Graduate Medical Education (GME) reporting and additional resident positions. He said statute directed formation of a GME committee whose report is due 07/01/2025 and that the law provided funding for up to 200 additional resident slots.

Hospital payment and service changes were another focus. Meyer said the pediatric and obstetrics/newborn DRG methodology changes were implemented in July 2024, with providers able to begin billing other rate changes on Oct. 1, 2024, and a state-plan amendment submitted in September 2024 pending federal approval. He explained system updates have been made so providers can bill under the new rates and that rulemaking will incorporate rate changes retroactively once finalized.

Behavioral health teaching hospitals and associated grants drew extensive committee questions. Meyer and Smoak said statute designated four hospitals — Tampa General, UF Health Shands, UF Health Jacksonville and Jackson Memorial — for behavioral health teaching-hospital status. Smoak said the agency implemented the designation in April 2024, posted the required grant application in November 2024 and has updated licensure systems and rules to receive applications.

Smoak and Meyer explained the statutory grant program may fund operations and fixed capital outlay and that the law appropriated up to $300,000,000 for the program, with no more than $100,000,000 available in each of the next three years. Meyer told the committee the agency will make funding recommendations to the Legislature and the governor and expected to submit the statutorily required recommendation by March 1, 2025.

Meyer outlined several new coverage or licensure items in the 2024 laws that require federal approvals or system changes, including Mobile Crisis Response Services (federal approval pending, estimated summer 2025), Acute Hospital Care at Home (implemented Nov. 2024 without federal authority required), and advanced birth centers (new licensure class; AHCA is drafting rules and updated the licensing database). Smoak said hospitals must submit non-emergent care access plans with license renewals starting July 1, 2025; those plans must not conflict with federal EMTALA (Emergency Medical Treatment and Labor Act) requirements.

The agency also described implementation of a new state-level rural emergency hospital license classification in response to a federal Medicare certification option (Senate Bill 644). Smoak said the state rule requires qualifying hospitals to have no more than 50 beds, provide 24/7 emergency services, be sufficiently staffed and have transfer agreements with higher-level trauma centers.

Committee members asked AHCA officials detailed questions about timing and spending, particularly for the behavioral health teaching-hospital grants and GME slots. Meyer repeatedly said the agency is meeting statutory deadlines and will provide follow-up materials to the committee where he lacked exact status details during questioning.

AHCA closed its presentation by listing several legislatively required reports and their statuses: the advanced birth center report (submitted January 2025), an analysis of potentially preventable health-care events (submitted October 2024), the GME committee report (due 07/01/2025) and the TEACH funding program report (due 12/01/2025). Meyer and Smoak offered to provide additional materials to senators who requested them during the post‑presentation Q&A.