Ahca managed medicaid. 071, Florida Statutes.

Ahca managed medicaid. Under Pre-eligibility Plan Choice there is no change to who is eligible to enroll, who is required to enroll, or SMMC HomeFederal AuthoritiesProvider EnrollmentProvider Enrollment is responsible for enrolling qualified providers to receive Medicaid reimbursement for services rendered to Statewide Medicaid Managed Care and Medicaid Fee-For-Service recipients. Learn what’s changing and what to do. CI 2022-01 Transition of Care (issued 3/24/2022) [ 143. , the Florida State Plan, 1115 waivers and home and community based service wai Jan 21, 2025 · Home Medicaid Statewide Medicaid Managed Care 2025-2030 SMMC Plans Agency-Approved Contract Materials Case Management File Audit Report Operational Guidelines [ 33. Why it matters: State health plan contracts are awarded and expire periodically. These complaints are reviewed and responded to by trained staff members. , Table 9 Summary of Reporting Requirements The Managed Care Policy and Contract Development Unit is responsible for developing, maintaining, and amending the Statewide Medicaid Managed Care contracts. Oct 18, 2024 · The Agency for Health Care Administration (Agency) contracts with health and dental plans to provide Medicaid services to health plan enrollees. Medicaid also assists the elderly and people with disabilities with the costs of nursing facility care and other medical and long-t SMMC HomeFederal AuthoritiesProvider EnrollmentProvider Enrollment is responsible for enrolling qualified providers to receive Medicaid reimbursement for services rendered to Statewide Medicaid Managed Care and Medicaid Fee-For-Service recipients. You have a right to file an appeal How do I file an appeal? The Florida Agency for Health Care Administration (Agency) is no longer required to mail 1095B tax notices. Unit Responsibilities include:Support of Capitation Rate Development The Managed Medical Assistance program provides primary and acute medical care, and behavioral health and dental services for the majority of Medicaid recipients. 9 kB ] Chronic Disease Management Program Highlight [ 172 kB ] Continuity of Care – Behavior Analysis (BA) Providers [ 196. 4 kB ] The Intellectual and Developmental Disabilities Comprehensive Managed Care (ICMC) Program is a statewide Medicaid program that gives people with intellectual and developmental disabilities a single, coordinated source for all their health care and support needs. This program offers an additional pathway for providing support and services to individuals with intellectual and developmental disabilities. Florida Medicaid managed care plans must comply with the service coverage requirements outlined in this policy, unless otherwise specified in the AHCA contract with the Florida Medicaid managed care plan. 5 kB ] Recipient Support Report a Complaint SMMC Plan Contacts for Recipients [ 148 kB ] Layered Approach to Drive Continued Improvement Managed Medical Assistance and Dental Programs The improved Quality Strategy is designed to enhance the quality of care provided to Medicaid recipients by providing a continual and increasing incentive, with corresponding penalties, for the Managed Care Plans and Dental Plans to achieve and maintain high performance in key health and dental measures. MMA plans can participate in t standard plan or a specialty plan. There are three different programs that makeup the Statewide Medicaid Managed Care Managed Medical Assistance (MMA) Program, Long-term Care (LTC) Program, Dental Program, and the Intellectual & Developmental Disabilities Comprehensive Managed Oct 18, 2024 · Statewide Medicaid Managed Care (SMMC) New Program Highlight: The Individual Budgeting (iBudget) Waiver The Agency for Health Care Administration (Agency) contracts with health and dental plans to provide Medicaid services to health plan enrollees. All plans have a provider complaint system to allow providers to dispute plan policies, Apr 13, 2023 · This week our In Focus section reviews the Florida Statewide Medicaid Managed Care Program (SMMC) Invitation to Negotiate (ITN), released on April 11, 2023, by the Florida Agency for Health Care Administration (AHCA). Dental A person eligible for Florida Medicaid can be enrolled in both the MMA and LTC program or just the MMA program. 2 MB ] under the Inpatient Psychiatric Services for Individuals under 21 benefit. 1 kB ] Behavior Analysis Program Highlight [ 212. How to File a Complaint Regarding a Medicaid Managed Care Plan How to File a Complaint Enrollees who are having trouble accessing services or who are encountering other problems with their managed care plan can file an official complaint with AHCA. This document is part of a series that highlights the program changes in the new Statewide Medicaid Managed Care (SMMC Apr 24, 2024 · The Centers for Medicare and Medicaid Services (CMS) earlier this week released the Medicaid Managed Care final rule, marking a substantial update in the framework governing Medicaid and the Children’s Health Insurance Program managed care plans. Managed Medical Assistance (MMA) Services Available in the Pilot ProgramMMA services include primary and acute medical care and behavioral health services. Home Medicaid Statewide Medicaid Managed Care 2025-2030 SMMC Plans SMMC Home Federal Authorities 2025-2030 SMMC Plans 2025-2030 Model Health Plan Contract 2025-2030 Model Dental Plan Contract Agency Communications to SMMC Plans SMMC Report Guide Agency-Approved Contract Materials Administrative Subcontractors and Affiliates Report [ 666. 27 mill Background screenings are required for individuals working in AHCA-licensed facilities and Medicaid Provider Enrollment to ensure the safety and well-being of the population they serve. Performance Measure Data Submissions for MedicaidThe Agency monitors the Medicaid health plans’ performance through a combination of HEDIS, Adult and Child Core Set, and Agency-defined performance measures. The Department of Children and Families (DCF) is responsible for determining financial eligibility for services. 6 kB ] Plan Type Program Highlight [ 506. Florida Medicaid covers behavior analysis services through the Statewide Medicaid Managed Care (SMMC) program and the fee-for-service delivery system. Medicaid Actuarial ServicesThis unit provides advanced financial and statistical support for the Bureau relating to Capitation Rates, Risk Adjustment Models and Payment Methodologies. Expanded Benefits Home Medicaid Statewide Medicaid Managed Care 2025-2030 SMMC Plans Expanded Benefits Jul 29, 2024 · Florida Medicaid officials are moving quickly to try to resolve legal challenges to the state’s round of Medicaid managed care contracts that are worth billions. com Official website of the State of Florida The Florida Agency for Health Care Administration (AHCA) created healthfinder. The Agency for Health Care Administration (AHCA) administers the Statewide Medicaid Managed Care (SMMC) Long-Term Care program, sets coverage policy, and gets those eligible for services enrolled in a LTC plan. Question: Do I have to pay anything to enroll in the program? Answer: No. What’s happening: The Agency for Health Care Administration (AHCA), which regulates state Medicaid managed health plans, has announced its intention to award contracts to five health plans operating across the state. AHCA and FCC have announced 3 Town Halls for families, self advocates and providers to attend and learn more below: Purpose General Provisions Under the SMMC program, the Agency for Health Care Administration (Agency) contracts with the Managed Care Plan, as defined in Section XVI. T Call your Medicaid health plan for any questions about your Medicaid services. To view a specific Contract/Agreement once the search results appear, select the Agency Assigned Contract ID. This document is part of a series that highlights the program changes in the new Statewide Medicaid Medicaid Managed Care Plan Report Guide The Medicaid Managed Care Plan Report Guide (Report Guide) is a companion to each Managed Care Plan’s Contract with the Agency for Health Care Administration. According to the announcement posted late Friday AHCA intends to With some exceptions described below, internal appeals should be filed directly with your health plan; you can request a Medicaid Fair Hearing with the Agency for Health Care Administration (AHCA) if the internal appeal with the plan is unfavorable. 1. Dental services are provided through a statewide managed care dental plan. This document is part of a series that highlights the program changes in the new Statewide Medicaid Managed Care (SMMC The Agency for Health Care Administration (AHCA or Agency) may request your Social Security Number pursuant to Section 119. Will my doctor need to stop providing treatment? The Florida Agency for Health Care Administration (AHCA) created healthfinder. This Portal Login page will allow an authorized user access to external systems maintained by the Agency for Health Care Administration (AHCA) for the purpose of viewing and maintaining information. Florida’s 2014 transition from a mix o Managed Medical Assistance Plan vs Fee-for-Service [ 183. 0 Snapshot: Continuity of Care Provisions The Agency for Health Care Administration (Agency) contracts with health and dental plans to provide Medicaid services to health plan enrollees. Seeing your doctor is easier than you think with&n Increased opportunity for individuals needing long-term care to transition from a nursing facility to their own home or other community living A Snapshot of the Florida Statewide Medicaid Managed Care Program The Statewide Medicaid Managed Care (SMMC) Program has two program components: 1. If you disagree with AHCA’s denial of a For Cause plan change request. You can check your Medicaid eligibility and enrollment status View and update your address Request help using secure messaging Enroll in a plan or change plans File complaint and see what is happening with your complaint Go paperless Answer: Florida Community Care (FCC) is a Florida-based statewide Medicaid managed care plan providing comprehensive coverage to persons eligible for the State’s Long-Term Care (LTC) program. 6 kB ] Case Management File Audit Report Operational Guidelines [ 35. The updated contracts, representing tens of Florida Medicaid’s Covered Services and HCBS Waivers The list below provides direct links to a general overview for each of the covered services. 8 kB ] Continuity of Care Information – SMMC Plan Website Links [ 136. Home Health MMA Pre-eligibility Plan Choice MMA Pre-eligibility Plan Choice You are on this page because you have completed your application for benefits, including Medicaid, with DCF ACCESS System. g. Health Quality Assurance licenses and/or certifies and regulates 40 d The Bureau of Policy is responsible for the development, coordination and implementation of Florida Medicaid program policy including: all Medicaid federal authorities (e. About the Agency for Health Care Administration | Contact AHCA | Public Records | Public Meetings Medicaid Health Quality Assurance Agency Administration Find a Facility Careers Our Agency was statutorily created by Chapter 20, Florida Statutes as the chief health policy and planning entity for the state. These teams provide coordination of provider enrollment functions, provider data maintenance, outreach, education, and issue resolution to providers, the Medicaid managed care plans, the Medicaid Regional Offices, and program operating partners at the Department of Health and the Agency for Persons with Disabilities. Nevertheless, the AHCA has been assigning Medicaid-eligible intellectually disabled people into the managed-care program unless they tell the state they don’t want to be enrolled. Plans that aren’t chosen to participate are essentially locked out of the Medicaid managed care program for six years Medicaid is a state/federal program that pays for medical services for low-income pregnant women, children, individuals who are elderly or have a disability, parents and women with breast or cervical cancer. Contract management includes ensuring that the managed care plans meet Medicaid contractual requirements, including the timely provision of medically Feb 1, 2025 · Agency MPIP Model 2024-2025February 1, 2025- September 30, 2025Due to the transition to the new Statewide Medicaid Managed Care (SMMC) health plan contracts on February 1, 2025, the 2023-2024 MPIP year was extended through January 31, 2025. The Agency for Health Care Your new statewide Medicaid managed care plan or long-term care (LTC) plan is required to honor ongoing health care services or routine appointments that were previously authorized through a different plan or directly from Medicaid (fee-for-service) prior to enrollment in the new plan. Once enrolled into the Pilot program, individuals will get their Medicaid benefits and long-term care benefits from the Pilot program. If a member is already receiving a prior authorized ongoing course of treatment with any provider, the plan is responsible for the costs of continuing that treatment, without any form of authorization and without regard to whether the services are Statewide Medicaid Managed Care (SMMC) 3. Medicaid Analytics is composed of five functional units organized to provide a strong foundation of responsi Apr 11, 2023 · The contracts will control the future of the state's $38B Medicaid program. Most Medicaid recipients are required to enroll in an MMA plan for their services. Florida Community Care (FCC) was selected to be the sole managed care plan operating the Pilot. Please contact the State at 1-877-254-1055 for more information about enrollment in dental plans. , the Florida State Plan, 1115 waivers and home and community based service wai About the Agency for Health Care Administration | Contact AHCA | Public Records | Public Meetings Medicaid Health Quality Assurance Agency Administration Find a Facility Careers Our Agency was statutorily created by Chapter 20, Florida Statutes as the chief health policy and planning entity for the state. 1 kB ] At-A-Glance: Medicare and Medicaid Managed Care: Dual Eligibles in Statewide Medicaid Managed Care (SMMC) [ 250. Agency Communications to SMMC Plans Effective 2025-2030 Home Medicaid Statewide Medicaid Managed Care 2025-2030 SMMC Plans Agency Communications to SMMC Plans Effective 2025-2030 AHCA Portal - Login This Portal Login page will allow an authorized user access to external systems maintained by the Agency for Health Care Administration (AHCA) for the purpose of viewing and maintaining information. gov to provide easy access to health care information. Here’s a guide to help providers understand those rules and how to resolve any issues you may encounter: Provider Data: Check These Reports AHCA shares provider data via three In this role, AHCA collaborates with federal and state agencies and managed care organizations (MCOs). 27 mill The Agency for Health Care Administration (Agency) contracts with health and dental plans to provide Medicaid services to health plan enrollees. fl. This document is part of a series that highlights the program changes in the new Statewide Medicaid Managed Care (SMMC Oct 1, 2023 · SMMC HomeFederal Authorities2018-2024 Model Health Plan Contract Attachment I – Scope of Services – October 1, 2023Attachment II – Core Contract Provisions – October 1, 2023Exhibit II-A - Managed Medical Assistance Program May 9, 2025 · While most Medicaid beneficiaries in Florida are required to enroll in that managed-care program, people with intellectual disabilities are not. Updates to Behavior Analysis Up-to-date information regarding Florida Medicaid behavior analysis service can be found here. The Bureau of Medicaid Data Analytics provides information vital to the monitoring and management of the multi-billion dollar Medicaid Program. myflorida. All complaints submitted to the Agency are: Statewide Medicaid Managed Care Statewide Medicaid Managed Care (SMMC) is the program where most Medicaid recipients receive their Medicaid services. Be certain to look at our Licensing and Certification page for specific links to applications forms. Below you can access rule information about adopted rules and rules curre Outreach and Presentations Home Medicaid Statewide Medicaid Managed Care New SMMC Program Outreach and Presentations Medicaid Managed Medical Assistance Specialty Plans health care to recipients enrolled in an MMA pl n. We are primarily responsible for the state's estimated $25. Licensure Application Forms by Provider TypeConsumersTo file a complaint about a health care facility, such as a hospital, nursing home, assisted living Install the FL Medicaid Member Portal on your phone or tablet! May 8, 2025 · Florida Medicaid Managed Care changes in 2025: Key updates for providers and billers under AHCA’s new SMMC 3. ahca. – Today, the Agency for Health Care Administration (Agency) announced its intent to award contracts to five (5) health plans as a result of the re-procurement of the Statewide Medicaid Managed Care (SMMC) program. A. IDD, or Intellectual and Developmental Disabilities pilot, is the technical name for the managed care model that AHCA and APD are implementing in Hardee, Highlands, Hillsborough, Manatee If the issue involves a Medicaid Managed Care Plan, you should use the plan’s provider complaint process prior to submitting a complaint to the Agency.   If you are enrolled in a SMMC health or dental plan go to the SMMC website for more info Aug 31, 2024 · Provider Guide: AHCA Rules For Medicaid Enrollment, Billing Date: 08/31/24 Sunshine Health reminds providers that AHCA has set important enrollment and billing requirements that they must follow as Medicaid providers. The health and/or dental plan is responsible for coordinating care for new enrollees transitioning into managed care or who are changing plans. An email will be deliv Apr 12, 2024 · The Agency for Health Care Administration on Friday announced the names of the winning bids for the Medicaid managed care program. If your complaint is regarding Medicaid eligibility or the application process, please contact the Department of Children and Families ACCESS Program. Home Health Enroll Enrolling in a Health Plan Ways to Enroll Online Click here to create a FL Medicaid Member Portal account and manage enrollments online. The Division is funded with more than $49 million in state and federal funds. Accessing Telehealth Through the Florida Medicaid ProgramMedicaid health care can help you get treatment without going to the doctor's office. SMMC HomeFederal AuthoritiesMedicaid Managed Care Plan Report GuideThe Medicaid Managed Care Plan Report Guide (Report Guide) is a companion to each Managed Care Plan’s Contract with the Agency for Health Care Administration. The Agency must still report individuals’ qualifying health coverage to the Internal Revenue Service (IRS). The Florida Medicaid program has an email alert system to supplement the present method of receiving Provider Alerts information and to notify registered providers or interested parties of "late-breaking" health care information. The Quality Bureau provides data-driven, focused and systematic feedback on the quality of Florida’s Medicaid program to federal and state agencies, Medicaid recipients, Medicaid managed care plans, and providers. If anyone in your household was eligible for Compliance Actions Home Medicaid Statewide Medicaid Managed Care Compliance Actions Compliance Action Dashboard Archives Statewide Medicaid Managed Care 2025-2030 SMMC Plans Data Book - Dental Program Re-Procurement IDD - Enrolling in the Pilot IDD - Expanded Benefits IDD - Frequently Asked Questions IDD - Information for Providers Mar 24, 2022 · Home Medicaid Statewide Medicaid Managed Care SMMC 2018-24: Agency-Approved Contract Materials CARES Long-Term Care Transition Referral Form and Instructions [ 25 kB ] Web site updated with this material 3/25/2022. The rule introduces enhancements aimed at improving care access, quality, and outcomes, with implications for long term and post-acute care (LTPAC The Florida Legislature directed the Agency for Health Care Administration (AHCA) in partnership with the Agency for Persons with Disabilities (APD) in 2023 to develop an additional pathway to access services. Recipient SupportManaged Care RecipientsStatewide Medicaid Managed Care (SMMC) is the program where most Medicaid recipients receive their Medicaid services. The Florida Medicaid coverage policies, fee schedules, and Rule are available on the Agency Website. 5 kB ] Plan Non-Emergent Transportation Contacts [ 414. Home Letters and Brochures Letters and Brochures DId you know that you can view your personal letters conveniently and securely online? Click here to sign up for a FL Medicaid Member Portal account. 071, Florida Statutes. Medicaid Helpline staff can also help you check on the status of a complaint submission. The Agency recently entered into new contracts with health and dental plans that will greatly benefit enrollees and providers. This document is Program Highlights Home Medicaid Statewide Medicaid Managed Care New SMMC Program Program Highlights Ambulatory Surgical Center Highlight [ 199. If you are denied the opportunity to opt out by your plan and AHCA, you may request an appeal with the Medicaid Hearing Unit at the Agency for Health Care Administration (AHCA). SMMC Florida helps eligible Medicaid members get the care they need through health plans that cover doctor visits, medicines, and other services. The Agency for Health Care Administration (AHCA) posted an amended timeline for its Oct 18, 2024 · Statewide Medicaid Managed Care (SMMC) New Program Highlight: Continuity of Care Provisions The Agency for Health Care Administration (Agency) contracts with health and dental plans to provide Medicaid services to health plan enrollees. Starting with the 2020 calendar year, Florida Medicaid and Florida KidCare programs stopped automatically mailing out these notices. FCC was selected as the Medicaid managed care plan for the pilot. 0 program will be managed by eight managed care organizations (MCOs), coordinating health care for approximately three million Medicaid recipients. Resource Information Information on Medicaid health plans and services is available on the Statewide Medicaid Managed Care webpage. , the Florida State Plan, 1115 waivers and home and community based service wai Home Health Health Plans and Program Health Plans and Program In Florida, most Medicaid recipients are enrolled in the Statewide Medicaid Managed Care program. 3 kB ] Medicaid Points of Contact [ 379 kB ] New Plans by Region [ 46. 1 kB ] Below are times when you can file a Medicaid Fair Hearing request: If you disagree with the denial, reduction, suspension or termination of Medicaid service or services made by AHCA for regular Medicaid or your Statewide Medicaid Managed Care Plan. Jul 1, 2025 · Managed Care Plan Network Access; Requires that AHCA include specified requirements relating to care from, & reimbursement to, out-of-network Medicaid providers in agency's contracts with Medicaid managed care plans; authorizes enrollees of Medicaid managed care plans to receive care from Medicaid providers not under contract with plan Third Party Liability (TPL)The Third Party Liability Unit is responsible for identifying, managing and recovering funds for claims paid for by Florida Medicaid for which a third party was liable, thereby ensuring Medicaid is the payer of last resort. 7 kB ] PPEC Program Highlight [ 243. For specific policy and limits information, please see the Medicaid coverage policies and fee To opt out of managed care because you are in a “voluntary” group, contact AHCA Choice Counseling or log on to the online portal. These changes include new contracts with health plans and a reduction in the number of regions within the system. Licensure Application Forms by Provider TypeConsumersTo file a complaint about a health care facility, such as a hospital, nursing home, assisted living The Agency for Health Care Administration (AHCA) has implemented the Online Licensing System to submit initial, renewal, or change during licensure period (excluding changes in controlling interest) applications online electronically. , Definitions and Acronyms, to provide services to recipients. Agency for Health Care Administration 2727 Mahan Drive, MS 62 Tallahassee, FL 32308 The Pilot is administered by the Agency for Health Care Administration (AHCA) in partnership with the Agency for Persons with Disabilities (APD). Statewide Medicaid Managed Care Program Procurement Updates The Agency for Health Care Administration (Agency) posted an Invitation to Negotiate (ITN) for the Statewide Medicaid Managed Care (SMMC) program on April 11, 2023. Implementation of the SMMC program is complete and operational statewide as of August 1, 2014. Through the ICMC Program, members receive regular health care services such as doctor visits, prescriptions, and medical equipment SMMC HomeReport a ComplaintClaims Dispute ResolutionRecipient ResourcesSubmit QuestionsStatewide Medicaid Managed Care Data and ReportsPerformance Measure DataHealth Expanded Benefits The Agency for Health Care Administration (Agency) contracts with Medicaid health and dental plans to provide services to health plan enrollees. On April 12, 2024, the Agency announced its intent to award contracts as a result of the SMMC procurement. Recipient Resources Submit Questions Statewide Medicaid Managed Care General Program Information Continuity of Care Provisions Program Highlight [ 114. IDD, or Intellectual and Developmental Disabilities pilot, is the technical name for the managed care model that AHCA and APD are implementing in Hardee, Highlands, Hillsborough, Manatee Resource Information Information on Medicaid health plans and services is available on the Statewide Medicaid Managed Care webpage. Complaint FormsLicensed Health Care Facility ComplaintsLicensed Health Care Facility Complaint FormComplaint Form for Unlicensed Health Care FacilitiesUnlicensed Health Care Facilities Complaint FormOffice of Medicaid Program Integrity - Medicaid Fraud When there is a cost-sharing amount for a dual eligible, the Medicare system automatically transmits a ‘crossover’ claim to the Medicaid system, for processing of the cost-sharing amount in accordance with SMMC contract requirements. If you have put off going to see the doctor, wait no more. To assist providers in navigating this transition, the Agency for Health Care Administration (AHCA) has created a dedicated New SMMC Program webpage featuring a comprehensive suite of AHCA: About MedicaidMedicaid Plan Management Operations The Bureau of Plan Management Operations is responsible for the primary oversight of Medicaid’s managed care programs, with a focus on the Statewide Medicaid Managed Care (SMMC) program. The following MMA Statewide Medicaid Managed Care Program Procurement Updates The Agency for Health Care Administration (Agency) posted an Invitation to Negotiate (ITN) for the Statewide Medicaid Managed Care (SMMC) program on April 11, 2023. About the Agency for Health Care Administration | Contact AHCA | Public Records | Public Meetings Medicaid Health Quality Assurance Agency Administration Find a Facility Careers Our Agency was statutorily created by Chapter 20, Florida Statutes as the chief health policy and planning entity for the state. This includes Medically Needy and iBudget recipients. Provi Dec 12, 2024 · The SMMC 3. 2 billion Medicaid program that will serve a projected 4. Jul 25, 2024 · The state wants to unfurl the new six-year Medicaid-managed care contracts with plans across the state beginning Sept. Am I required to have a dental plan? All Medicaid recipients, whether they are getting services through straight Medicaid or a MMA plan, are required to enroll in a dental plan. Managed Medical Assistance (MMA) and Long-Term Care (LTC) 2. AHCA has established annual performance targets for program integrity, with specific emphasis on identifying and preventing overpayments within the Medicaid program. Medicaid is the medical assistance program that provides access to health care for low-income families and individuals. People on Medicaid will get services using one or more of these plan types: • Managed Medical Assistance (MMA): Provides Medicaid covered medical Use the below support tools and how-to videos, to complete a review, re-apply and/or ask for help for your household eligibility for Medicaid and/or Medically Needy. Individuals will also be enrolled into a Statewide Managed Care Dental Plan. These can be used to compare the Florida Medicaid will not pay for continuous or episodic services after the emergency has been alleviated. SIPP services are authorized by Attachment 3-1-A of the Florida Medicaid State Plan [ 7. Beginning February 1, 2025, all individuals in Florida Medicaid, except for a small group, will be automatically assigned by the Agency for Health Care Administration (AHCA) to a managed care plan. If you need help finding contact information for your plan, call our Medicaid Helpline at 1-877-254-1055 or visit Feb 12, 2024 · Lawmakers gave the green light to test whether managed care is a viable delivery system for people with intellectual and developmental disabilities last year. The program has three parts: Managed Medical Assistance, Long-Term Care, and Dental. The M To view a list of all of the Agency’s Contracts and Agreements, simply select the Agency for Health Care Administration and hit search. RulesThe Rules Unit is responsible for coordinating and providing support to Florida Medicaid staff related to administrative rules promulgated in the Florida Administrative Code. The IDD Managed Care Pilot will be expanding on 10/1/25. Florida law mandates that SMMC health plans be re-procured every 6 years; this was the second re-procurement. If provided, the Agency will use your information for purposes of finding the requested information. . 10. The Florida Legislature directed the Agency for Health Care Administration (AHCA) in partnership with the Agency for Persons with Disabilities (APD) in 2023 to develop an additional pathway to access services. 7 kB The Statewide Medicaid Managed Care (SMMC) program has two key components: The Managed Medical Assistance program and the Long-Term Care program. AHCA will likely start the work necessary to accomplish that, including Medicaid Managed Long Term Services & Supports (MLTSS) Brief: Two pages, pdf States are shifting away from traditional fee-for-service Medicaid, often using § 1115 waivers to provide capitated MLTSS programs in efforts to streamline program administration, improve care coordination, and expand access to home and community-based services (HCBS). 1 kB ] TALLAHASSEE, Fla. 0 program. It provides details of plan reporting requirements including instructions, location of templates, and submission directions. 1 kB ] Feb 1, 2025 · Significant changes to Florida’s Medicaid managed-care system take effect this month, impacting millions of beneficiaries across the state. Our Agency was statutorily created by Chapter 20, Florida Statutes as the chief health policy and planning entity for the state. In addition, the Managed Care Contract Development Unit is responsible for developing, maintai The Agency is responsible for health facilities licensure, inspection, and regulatory enforcement; investigation of consumer complaints related to health care facilities and managed care plans; the implementation of the Certificate of Need program; the The Bureau of Quality is responsible for quality measurement and improvement, research and evaluation of Medicaid managed care plans, monitoring Medicaid managed care clinical outcomes, and oversight of prior authorization of services, in addition to other duties to provide data and system feedback on the Medicaid program. 5 kB ] Web site updated with this material 07/10/2025 2025-2030 LTC Contract Citation: Attachment II, Exhibit II-B, Section XV. Oct 18, 2024 · Statewide Medicaid Managed Care (SMMC) New Program Highlight: Continuity of Care Provisions The Agency for Health Care Administration (Agency) contracts with health and dental plans to provide Medicaid services to health plan enrollees. The Division of Health Quality Assurance protects Floridians through oversight of health care providers. It provides de Oct 18, 2024 · The Agency for Health Care Administration (Agency) contracts with health and dental plans to provide Medicaid services to health plan enrollees. Feb 22, 2024 · The state does not anticipate multibillion-dollar Medicaid managed care contracts to be awarded until March 25. Provi Be certain to look at our Licensing and Certification page for specific links to applications forms. ucgzlq sttga qdsmv gbrqc qgxm chrwp owvk xqg wvvjh qchranp