Statewide Medicaid Managed Care LTC Program Begins

The Statewide Medicaid Managed Care Long-term Care Program began in Region 7 (Orange, Osceola, Seminole, and Brevard Counties) effective August 1, 2013.

REMINDER:  Continue services to your clients during the transition period!  You will get paid for services provided.

LTC plans must continue enrollees’ current services for up to 60 days until a new assessment and care plan are complete and services are in place.

Service providers that have not contracted with an enrollee’s LTC plan are required to continue serving the enrollee for up to 60 days or until the enrollee selects another service provider and a new plan of care has been developed.

The LTC plan must authorize and pay for services rendered by the non-contracted provider until:

  • A contracted provider is in place, and
  • The LTC plan notifies the non-contracted provider in writing that services and reimbursement will end on a specific date.

What Should Providers Do if They Have Difficulty Getting Paid?

  • Providers should contact their local Medicaid office.
  • Contact numbers can be found at:  http://ahca.myflorida.com/Medicaid/index.shtml#areas
  • The Agency will ensure providers are paid appropriately and timely for services rendered according to a current care plan.

More detail is available in the linked PowerPoint.

For information on the Statewide Medicaid Managed Care Long-term Care Program, including upcoming webinars, past presentation training materials, and Frequently Asked Questions, please visit our website at http://ahca.myflorida.com/SMMC.  Go to the “News and Events” tab for upcoming Webinars and events. Sign up to receive program updates by clicking the red “Sign Up for Program Updates” box on the right side of the page.

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