Posts Tagged ‘Statewide Medicaid Managed Care’

Florida’s 1115 MMA Managed Medical Assistance (MMA) Waiver Amendment

September 25, 2014

The Agency for Health Care Administration (the Agency) is seeking federal authority to amend Florida’s 1115 MMA Managed Medical Assistance (MMA) Waiver (Project Number 11-W-002064) to allow certain populations who were previously excluded from the MMA program to voluntarily enroll.

The proposed amendment will allow for Medicaid-eligible recipients residing in group home facilities licensed under Section 393.067, Florida Statutes, as well as Medicaid-eligible children receiving Prescribed Pediatric Extended Care (PPEC) services to become eligible to voluntarily enroll in Florida’s MMA program, a component of the Statewide Medicaid Managed Care (SMMC) program. This amendment is being submitted to implement Florida Law that allows recipients residing in a group home facility and children receiving PPEC services to voluntarily enroll in Florida’s MMA program upon federal approval.

The proposed amendment will:

  • Ensure continuity of care and allow these group home residents access to expanded benefits offered by the plans;
  • Allow for those children receiving PPEC services and currently enrolled in the Children’s Medical Services Network or another managed care plan to remain in that plan without disruption of services, ensuring their continuity of care and ensuring children will be able to take advantage of the higher plan standards required and the expanded benefits offered by the plans.

The Agency is conducting a 30-day public notice and public comment period that takes place between September 17, 2014 and October 17, 2014.  Please visit the MMA Federal Authorities page for more information on the public meetings, information for submitting comments, and to view a comprehensive description of the waiver amendment request.

The Agency is hosting a public meeting to solicit public input on the amendment of Florida’s 1115 Managed Medical Assistance (MMA) Waiver.   On September 17, 2014, the Agency published the following public meeting notice in the Florida Administrative Register.

The notice invites all interested parties to the public meetings and provides the meeting dates, times, and locations.  Individuals who will be unable to attend the meeting in person can participate via conference call by using the toll free number provided in the FAR notice. During the meetings, the Agency will provide an overview of the provisions in Part IV of Chapter 409, Florida Statutes, related to the MMA program; a description of the amendment request; and time for public comments.

The 1115 MMA Waiver Amendment Public Meeting will be held on

Monday, September 29, 2014; from 1:00 p.m. to 2:00 p.m.

Agency for Health Care Administration
6800 North Dale Mabry Highway
Main Training Room
Tampa, FL 33614

Conference Line: 1-888-670-3525

Participant Code: 4201652735 #

Mail comments and suggestions to: 

1115 MMA Waiver Amendment Request
Office of the Deputy Secretary for Medicaid
Agency for Health Care Administration
2727 Mahan Drive, MS #8
Tallahassee, Florida 32308

E-mail comments and suggestions to:  with “1115 MMA Waiver Amendment Request” referenced in the subject line.

Humana to Buy Key Player in Florida’s Medicaid Program

July 26, 2013

TALLAHASSEE — As the state prepares to move forward next month with shifting thousands of elderly Floridians into Medicaid managed-care plans, Humana Inc. is buying a major player in the program.

Humana said Wednesday it has reached an agreement to acquire American Eldercare Inc., which has received contracts to provide long-term care under Medicaid to seniors throughout the state. American Eldercare also has been the largest provider in the state’s longstanding “nursing-home diversion” program. (more…)

Advocates Urge More Government Oversight of Medicaid Managed Care

July 9, 2013

By Jenni Bergal, Kaiser Health News

When the federal government recently gave Florida the green light to vastly expand its experiment with privatizing Medicaid, patient advocates quickly raised an alarm.

They cited serious problems with the state’s five-county pilot managed care program and urged close monitoring of the companies that run private Medicaid plans to ensure that they don’t scrimp on care.

Advocates and experts say that the need for oversight is growing nationally as states have increasingly contracted out the huge state-federal program for the poor to insurance companies, aiming to control costs and improve quality through close management of patient care. About 30 million people are in these plans now. Under the federal health law that launches Jan. 1, eligibility will be expanded and about 7 million more will be covered by Medicaid. Many will be placed in managed care. (more…)

Long-Term Care Medicaid Patients Start Enrolling

May 20, 2013

Phone counselors are now available to help long-term care Medicaid recipients choose their health plans. State officials say the call centers went live Monday. Long-term care Medicaid recipients can call the hotline and ask questions about what doctors and medications are covered in different plans. (more…)

Contract Signing Ceremony Commemorates Statewide Medicaid Managed Care Roll-Out

May 6, 2013

Tallahassee, Fla.— The Agency for Health Care Administration (Agency) has been working diligently toward transforming Florida Medicaid since mid-2011 when the legislation that created the Statewide Medicaid Managed Care program became law. The Agency, in partnership with the Department of Elder Affairs (DOEA), achieved a critical milestone today as Secretary Liz Dudek executed contracts with each of the seven health plans selected to provide services via the SMMC Long-term Care program.

“The signing of these contracts solidifies the commitment from each health plan to deliver high quality services to the approximately 85,000 elderly or disabled Floridians statewide who will be enrolled in the Long-term Care program,” said Agency Secretary Liz Dudek. “The Agency has been conducting targeted outreach to recipients, providers and stakeholders, and we look forward to beginning to provide long-term care services in this new way starting August 1 for those in the greater Orlando area and then working our way around the state.” (more…)

AHCA: Home Care Providers and Their Role in Medicaid Managed Care

March 5, 2013

Medicaid ReformThe Agency for Health Care Administration recently presented a webinar on Statewide Medicaid Managed Care (SMMC) for long-term care (LTC) providers, including home health agencies. The webinar detailed the basic components of Medicaid’s transition from fee-for-service to managed care, as passed into law in 2011 and approved by the federal government last month. The state will begin enrolling Medicaid recipients into managed care plans beginning August 1 in District 7 (Orange, Osceola, Seminole and Brevard counties). (more…)

Plans to Expand Florida Medicaid Welcomed and Feared

February 25, 2013

By Phil Galewitz, Kaiser Health News

Almost overnight, Florida has gone from being an ardent opponent of the federal health care law to a laboratory for an ambitious experiment under the law.

If state lawmakers back Gov. Rick Scott’s plan to expand Medicaid, it will be an experiment with a determinedly free-market twist. Scott’s turnabout on the Medicaid expansion came a few hours after the federal government tentatively approved his application to fully privatize the federal- state program for the poor.

That development has put health providers and consumers in a quandary: Most are elated that more than 1 million Floridians are in line to gain health coverage starting next year and that hundreds of millions in federal dollars will flow into the state to cover their medical services. But they’re also concerned that that coverage will be delivered through managed care plans with a mixed record of providing quality care in Florida. (more…)

Gov. Scott Announces Support for Medicaid Expansion

February 22, 2013

By Carol Gentry, Health News Florida

Hospitals, consumer groups and Democrats celebrated Thursday as they recovered from shock over Gov. Rick Scott’s change of heart on Medicaid expansion.

Tea Party leaders tweeted moans about betrayal.

Legislators reminded Scott it’s not over yet.

And Medicaid HMO companies – especially WellCare Health Plans Inc. – started looking very good to investors. Stifel analyst Tom Carroll sent a note titled “Lightning Strikes in Florida,” saying Florida’s move may influence other red states, with Texas as the most-sought-after plum. It has an estimated 11 percent of the group of would-be Medicaid eligibles; Florida has 6 percent. (more…)

AHCA & DOEA to Hold Webinar for LTC Potential Network Providers

February 22, 2013

The Agency for Health Care Administration and the Department of Elder Affairs will cohost a webinar at 2:00pm on February 27, 2013, to provide interested potential network providers, including home care agencies, with a general overview and introduction to the Statewide Medicaid Managed Care Long-Term Care Managed Care program and to provide answers to frequently asked questions. This will be the first in a series of webinars.

The webinar can accommodate up to 500 participants, and will be open on a first-come first-serve basis. In order to accommodate as many participants as possible, please try to consolidate participate in within your organization. (more…)

UPDATE: 3 Companies Win Big in Florida Medicaid

February 18, 2013

The Florida Current reported on Friday that the Agency for Health Care Administration reached agreements with two companies that filed protests for not being selected to participate in a long-term managed care program. AHCA said Molina Healthcare of Florida Inc. and Humana Medical Plan Inc. have accepted offers to serve Medicaid recipients. The two were not among companies selected when contracts were first announced in January. 

Humana and Molina join five other companies selected to participate in the program. Molina accepted AHCA’s offer to be a provider in regions 5, 6 and 11. Humana accepted the offer to serve regions 4, 10 and 11. The original article with the complete list of selected plans can be found below.

By , Health News Florida

Three companies stand out as major winners in Florida’s competition for contracts in the Statewide Medicaid Managed Care Program for Long-Term Care, a market worth an estimated $3 billion.

They are American Eldercare, Sunshine State Health Plan and UnitedHealthcare of Florida. (more…)