UPDATE: Hurricane Irma (Last Updated: September 8, 2017)
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September 8, 2017, Guidance to All Providers Regarding Provision of Services During Hurricane Irma:
This Guidance Applies for Both Fee-For-Service and Managed Care Providers
It is imperative Florida Medicaid recipients maintain access to services during the disaster period. To this end, the Agency will ensure reimbursement for services that are provided in good faith to eligible recipients:
Please Keep Providing Services
- The Agency will waive all prior authorization requirements for Medicaid services during the disaster period.
- Early prescription refill edits have been lifted for all maintenance medications (this does not apply to controlled substances).
- If a recipient requires services beyond limits stated in policy in order to maintain safety and health, providers can furnish the service.
- For providers furnishing services out of state or for providers not currently enrolled in Florida Medicaid, we encourage you to provide needed services to any Florida Medicaid recipient who has been displaced.
Medicaid Transportation Services
- Medicaid transportation providers are continuing to provide transportation to critical medical services, such as chemotherapy and dialysis and inter-facility transfers, when the facilities providing those services remain available and when the safety of the recipient and the driver can be assured.
- Medicaid transportation providers are making county by county assessments regarding the availability of providers and their ability to safely provide transportation. In some areas they are beginning to resume normal operations. Please contact the transportation providers directly if you are in need of transportation.
Out-of-State or Non-Medicaid Providers:
- For reimbursement purposes, the Agency will expedite enrollment for out-of-state or non-medicaid providers on a provisional (temporary) basis after services are rendered. The process for provisional provider enrollment is located at http://www.mymedicaid-florida.com.
- All out-of-state or non-enrolled providers wishing to provide services should provide services. Pharmacies needing to immediately dispense prescription refills to displaced Florida Medicaid recipients should dispense the prescriptions and follow the provisional enrollment process.
- Providers that are not enrolled in Florida Medicaid that furnish services during this emergency period should maintain as much documentation as possible to help the Agency properly and timely adjudicate claims after the storm. This includes:
- Recipient information
- Services rendered with dates and location
- Information on the nature of the emergency necessitating the provision of services (if applicable)