UPDATE: Hurricane Irma Provider Information                                       (Last Updated: September 22, 2017)


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September 21, 2017, Instructions for Enrollment and Payment for Services Rendered During the Hurricane Irma Disaster

The purpose of this alert is to provide detail on how to implement the 9/8/17 provider alert, Guidance to All Providers Regarding Provision of Services During Hurricane Irma: This Guidance Applies for Both Fee-For-Service and Managed Care Providers.

The Agency for Health Care Administration (Agency) will ensure reimbursement for services provided in good faith to eligible Florida Medicaid recipients during the Hurricane Irma disaster grace period. The Agency’s Hurricane Irma disaster grace period is from 9/7/17 through 9/21/17.

Section I of this alert provides updated policy guidance and applies to services rendered through both the fee-for-service (FFS) delivery system and the Statewide Medicaid Managed Care (SMMC) program, unless otherwise stated.

Section II of this alert provides reimbursement/payment guidance and applies to services rendered in the FFS delivery system, unless otherwise specified.

Section I: Policy Guidance

Services Provided During the Disaster Grace Period (9/7/17 through 9/21/17)

Prior Authorization Requirements

Limits on Services

Provisional Enrollment

Services Provided Outside of the Disaster Grace Period

Section II: Payment Guidance

General Requirements
The Agency and its Medicaid health plans will implement claims payment exceptions processes for any medically necessary services furnished during the disaster grace period that normally would have required prior authorization, that were rendered by a non-participating provider, or that exceeded normal policy limits for the service.

Providers that furnished services to Medicaid health plan enrollees should work directly with each plan on reimbursement protocols. The Agency is requiring that Medicaid health plans create a web page dedicated to providing detailed instructions to providers for how to seek reimbursement through each Medicaid health plan’s claims payment exceptions process. A direct link to each plan’s claims payment exceptions website will be located on the Agency’s website by September 26, 2017.

Providers that wish to receive payment for services rendered during and outside of the disaster grace period are required to be enrolled with Florida Medicaid or provisionally enrolled with Florida Medicaid prior to submitting claims. For services provided to recipients receiving services through the FFS delivery system, provisional providers should submit claims in accordance with the instructions located at: http://www.mymedicaid-florida.com.

Providers Currently Enrolled with Florida Medicaid
Providers that furnished services to recipients receiving services through the FFS delivery system must comply with the requirements below:

Reimbursement Rates (for services provided during the disaster grace period)

Additional Information

Maintenance of Supporting Documentation

Agency’s Hurricane Irma Website

Medicaid Contact Center

Additional questions from providers may be directed to the Florida Medicaid Contact Center at 1-877-254-1055.