Commercial HMOs
Florida's commercial HMOs are dually regulated by the Agency for Health Care Administration (Agency) and the Department of Financial Services (DFS). The Agency monitors quality of care-related issues and the Department of Insurance monitors financial and contractual issues. To become a commercially licensed HMO, an organization must receive a health care provider certificate from the Agency and a certificate of authority from DFS.  

The Agency's Network Services Unit (NSU) issues and renews health care provider certificates by approving provider networks for completeness and authorizing activity within specific geographic service areas. The NSU tracks national accreditation status as a quality of care standard. In addition, risk management surveys and individual complaint surveys allow the NSU to monitor the overall activity of health plans to ensure compliance with current regulations.

Quality of care issues, such as timely access to appropriate health care professionals or services, are monitored and enforced by the Agency through desk reviews and on-site surveys.

• Listing of current Florida Commercial HMOs is available in the "Health Maintenance Organization Consumers' Guide" published by the Florida Department of Financial Services
• Florida HMO Geographic Service Area, by County Updated 01/02/2008
• Florida HMO Accreditation Status Report   Updated 08/08/2007
• More information for Providers
• More information for Consumers

Medicare HMOs

Medicare HMOs are federal programs regulated by the Health Care Financing Administration, or HCFA.