Medicaid Health Plan 2009-2012 Contract and Related Information

Prior Medicaid Health Plan Contracts and Related Information

Provider Service Networks (PSNs)


Medicaid Prepaid Dental Health Plan Contract:
NOTE: The 2006-2009 Dental Contract has been extended through 2010 and into 2011.

Standard Contract (63KB, pdf)
Attachment I: Scope of Services (635KB, pdf) 
Attachment II: Business Associate Agreement (26KB, pdf)
Attachment III: Lobbying (13KB, pdf)
Attachment IV: Debarment Form (28KB, pdf)
Attachment V: Subcontractor Utilization Report Form(50KB, pdf)

2011 Templates:

Financial (194KB, xls)
Enrollee-Dental-User (46KB, xls)
FQHC Report (47KB, xls)
Grievance (87KB, xls)
Incentive-Distribution (69KB, xls)
Service Utilization (1.02MB, xls)
CHCUP-Dental 60% (28KB, xls)
Dental Health CheckUp-CMS416 (61KB, xls)

Prior Contracts:

HMO:
PRE-PAID DENTAL:
Medicaid HMO Contracts 2006-2009  
Medicaid HMO Contract 2004-2006  Medicaid Pre-Paid Dental 2004-2006
Medicaid HMO Contract 2002-2004  
Medicaid HMO Contract 2000-2002  
Medicaid HMO Contract 1998-2000  

HMO Capitation Information

March 2009 Medicaid Non-Reform Capitation Rates
Medicaid HMO Capitation Rates for 2008-2009 Contract Year
Medicaid HMO Capitation Rates for 2007-2008 Contract Year
Medicaid HMO Capitation Rates for 2006-2007 Contract Year

Medicaid HMO Capitation Rates for 2005-2006 Contract Year
Medicaid HMO Capitation Rates for 2004-2005 Contract Year
Medicaid HMO Capitation Rates for 2003-2004 Contract Year
Medicaid HMO Capitation Rates for 2002-2003 Contract Year

Medicaid HMO Capitation Rates for 2001-2002 Contract Year
Medicaid HMO Capitation Rates for 2000-2001 Contract Year
Medicaid HMO Capitation Rates for 1999-2000 Contract Year



Agency Notification Letters -
Please go to MEDICAID REFORM CONTRACT INFORMATION for Agency Notification Letters (Dear Health Plan).

2008

Description: Date:
 Request for Benefit Information Cards (166KB, pdf)  5-14-09
   


Policy Transmittals
-
Please go to MEDICAID REFORM CONTRACT INFORMATION for Reform Policy Transmittals.

2008

Description
Date
 08-05 Non-Reform Performance Measures, FARS/CFARS Reporting (1021KB, pdf)  04/30/08
 08-06 Notice of Discontinuation of Provider Default ID Usage (90KB, pdf)  04/28/08
 08-08 Unborn Activation Process (1.07MB, pdf)  12/12/08
       08-08 Unborn Activation Attachment #1 (701KB, pdf)  12/12/08
       08-08 Unborn Activation Attachment #2 (521KB, pdf)  12/12/08
       08-08 Unborn Activation Attachment #3 (518KB, pdf)  12/12/08


NOTE:
Please note that the Reform contract and the 08-05 Non-Reform policy transmittal contain an error in the e-mail address to submit performance measures reports.  In the reporting instructions contained in attachment B of the 08-05 policy transmittal as well as Section XII. I. 2.g. Reporting Instructions for the Performance Measures Report of the Medicaid HMO Reform Contract, the correct email address should be MRPM@ahca.myflorida.com.


2007

Transmittal Archives:

2006 Policy Transmittals Archive
2005 Policy Transmittals Archive
2004 Policy Transmittals Archive
2003 Policy Transmittals Archive
2002 Policy Transmittals Archive
2001 Policy Transmittals Archive
2000 Policy Transmittals Archive
1999 Policy Transmittals Archive


Title XXI Immunizations

In June of 1999, Policy Transmittal 99-03(380KB, doc) described the Vaccines for Children Program (VFC) and its relationship to Title XXI Medikids. This policy statement also addressed billing options. In May of 2001, a revision was published in Policy Transmittal 01-07 (26KB, pdf). Now there is only one billing option: Direct service providers must bill Medicaid fee-for-service. For a copy of the reimbursement rates that apply when providers supply immunizations to Medicaid HMO-enrolled MediKids, access the document titled Immunization Codes for HMOs, HCPCs 2001. You will also find other useful information at this MediKids Publications site.

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Reporting Medicaid Fraud