MediPass Information


NOTE:

Effective October 1, 2014, the MediPass program will sunset statewide. (See s. 409.9122, F.S.) The Agency for Health Care Administration is preparing for the implementation of the Statewide Medicaid Managed Care program (SMMC). (See s. 409.965, F.S.)  The SMMC program consists of two parts, Long-term Care and Managed Medical Assistance. For information on these programs and the implementation schedule, please visit the Statewide Medicaid Managed Care program website.

What is MediPass?

Most people enrolled in Medicaid must enroll in a managed health care plan. MediPass, Health Maintenance Organizations (HMO), and Provider Service Networks (PSN) are managed health care plans offered to people enrolled in Medicaid.  The difference between MediPass and the other managed health care plans is that MediPass is run by the State of Florida.  The Florida Medicaid program manages MediPass through the Agency for Health Care Administration.  MediPass is a statewide primary care case management program.  With MediPass, members are assigned to a primary care provider who is responsible for managing and coordinating all of the member's health care needs. Members and providers are allowed the opportunity to develop the doctor/patient relationship which ensures continuity of care and reduces duplication of services.

The same services that are available under Medicaid are also available under MediPass.  The following are services that are available to all MediPass members:

Please refer to the Florida Medicaid Summary of Services for more information regarding the services available through Medicaid. (En Español)

The MediPass provider receives a per month per member management fee for each patient assigned to their panel. Medical doctors, doctors of osteopathy, physician assistants, advanced nurse practitioners, county health departments, rural health facilities and federally qualified health centers may enroll with MediPass as a primary care provider.“

MediPass History

In March 1989, the state of Florida requested federal approval to develop the Medicaid Provider Access System (MediPass). The state received waiver approval from the Health Care Financing Administration in January 1990. The MediPass program was developed and administered by the Florida Medicaid program. Since October 1991, MediPass has enrolled thousands of Medicaid members across the state. MediPass was originally implemented as a pilot project, but by 1996 the program was expanded statewide. The state is required to submit a renewal application every two years to the Centers for Medicare and Medicaid Services in order to continue the MediPass program.

Today, MediPass serves more than 600,000 members with a network of approximately 5,000 MediPass providers. The MediPass Program has contracted with disease management organizations to provide disease management services to MediPass members living with certain diseases. The disease management program serves thousands of MediPass members with chronic illnesses.

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FAQs

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