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FLORIDA MEDICAID

 

Welcome to Medicaid!


Justin Senior
Deputy Secretary for Medicaid

Phone: (850) 412-4000

Medicaid is the medical assistance program that provides access to health care for low-income families and individuals.  Medicaid also assists aged and disabled people with the costs of nursing facility care and other medical expenses.  Eligibility for Medicaid is usually based on the family’s or individual’s income and assets.

In Florida the Agency for Health Care Administration (AHCA) is responsible for Medicaid.  We are the equivalent of the corporate head office.  The Department of Children and Families acts as our agent by enrolling people in Medicaid.  We contract with other state agencies and private organizations to provide the broad range of services that Medicaid offers its participants. 

AHCA is also the lead agency for the Children’s Medical Insurance Programs (Title XXI–SCHIP).  In Florida, this program is known as the Florida KidCare program and is the state's children health insurance program for uninsured children.

Medicaid serves approximately 3.3 million people in Florida, with over half of those being children and adolescents 20 years of age or younger. Estimated expenditures for Fiscal Year 2012-13 (July 2012 through June 2013) are approximately $21 billion.

To meet the needs of Medicaid participants, we have approximately 114,000 Florida Medicaid enrolled individuals and facilities offering health care services.  If you are a medical provider interested in serving Medicaid recipients, an online enrollment application is available for your convenience at our Fiscal Agent Web Portal. Medicaid's fiscal agent processes approximately 135 million claim lines every year.

At times, individuals confuse Medicaid and Medicare, but Medicare is a separate program.  Medicaid is a partnership between the states and the federal government, with each paying about half the cost.  Each state operates its own Medicaid program under a state plan that must be approved by the federal Centers for Medicare and Medicaid Services or CMS.  The Plan outlines current Medicaid eligibility standards, policies and reimbursement methodologies to ensure the state program receives matching federal funds.  Additional information regarding coverage and reimbursement can be found in the Medicaid handbooks and fee schedules.

Per federal regulations, certain services must be offered by all states, but each can place some limits on the services. There are also optional services that a state may choose to offer, variations in eligibility groups, different limits on income and assets to decide eligibility, and differences in how much states pay their Medicaid providers.  For more information about Medicaid covered services view the Summary of Services.

The Deputy Secretary of Medicaid oversees the Divisions of Medicaid Operations, Medicaid Finance, and Medicaid Health Systems. The Assistant Deputy Secretary for Medicaid Operations oversees the Bureau of Medicaid Services, the Bureau of Pharmacy Services, and the Performance, Evaluation and Research Unit.  The Assistant Deputy Secretary for Medicaid Finance is responsible for the oversight of the Bureaus of Contract Management, Program Analysis, and Program Finance.  The Assistant Deputy Secretary for Medicaid Health Systems is responsible for the oversight of the Bureaus of Health Systems Development, the Bureau of Medicaid Field Operations, and the Choice Counseling Unit.

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Medicaid Services


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  • The Florida Medicaid program is responsible for policies, procedures, and programs to promote access to quality acute and long-term medical, behavioral, therapeutic, and transportation services for Medicaid beneficiaries.  AHCA is also the lead agency for the Children’s Medical Insurance Programs (Title XXI –SCHIP).  As lead Medicaid Agency, AHCA also is responsible for the rules and federal compliance for waiver programs housed within other state agencies, such as the Developmentally Disabled Waiver and the Nursing Home Diversion Waiver.

  • For additional information relating to Medicaid covered services please click on one of the tabs above.  A description of the services offered by the Florida Medicaid program can be found in our Summary of Services.

  • Some Medicaid services are subject to utilization review by a Quality Improvement Organization (QIO) under contract with AHCA.

  • During the rule making process, draft versions of handbooks, fee schedules and other documents related to fee for service and waiver rules are available to download.

  • Home Health Services
    Home Health services provide medically-necessary care to an eligible Medicaid recipient whose medical condition, illness or injury requires the care to be delivered in the recipient’s place of residence.  For recipients under 21 years old, services must be delivered at the place of residence or other authorized setting.  These services promote, maintain, or restore health, or minimize the effects of illness and disability.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Child Health Services


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  • Child Health Services
    Per Federal regulations, states are required to provide any medically necessary care required by child eligibles. 

  • Florida KidCare
    Florida KidCare is the state's children health insurance program for uninsured children.

  • MediKids
    MediKids is a Florida KidCare Program. Administered by the Agency for Health Care Administration, the program offers low-cost health insurance coverage for children ages 1 through 4.

 

 

 

 

 

 

 

 

 

 

 

 

 

Long-term Care


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  • Assistive Care Services
    Assistive Care Services is for low-income residents of enrolled assisted living facilities (ALFs), qualified residential treatment facilities (RTFs) and adult family-care homes (AFCHs).

  • Home and Community Based Waivers
    Home and Community Based Waivers programs are the federally approved Medicaid programs authorized by Title XIX of the Social Security Act, Section 1915(c) that provide services in the home for persons who would otherwise require institutional care in a hospital, nursing facility, or intermediate care facility.

  • Nursing Home Transition
    Nursing Home Transition is the voluntary transfer of an eligible Medicaid beneficiary residing in a nursing home to a community setting such as a family member’s home, an apartment or home, an Assisted Living Facility or Adult Family Care Home.

  • Florida Long-term Care Partnership Program
    Florida’s Long-Term Care Partnership Program is a partnership program between Medicaid and private long-term care insurers designed to encourage individuals to purchase private long-term care insurance.

  • Medicaid Nursing Facility Provider Information
    The Department of Children and Families (DCF) district offices staff determines eligibility for Institutional Care Program (ICP) services.

  • Medicare Advantage Special Needs Plan (MA SNP)
    Florida Medicaid will coordinate with Medicaid enrolled Medicare Advantage Special Needs Plans to cover costs for beneficiaries who are eligible for both Medicare and Medicaid (duals), and who are enrolled in a Medicare Advantage Special Needs Plan (MA SNP).

  • Statewide Medicaid Managed Care Program
    House Bill (HB) 7107, relating to Medicaid Managed Care, was passed by the Florida Legislature on May 6, 2011.  The bill outlines a comprehensive expansion of managed care for most Medicaid recipients throughout Florida.

 

 

 

 

 

 

 

 

 

Mental Health and Substance Abuse


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  • Medicaid Managed Behavioral Health Care
    Medicaid Managed Behavioral Health Care Advisory Forums are open public “fact-finding” or “information gathering” forums that are designed to promote the coordination, integration, quality, and efficiency of the mental health system of care.  This open public forum provides opportunities for beneficiaries, providers, and community stakeholders to discuss ideas and pose questions to the Managed Care Organizations and the Agency.

  • Medicaid Certified Match Substance Abuse Program
    The Medicaid Certified Match Substance Abuse Program presents an opportunity for counties to increase local, public funds committed to substance abuse treatment for Medicaid recipients, by receiving federal matching funds for three new Medicaid funded substance abuse services. These three new Medicaid substance abuse services approved for the Local Medicaid Match Certification program are listed below:

    • Alcohol and/or Drug Intervention Services
    • Comprehensive Community Support Services
    • Comprehensive Community Support Services

  • Screening, Brief Intervention and Referral to Treatment (SBIRT) Model
    This is a manual that has been developed to guide Medicaid practitioners in using the Screening, Brief Intervention and Referral to Treatment (SBIRT) model.  SBIRT is a public health approach to treatment which supports preventative care and the identification of health concerns early in treatment before they become chronic, acute or require deep end medical treatment, such as emergency services or hospital care. 

 

 

 

 

 

 

 

 

 

 

 

Other Programs


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  • Medicaid Family Planning Waiver Program
    Medicaid Family Planning Waiver Program is a family planning program that is extended to women losing Medicaid eligibility within the past two years.  Eligible women may receive up to two years of extended family planning  services.

  • Medical Equipment and Supplies (DME)
    DME is defined as medically-necessary equipment that can withstand repeated use, serves a medical purpose, and is appropriate for use in the recipient’s home as determined by the Agency for Health Care Administration (AHCA).

  • Disease Management (Physician / Providers)
    Find out about our Disease Management programs and how they can help improve health outcomes for your patients.

  • Disease Management (MediPass Members)
    Find out more about our Disease Management program for members with chronic diseases.

  • Organ Transplant Advisory Council
    The Florida Legislature established the Organ Transplant Advisory Council in 1985 to recommend indications for adult and pediatric organ transplants to the Agency for Health Care Administration. The council consists of twelve members who are physicians. The council also formulates guidelines and standards for organ transplants and for the development of End Stage Organ Disease and Tissue/Organ Transplant programs. These recommendations, guidelines, and standards are only for those health programs funded through the Agency for Health Care Administration.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Statewide Medicaid Managed Care Program


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  • Statewide Medicaid Managed Care Program
    House Bill (HB) 7107, relating to Medicaid Managed Care, was passed by the Florida Legislature on May 6, 2011.  The bill outlines a comprehensive expansion of managed care for most Medicaid recipients throughout Florida.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medicaid Reform Pilot


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Statewide Prepaid Dental Program


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  • Statewide Prepaid Dental Health Plan
    In the 2010 proviso language (Specific Appropriation 204 of HB 5001), the Agency was directed to implement a statewide Prepaid Dental Health Plan (PDHP), with the exception of Miami-Dade where the existing pilot PDHP operates. Counties participating in the Reform Pilot are not included, resulting in the statewide PDHP program being implemented in 61 counties. Two vendors have been awarded contracts via an RFP process:  DentaQuest and Managed Care of North America (MCNA).

  • Miami-Dade Prepaid Dental Program
    Proviso authorizes the Agency to maintain the Prepaid Dental Pilot program in Miami-Dade County. In July 2004, the state implemented the Prepaid Dental Health Plan program, limited to Medicaid eligible children 20 years of age or younger in Miami-Dade County, to expand the use of dental management organizations in order to improve access, contain cost, and eliminate fraud. The Agency is authorized to contract with up to three PDHP vendors in Miami-Dade county.  The Agency is currently contracting with two vendors to manage the program in Miami-Dade County; DentaQuest and Managed Care of North America (MCNA).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Managed Care Organizations


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  • Medicaid Managed Care Health Plan
    The Bureau of Managed Health Care is responsible for the monitoring of all Medicaid Managed Care Health Plan contracts in the state. Bureau staff conduct desk and on-site reviews throughout the year to ensure contract compliance.

  • Provide Service Networks (PSN)
    PSN is a network established or organized and operated by a health care provider or group of affiliated health care providers, including minority physician networks and emergency room diversion programs that meet the requirements of Section 409.912 (4) (d) , F.S.

  • Exclusive Provider Organization (EPO)
    EPOs are individual providers or groups of providers who have entered into written agreements with an insurer to provide health care services to subscribers.

  • Prepaid Dental Health Plan
    Prepaid Dental Health Plans (PDHPs) are Medicaid managed dental care options available to Medicaid recipients in Miami-Dade County 20 years of age or younger who are not enrolledin an health maintenance organization (HMO) that provides dental services.

  • Prepaid Mental Health Plan
    Prepaid Mental Health Plans (PMHPs) are comprehensive managed mental health care service plans that are available to a Medicaid recipients who are enrolled in MediPass, and Provider Service Networks for their physical health care services.  The Child Welfare PMHP is a specialized PMHP to address the complex needs of Medicaid-eligible children who are receiving specific services from the Department of Children and Families.  Child Welfare PMHP recipients may be enrolled in MediPass, HMOs, or Provider Service Networks for their physical health care services.

  • Medicare Advantage Special Needs Program
    Florida Medicaid will coordinate with Medicaid enrolled Medicare Advantage Special Needs Program to cover costs for beneficiaries who are eligible for both Medicare and Medicaid (duals), and who are enrolled in a Medicare Advantage Special Needs Plan (MA SNP).

  • Medicaid HMOs
    A Health Maintenance Organization (HMO) is an entity licensed under Chapter 641, Florida Statutes.   HMOs provide comprehensive Medicaid services to a defined population of Medicaid recipients.  HMOs are required by contract to ensure that their enrollees have access to all Medicaid state plan services and a complete network of providers.   HMO networks are not limited to Medicaid providers.  Some plans cover additional benefits beyond those paid for by Medicaid such as preventive adult dental.

 

 

MediPass Primary Care Case Management


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Managed Care Resources


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  • Managed Care Enrollment Reports
    This report shows Medicaid enrollment broken out in the following categories; a Comprehensive Report by Program and Assignment Plan, Medicaid Comprehensive Report By County, Medicaid Comprehensive Report By County and By Category of Eligibility , Market Share Report by Program and Plan, Medicaid Managed Care Plan [1915(b)] – HMO Enrollment by County, Medicaid Managed Care Plan [1915(b)] – HMO Enrollment by Category of Eligibility, Medicaid Managed Care Plan [1915(b)] – HMO TANF Enrollment by Age Group, Medicaid Managed Care Plan [1915(b)] – HMO SSI Enrollment by Age Group, Medicaid Pilot (1115) – Plan Enrollment by County, Medicaid Pilot (1115) – Plan Enrollment by Category of Eligibility, Medicaid Pilot (1115) – Provider TANF Enrollment by Age Group, Medicaid Pilot (1115) – Provider SSI Enrollment by Age Group.

  • Florida Medicaid Quality in Managed Care
    Florida Medicaid is committed to ensuring that health care services delivered through managed care plans are held to high standards of quality and excellence. All vendors contracted with the Agency to provide managed care services must meet specific requirements for ensuring quality both in services provided and in administrative processes involved in oversight of the plan's operations.

  • Medicaid Encounter Data System (MEDS) has been designed to collect, process, store, and report on managed care service activities and prescription drug utilization for all Florida Medicaid capitated health care providers and support specific information requests that may include: service utilization trends, quality of care, access to care, cost models, targeted studies, etc. MEDS will also support the risk model computations that set capitated payments for managed health care entities as defined in the Florida Medicaid Reform contracts.

  • Choice Counseling and Other Beneficiary Information
    Medicaid has specially trained people to answer questions and help beneficiaries enroll in the health plan that best fits their needs. These people are called choice counselors and they provide services free of change. Beneficiaries can speak with a choice counselor by phone or meet with a choice counselor face-to-face.

  • Enhanced Benefits Reward$ Program
    Florida Medicaid has a new program called the Enhanced Benefits Reward$ Program. This program is designed to reward recipients for taking part in activities that can improve your health. These activities, known as healthy behaviors, will earn credits that you can later use to buy health-related items at the pharmacy. You do not have to do anything to enroll in this program.

  • Medicaid Options
    Medicaid Options is Florida's Medicaid managed care enrollment program for all counties except Baker, Broward, Clay, Duval and Nassau.  Qualified beneficiaries enroll through the toll-free Medicaid Options HelpLine to receive their health care services.
  • Model Contracts and Amendments
    The consolidated model contracts can be found by clicking the above link.  The consolidated model contract is a streamlined version of the previous separate model health plan contracts (non-Reform, Reform, FFS PSN, capitated PSN, HMO and specialty plan for children with chronic conditions, and specialty plan for persons living with HIV/AIDS).  The Agency created one core contract that a health plan will sign with exhibits that detail any unique plan and population requirements of the particular plan (FFS PSN, capitated PSN, HMO, Reform or non-Reform, specialty population, age-group).

 

 

How to become a provider?


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  • Provider Enrollment
    Provider Enrollment is responsible for enrolling qualified providers to receive Medicaid reimbursement for services rendered to Medicaid recipients.

  • Provider Enrollment Help Line Information
    Florida Medicaid's Web Portal solution provides communication and self-service tools to the provider community.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Already a Provider?


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  • Fiscal Agent
    Florida Medicaid currently has a contract with HP Enterprise Services (HP) to serve as the state's Fiscal Agent. Some of the fiscal agent functions include:
    • enroll non-institutional providers,
    • process Medicaid claims,
    • serve as the enrollment broker for Medicaid recipients, and
    • distribute Medicaid forms and publications.

  • Public Information for Providers
    • Area Offices
    • Contact Us
    • Provider Support
      • Provider Bulletins
      • Provider Notices
      • Provider Handbooks
      • Provider Alerts
      • Fee Schedules
      • Forms
      • Recipient Notices
      • Training
      • FAQ
    • Provider Enrollment
      • Enrollment Status
      • Enrollment Wizart
      • Out-of-State Provider Enrollment
    • Electronic Data Interchange (EDI)
    • Managed Care
    • Pharmacy
    • Third Party Liability
    • National Provider Identifier

  • Secure Information for Providers
    • Provider Demographic Maintenance
    • Prior Authorization Search
    • Recipient Eligibility
    • Claims Status
    • Claims Submission - Dental, Institutional, and Professional
    • Provider Reports
    • Trade Files Area
    • Third Party Liability

 

 

 

 

 

 

 

Florida Medicaid Electronic Health Record Incentive Program


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  • Florida Medicaid Electronic Health Record Incentive Program
    Florida Medicaid is implementing a federally approved program that will provide incentive payments to eligible professionals and eligible hospitals participating in Medicare and Medicaid programs to adopt, implement, or upgrade, and show meaningful use of Electronic Health Record (EHR) technology. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Provider Resources


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  • Medicaid Fiscal Agent
    Florida Medicaid currently has a contract with HP Enterprise Services (HP) to serve as the state's fiscal agent. Some of the fiscal agent functions include: enroll non-institutional providers, process Medicaid claims, serve as the enrollment broker for Medicaid recipients, and distribute Medicaid forms and publications.

  • HIPAA
    Information for the Health Insurance Portability and Accountability Act (HIPAA) can be found by clicking on the link above.

  • Provider Fee Schedules
    The current Medicaid Provider Fee Schedules are to furnish the Medicaid provider with the appropriate fee schedules for covered services provided to eligible Florida Medicaid recipients.

  • Provider Bulletins
    The Medicaid Provider Bulletins are published by the state Medicaid office and Florida Medicaid Fiscal Agent. The bulletins contain new policies, training opportunities, and other pertinent Medicaid information.

  • Provider Handbooks
    The intent of the Medicaid Provider Handbooks is to furnish the Medicaid provider with policies and procedures needed to receive reimbursement for covered services provided to eligible Florida Medicaid recipients. The handbooks provide detailed descriptions and instructions on how and when to complete forms, letters, or other documentation.

  • Preferred Drug List
    The Preferred Drug List (PDL) is a listing of cost effective therapeutic options recommended by the Medicaid Pharmacy and Therapeutics Committee.

  • Enhanced Benefit$ Rewards Program
    The purpose of the Enhanced Benefit Account (EBA) program is to offer incentives to recipients enrolled in a Reform plan to participate in wellness activities also referred to as healthy behaviors.

  • Medicaid Newborn Eligibility Policy
    Information regarding newborn eligibility and unborn activation procedures and related information.

  • Medicaid Nursing Facility Provider Information
    The Department of Children and Families (DCF) district offices staff determines eligibility for Institutional Care Program (ICP) services.

  • Florida Medicaid Provider Training e-Library
    Florida Medicaid Provider Training e-Library houses training resources for Medicaid providers.  You can go through the list of PowerPoint presentations and videos and select those that interest you to learn more about Florida Medicaid policy. 

  • ICD-10
    Currently, health care entities are required by Federal regulations to use a standard code set to indicate diagnoses and procedures on transactions.  For diagnoses, the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code set is used.  For inpatient hospital procedures, the ICD-9 procedure code set (PCS) is used.  Effective October 1, 2014, the standard code set that is required for diagnosis codes is changing to the ICD-10-CM and the standard code set that is required for inpatient hospital procedures is changing to the ICD-10-PCS. 

  • *New* Qualified Hospital (QH) Presumptive Eligibility
    Effective January 1, 2014, Florida Medicaid enrolled hospital providers may elect to make presumptive eligibility determinations in accordance with federal law and state policy.

Medicaid Cost Reimbursement


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Current Information


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  • Current Information

    • Current List of Drug Rebate Manufacturers
    • 100 Day Supply Maintenance Meds
    • Counterfeit-proof Prescription Blank Program
    • Dispensing Requirements for Dade, Broward, Monroe, and Palm Beach counties
    • Diverted Pharmaceuticals Program
    • Drug Efficacy Study Implementation (DESI) 5 Drug List
    • Medicaid Recipient Lock-in Program
    • Ombudsman Information and Request for Multi-Source Brand Drug Form
    • 5.1 Payer Specifications
    • D.O. Payer Specifications
    • Pharmacy Meeting Notices
    • Remittance Advice Provider Alerts
    • State MAC Pricing
    • MAC Pricing Request Form
    • Summary of Drug Limitations

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Florida Medicaid Preferred Drug Program


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  • Preferred Drug List
    The Preferred Drug List (PDL) is a listing of cost effective therapeutic options recommended by the Medicaid Pharmacy and Therapeutics Committee.

  • Prior Authorization Requirements and Forms
    In order to obtain copies of pharmacy prior authorization forms, please click on the following link above.

  • Pharmaceutical and Therapeutics Committee
    The purpose of the Medicaid Pharmaceutical & Therapeutics Committee is to develop and implement a voluntary Medicaid preferred prescribed drug designation program, as mandated in the 2000 session of the Florida legislature, SB 2034.

  • Provider Synergies
    Follow this link to access information regarding the Supplemental Rebate Process for Florida Medicaid.

  • Drug Criteria
    Click on the above link to view drug criteria for Florida Medicaid. 

 

 

 

 

 

 

 

 

 

 

 

 

 

Drug Utilization Review


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  • Drug Utilization Review Board
    The Drug Utilization Board (DUR Board) reviews and approves drug use criteria and standards for both prospective and retrospective drug use reviews. It applies these criteria and standards in the application of DUR activities, reviews and reports the results of the drug use reviews, and recommends and evaluates the educational intervention programs.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medicaid Quality


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  • Florida Payment Error Rate Measurement (PERM)
    Florida is one of 17 States randomly selected by the Centers for Medicare and Medicaid Services (CMS) for the Florida Payment Error Rate Measurement (PERM) initiative for Federal fiscal year (FFY) 2011 (October 1, 2010 - September 30, 2011). For FFY 2010, CMS will measure Medicaid fee-for-service (FFS) claim payments, managed care capitation and premium payments made on behalf of beneficiaries.

  • Medicaid Performance, Research and Evaluations
    The mission of the Medicaid Research, Contracts and Evaluations is to advance Medicaid research, policy, and practice and enhance knowledge and understanding of the financing, organization, delivery, and outcomes of Medicaid health services. Its vision is to improve the health and quality of life for communities and Medicaid beneficiaries in Florida through evidence–based research and policy development.

  • Florida Medicaid Quality in Managed Care
    Florida Medicaid is committed to ensuring that health care services delivered through managed care plans are held to high standards of quality and excellence. All vendors contracted with the Agency to provide managed care services must meet specific requirements for ensuring quality both in services provided and in administrative processes involved in oversight of the plan's operations.

  • Florida Medicaid External Quality Review Organization
    Health Services Advisory Group (HSAG) is the contracted External Quality Review Organization (EQRO), for the State of Florida's Medicaid managed care program. The program is administered by the Agency for Health Care Administration (AHCA). The EQRO contract began in May of 2006.

  • Medicaid Program Oversight (MPO)
    The mission of the Medicaid Program Oversight (MPO) is to monitor, analyze and validate encounter data submissions from Medicaid Health Plans to enhance system processes for collecting and reporting encounter data, to determine Health Plans’ compliance with contractual requirements, and to measure health outcomes.  To that end, MPO collects, processes, stores, reports and analyzes the encounter data from managed care service activities and prescription drug utilization for all Florida Medicaid capitated Health Plans.  MPO also supports rate development and the risk model computations that set capitated payments for managed health care entities as defined in the Florida Medicaid Reform contracts.

 

 


General Information


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  • Sign Up for Health Care Alerts
    The Florida Medicaid program has an email alert system to supplement the present method of receiving Provider Alerts information and to notify registered providers or interested parties of "late-breaking" health care information.

  • Summary of Services
    In Florida, the Agency for Health Care Administration (AHCA) develops and carries out policies related to the Medicaid program. A description of the services offered by the Florida Medicaid program can be found in the Summary of Services, 2012-2013.

  • Florida Medicaid State Plan
    Florida's Medicaid State Plan (the Plan) is a large, comprehensive written statement describing the scope and nature of the Medicaid program. The Plan outlines current Medicaid eligibility standards, policies and reimbursement methodologies to ensure the state program receives matching federal funds under Title XIX of the Social Security Act.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other Agency Resources


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Contact Medicaid Area Offices


  • Do you need to know what services Florida Medicaid covers?
  • Do you need to know who provides Florida Medicaid services?
  • Do you need help with information and referral?
  • Do you need help with medical bills you are receiving?

Medicaid has eleven area offices that serve as local liaisons to providers and recipients. The area offices handle claims resolution, training, transportation and manage Child Health Check-Up screenings on a local level.

You can view contact and other detail information for an area office by clicking the links below, clicking on a county or by clicking an area on the map.

Area Office Map | Area 1 | Area 2a | Area 2b | Area 3a | Area 3b | Area 4 | Area 5 | Area 6 | Area 7 | Area 8 | Area 9 | Area 10 | Area 11


Florida Area Office Map Area 1 Area 2a Area 2b Area 3a Area 4 Area 3b Area 5 Area 7 Area 6 Area 9 Area 8 Area 10 Area 11

Alachua
Bay
Baker
Bradford
Brevard
Broward
Calhoun
Charlotte
Citrus
Clay
Collier
Columbia
Dade
DeSoto
Dixie
Duval
Escambia
Flagler
Franklin
Gadsden
Gilchrist
Glades
Gulf
Hamilton
Hardee
Hendry
Hernando
Highlands
Hillsborough
Holmes
Indian River
Jackson
Jefferson
Lafayette

Lake
Lee
Leon
Levy
Liberty
Madison
Manatee
Marion
Martin
Monroe
Nassau
Okaloosa
Okeechobee
Orange
Osceola
Palm Beach
Pasco
Pinellas
Polk
Putnam
Santa Rosa
Sarasota
Seminole
St. Johns
St. Lucie
Sumter
Suwannee
Taylor
Union
Volusia
Wakulla
Walton
Washington

 


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Reporting Medicaid Fraud