Florida Senior Care:
Provider Information
This page will serve as the link for potential FSC providers to access program information, beginning with the December 2007 "Call for Letters of Intent to Offer a Medicaid Florida Senior Care Plan"
Additional information will be added as it becomes available, including the provider application to be released in February 2008.
Florida Senior Care Health Plan Application and Supporting Documentation |
No. |
Document |
Description |
1 |
FSC Health Plan Application [291KB PDF]  4/8/08 |
This Health Plan Application is designed to capture detailed information that will facilitate a contract between the Agency and entities eligible to submit a Florida Senior Care Health Plan Application pursuant to s. 409.912(5), Florida Statutes (F.S.), which include the following:
- Commercially licensed Contractor in accordance with the provisions of Part I and Part III of chapter 641, Florida Statutes (F.S.).
- Other qualified provider – as defined in section 430.703(7), F.S.
- Community care for the elderly lead agency, other state certified community service network – in accordance with section 430.201 – 430.207, F.S.
|
2 |
FSC Health Plan DRAFT Model Contract, April 9, 2008 [3.12MB PDF] 4/11/08 |
This is a draft model contract for the FSC program. Updates will be provided during the application process between February 27, 2008 and August 1, 2008. |
3 |
FSC Health Plan Frequently Asked Questions 4/11/08 |
Questions and answers pertaining to the application, contract and related processes. |
| 4 |
CMS Form 1513 [550KB PDF]  4/8/08 |
Disclosure of Ownership and Control Interest Statement. |
| 5 |
Application Question 12 and FSC Health Plan (Provider Type 87) Provider Enrollment Instructions [97KB PDF] 4/18/08 |
Link to ACS for Provider Enrollment Application and related Documents
http://floridamedicaid.acs-inc.com/index.jsp |
AREA 7 Estimated Application Process Timeline:
Description |
Event Date |
Release Florida Senior Care Health Plan Application #01 |
February 26, 2008 |
Capitation Rates Meeting |
March 4, 2008 |
Technical Assistance Workshop: Health Plan Application |
March 4, 2008, 1-5 p.m. |
Florida Senior Care Health Plan Application #01 must be received by the Agency for Health Care Administration |
April 25, 2008 |
Application and Readiness Reviews Conducted |
April 28 – August 1, 2008 |
Execute Health Plan Contracts |
No later than August 29, 2008 |
Services Begin in Area 7 |
December 1, 2008 |
Please submit any questions in writing to the following:
Email: managediltc@ahca.myflorida.com OR
U.S. Mail:
Florida Senior Care-Health Plan Application
Agency for Health Care Administration
2727 Mahan Drive, Mail Stop #20
Tallahassee, Florida 32308
Call for Letters of Intent to Offer a Medicaid Florida Senior Care Plan, December 3, 2007 [43KB PDF]
Organizations Submitting a Letter of Intent to Serve Medicaid's Florida Senior Care Populations [13KB PDF]
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