Florida Medicaid Reform Pilot
Welcome to the Agency for Health Care Administration’s (the Agency’s) Medicaid reform website. Florida is leading the nation in changing the Medicaid program. For the first time, we will offer true flexibility in the program so health plans can better target the needs of the program’s participants. We believe this innovative approach will better match health care services with the needs of the citizens we serve. Together, we can create a better Medicaid program. We encourage you to visit the reform website frequently for information on upcoming meetings, updates on the status of reform implementation and other relevant information. Florida Medicaid Reform (2011-2014)
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submitted on June 30, 2010. The waiver extension period for Florida’s Section 1115 Research and Demonstration Waiver is December 16, 2011 through June 30, 2014. The following are links to the federal approval documents for the 3-Year waiver extension request. Click here for the Waiver Extension Request and related Documents, 06/30/10-12/15/11. 1115 Amendment Requests Please click on the following link to view the amendment requests submitted to CMS in accordance with CS/HB 7107 on http://ahca.myflorida.com/Medicaid/statewide_mc/index.shtml Medicaid Reform Annual ReportThe annual report documents accomplishments, project status, quantitative and case-study findings, utilization data, and policy and administrative issues in the operation of the 1115 research and demonstration waiver for each year of the waiver. The annual reports are completed and made available 120 days after the end of each demonstration year Click here to view the completed annual reports. Medicaid Reform Quarterly ReportsThe quarterly progress reports provide an analysis and the status of the various operational areas of the 1115 research and demonstration waiver. The quarterly reports are completed and made available 60 days after the end of each quarter. Click here to view the completed quarterly reports. Medicaid Reform Training for BeneficiariesBeginning in July 2007, there will be changes to Florida Medicaid in Baker, Clay, and Nassau Counties. These changes are needed to better meet the health care needs of Florida Medicaid beneficiaries. These changes are called “Medicaid Reform”. In Baker, Clay, and Nassau, beginning in April 2007, the local Medicaid office will be offering training meetings on these changes. If you would like to attend one of these meetings, please click on the link below and you will be guided to a site where you can sign up. http://apps.ahca.myflorida.com/medres/index.aspx Anyone needing further information, or special accommodations under the Americans with Disabilities Act of 1990 (for example, Braille or large print documents, sign language interpreter services, or closed-captioning) should contact the Medicaid Area Office at 1 (904) 353-2100 or toll free at 1 (800) 273-5880. Special accommodation requests under the Americans with Disabilities Act should be made at least seven business days prior to the public meetings. If TTY service is needed, Medicaid beneficiaries can call 1 (800) 955-8771 for assistance. Enhanced Benefits Reward$ ProgramFlorida Medicaid wants to encourage you to make healthy choices and participate in activities that will help keep you from getting sick. Beneficiaries in Florida Medicaid Reform plans will be eligible for enhanced benefits if they take part in specific activities. The goal is to reward your healthy behavior.
Presione (Click) aquí para obtener esta información en español Choice Counseling and Other Beneficiary Information
Provider InformationAs part of the Agency’s commitment to enhancing the implementation of reform, the Agency continues to expand its communication with providers that are considering developing a benefit package and submitting an application as a Medicaid HMO or Provider Service Network. This web page is one of many ways that the Agency communicates with potential plan applicants and current health plan contractors to provide the tools needed to complete the application and contracting processes. We encourage you to visit this site regularly.
Low Income Pool (LIP)The Low Income Pool (LIP) is established to ensure continued government support for the provision of health care services to Medicaid, underinsured and uninsured populations. Click here to proceed to the LIP information. Medicaid HMOsThe State of Florida purchases health care services from commercially licensed HMOs. The Bureau of Managed Health Care, along with the Bureau of Health Systems Development, is responsible for the approval and monitoring of all Medicaid HMO contracts in the state. Bureau staff conduct desk and on-site reviews throughout the year to ensure contract compliance.
Technical Advisory Panel (TAP)The Agency for Health Care Administration (AHCA) appointed nine people to serve on the Medicaid reform Technical Advisory Panel. The Panel was created by the Florida Legislature in House Bill 3B and will advise AHCA on various implementation issues with Medicaid reform. Click here to proceed to the TAP information. Florida Medicaid Reform (2005-2011)
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