Florida Medicaid Reform Health Plan Application, Model Contracts and Updates

The Application for Medicaid Reform Fee-For-Service Provider Service Networks (PSNs), Prepaid PSNs, Health Maintenance Organizations (HMOs) and other authorized Health Plans and the Reform Health Plan Model Contracts are now available. The multi-purpose Health Plan Application is designed to capture detailed information that will facilitate a contract between the Agency and any PSN, HMO or other authorized Health Plans that meet the requirements to become a Medicaid Reform Health Plan.

Florida Medicaid Reform Health Plan Application

May 2010 Health Plan Contract

The final draft May 2010 Health Plan Contract documents for the Medicaid Reform and non-Reform HMOs, Capitated PSNs and FFS PSNs is posted on the 2009-2012 Medicaid Managed Care Contract page.

The draft health plan contract combines the September 1, 2009 Health Plan Contract, the Agency’s Fine-Tuning Amendment executed by health plans in December 2009 and the Agency's Performance Measures Amendment executed by health plans in April and May 2010. These consolidated contract documents are used for both Reform and non-Reform HMO and PSN contracts.

Health Plan Report Guide

The final draft Health Plan Report Guide for use with the September 1, 2009 Health Plan contract has been posted is posted on the 2009-2012 Medicaid Managed Care Contract page.  Health plan reporting specifications for all September 1, 2009 Health Plan Contract-required reports are provided in this Report Guide.  Also posted are links to the report templates listed in the guide.