The State is seeking federal authority to amend Florida’s 1115 Managed Medical Assistance (MMA) Waiver (Project Number 11-W-002064) to assign Medicaid-eligible individuals who are mandated to participate in Florida’s MMA program, a component of the Statewide Medicaid Managed Care program, to a managed care plan immediately after eligibility determination. The State is requesting an effective date of September 1, 2015.
The State is requesting this amendment to remove the 30-day period between eligibility determination and managed care plan enrollment and to amend the auto-assignment criteria to conform to Section (s.) 409.977(2), Florida Statutes, which states:
"When automatically enrolling recipients in managed care plans, the agency shall automatically enroll based on the following criteria: (a) Whether the plan has sufficient network capacity to meet the needs of the recipients. (b) Whether the recipient has previously received services from one of the plan’s primary care providers. (c) Whether primary care providers in one plan are more geographically accessible to the recipient’s residence than those in other plans.”
The proposed amendment will allow individuals to be enrolled in a managed care plan immediately after eligibility determination. Under the proposed amendment, individuals will receive both their managed care plan assignment and information about the managed care plan choices in their area, to encourage an active selection, immediately after eligibility determination.
During the initial 30-day period post-enrollment, if a recipient decides to change plans, the change will take effect the first day of the following month. The 30-day change period will be followed by a 90-day disenrollment period. During the 90-day disenrollment period, if a recipient decides to change plans, the change will take effect the first day of the following month.
The following is an historical description of the federal and state authority granted since authorization of the waiver (Project Number 11-W-00206/4) was obtained in 2005.
Initial 5-Year Period (2006-2011): On October 19, 2005, Florida's 1115 Research and Demonstration Waiver named “Medicaid Reform” was approved by Federal CMS. The program was implemented in Broward and Duval Counties July 1, 2006 and expanded to Baker, Clay and Nassau Counties July 1, 2007. The program was terminated August 1, 2014 with the implementation of the MMA program. The state authority to operate this program is located in s. 409.91211, F.S., and sunsets October 1, 2014.
Three-Year Extension Period (2011-2014): On December 15, 2011, the State received Federal CMS approval to extend the waiver to maintain and continue operations of Medicaid Reform for the period July 1, 2011 to June 30, 2014.
MMA Waiver Amendment (2014): On June 14, 2013, the State received Federal CMS approval to amend the waiver to terminate the Medicaid Reform program and implement the MMA program as approved by Federal CMS. The name of the waiver was changed to Florida’s MMA program.
Three-Year Waiver Extension (2014-2017): During the 2011 Florida Legislative session, the Florida Legislature passed and Governor Scott signed legislation to expand managed care in the Florida Medicaid program with the creation of the MMA program. Part IV of Chapter 409, F.S., directed the Agency to submit any federal waiver or state plan amendment requests to Federal CMS as necessary to implement the MMA program no later than October 1, 2014. In accordance with this directive, the Agency sought and received approval to extend the waiver authorization period from July 31, 2014 until June 30, 2017.
To view the July 31, 2014, approved Special Terms and Conditions of the waiver, Waiver Authorities document, Expenditure Authorities document and the Approval Letter, please click on the following links:
The Agency will provide for a 30-day public notice and comment period prior to the submission of the waiver amendment to Federal CMS. The Agency will consider all public comments received regarding the development of the waiver amendment.
The 30-day public notice and public comment period begins March 27, 2015 and ends April 26, 2015.
To view a comprehensive description of the waiver amendment request, please click the following link:
The dates, times and locations of the public workshops to be held are as follows:
|Schedule of Public Meetings|
Conference Line: 1-877-299-4502
|April 7, 2015||
1:00 p.m. – 3:30 p.m.
Agenda [39KB PDF]
Conference Line: 1-877-299-4502
|April 14, 2015||
3:00 p.m. – 5:00 p.m.
Agenda [51KB PDF]
Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 7 days before the workshop/meeting by contacting Heather Morrison at (850) 412-4034 or by email at Heather.Morrison@ahca.myflorida.com.
If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1 (800) 955-8771 (TDD) or 1 (800) 955-8770 (Voice).
The 30-day public comment period begins March 27, 2015 and ends April 26, 2015.
To submit comments by postal service or internal email, please follow the directions outlined below. When providing comments regarding the 1115 MMA Waiver amendment request, please have ‘1115 MMA Waiver Amendment Request’ referenced in the subject line.
Mail comments and suggestions to:
1115 MMA Waiver Amendment Request
Office of the Deputy Secretary for Medicaid
Agency for Health Care Administration
2727 Mahan Drive, MS #8
Tallahassee, Florida 32308
You may also email your comments and suggestions to
If you would like to be added to the Interested Parties List to receive email updates about the 1115 MMA Waiver Amendment Request, please provide your information in the box located in the top right hand side of this page named, “Sign Up for Program Updates.” Please note that information will be sent to this list via mass email. Your email server may recognize this as Spam or Junk Mail and, therefore, some action may be required on your part to receive notices.
Public Comments as of April 27, 2015 [474KB PDF]