Comprehensive Statewide Hemophilia Disease Management Program (DMOH assignment plan)
The Comprehensive Statewide Hemophilia Disease Management Program (DMOH assignment plan) will continue to exist under MMA, and these drugs are carved out from the pharmacy benefit provided by managed care plans. Recipients who need prescribed drugs as treatment for hemophilia or von Willebrand disease will receive those drugs through this program.
- Must have active Medicaid eligibility and be prescribed drugs in therapeutic classes identified by the Agency as treatment for hemophilia or von Willebrand disease.
The contracts are between AHCA and Coram and Caremark CVS to provide care management and pharmacy benefits management for eligible Medicaid beneficiaries with hemophilia or von Willebrand disease on a statewide basis.
- Coram - ACHA Contract No. FA997
- Caremark CVS – AHCA Contract No. FA998
- Both contracts were implemented on 11/1/2012
Services Provided through Contracts
- Predictive modeling, disease management, provider consultation, product management and product dispensing.
- The hemophilia drugs are carved out of the capitation payment to managed care enrollees, and are paid fee-for-service.
- Sections 1915(b) (3) and (b) (4) of the Social Security Act grant the State of Florida 1915(b) Medicaid Managed Care Waiver authority.
- 409.912- Cost Effective Purchasing of Healthcare
- 409.912(IX) Implement Disease Management Programs