Statewide Medicaid Managed Care

Report a Complaint

In 2011, the Florida Legislature created Part IV of Chapter 409, Florida Statutes, directing the Agency to create the Statewide Medicaid Managed Care (SMMC) program.  The SMMC program has two key components:  the Managed Medical Assistance program and the Long-term Care program.

Please select one of the links below for more information.

Recipients

Providers

Plans

Program Information

Title Date
Managed Medical Assistance Specialty Plans [88KB PDF] January 21, 2015
Coordinating Dual Eligibles’ Medicare and Medicaid Managed Medical Assistance Benefits Snapshot [130KB PDF] December 1, 2014
Expanded Benefits Offered by Plans [47KB PDF] November 11, 2014
Network Providers & Potential Network Snapshot [418KB PDF] September 30, 2014
Documenting Patient Responsibility for Reimbursement of Nursing Facility Services Snapshot [319KB PDF] September 30, 2014
Nursing Facility Services and Medicaid Pending Snapshot [60KB PDF] September 30, 2014
Requirements for Reimbursement of Nursing Facility Medicare Part A Coinsurance Claims Snapshot [124KB PDF] September 30, 2014
Requirements for SMMC Reimbursement of Nursing Facility Medicare Part B Claims Snapshot [55KB PDF] September 30, 2014
Patient Responsibility and Reimbursement of Nursing Facility Services Snapshot [367KB PDF] September 30, 2014
Pro-Rating Patient Responsibility for Reimbursement of Nursing Facility Services Snapshot [61KB PDF] September 30, 2014
Why Nursing Facility Services Are Not Mixed Services Snapshot [49KB PDF] September 30, 2014
Ambulance Transportation Service Requirements in the MMA Program [129KB PDF] September 23, 2014
Targeted Case Management Snapshot [179KB PDF] August 27, 2014
Mixed Services Snapshot [257KB PDF] August 27, 2014
Prescribed Drug Services Snapshot [178KB PDF] August 27, 2014
Services New to the MMA Program [61KB PDF] July 8, 2014
General Transportation Service Requirements in the MMA Program Snapshot [131KB PDF] July 7, 2014
Children’s Medical Services Network Plan [75KB PDF] June 5, 2014
Florida Assertive Community Treatment Program & Managed Medical Assistance Snapshot [65KB PDF] May 30, 2014
Child Welfare Population Snapshot [73KB PDF] May 9, 2014
Children’s Multidisciplinary Assessment Team (CMAT) Services Snapshot [66KB PDF] May 9, 2014
SMMC Exemptions [50KB PDF] April 30, 2014
The Individual Budgeting (iBudget) Waiver and the Managed Medical Assistance Program Snapshot [44KB PDF] April 24, 2014
Continuity of Care Requirements [112KB PDF] April 18, 2014
Durable Medical Equipment Contracts in the Managed Medical Assistance Program [47KB PDF] March 28, 2014
April 1, 2014
Assistive Care Services in SMMC [124KB PDF] March 3, 2014
LTC Plan Enrollee Survey [72KB PDF] February 18, 2014
Letter to Consumable Medical Supplies Providers [43KB PDF] October 3, 2013
Integrated Dual Eligible Plans [45KB PDF] August 9, 2013
Letter to Nursing Facilities [86KB PDF] July 22, 2013
Clarification: Specialty Plans [51KB PDF] November 21, 2012
Specialty Plans [52KB PDF] September 28, 2012
Contracting Required Pursuant to Section 409.975(1)(d)  [38KB PDF] September 11, 2012
Long-term Care Managed Care Program Application Process for Medicare Advantage Special Needs Plans [63K PDF] September 10, 2012
Respondents to Statewide Medicaid Managed Care Long-term Care (LTC) Invitations to Negotiate [165KB PDF] August 31, 2012
Documentation Accepted for Plan Provider Networks [63KB PDF] June 21, 2012
Updated Guidance Statement: Participation of Medicare Advantage SNP plans in the SMMC LTC Component [46KB PDF] June 8, 2012
August 16, 2012
Participation of Provider Service Networks in the LTC Component of the SMMC program [46KB PDF] May 30, 2012
Aging Network Service Providers  [47KB PDF] May 17, 2012
Provision of Case Management Services [52KB PDF] April 4, 2012
Reimbursement for Transportation Services [52KB PDF] April 4, 2012
Respondents to Statewide Medicaid Managed Care Managed Medical Assistance (MMA) Invitations to Negotiate [95KB PDF] April 3, 2012
Enrollment in Medicare Advantage plans that are not subject to competitive procurement [44KB PDF] February 10, 2012
Provision of medical care services to Long-term Care plan enrollees after full program implementation [47KB PDF] February 10, 2012
Responsibility for the provision of duplicative services to a recipient enrolled in both a Long-term Care plan and a Managed Medical Assistance plan [47KB PDF] February 10, 2012
HMO Certificate of Authority [44KB PDF] January 18, 2012
Related to the March 16, 2012, Version of the Long-term Care Managed Care Data Book [66KB PDF]  
Related to Upcoming Public Meeting to Address Questions Regarding the Long-term Care Data Book Released on March 16, 2012 [64KB PDF]