Medicaid Policy

Erica Floyd Thomas
Bureau Chief

2727 Mahan Drive
Mail Stop #20
Tallahassee, FL 32308

Phone: (850) 412-4003
Fax: (850) 414-6236

The Bureau of Policy is responsible for the development, coordination and implementation of Florida Medicaid program policy including: all Medicaid federal authorities (e.g., the Florida State Plan, 1115 waivers and home and community based service waivers, administrative rules, coverage policies and managed care plan contracts) related to services covered by Florida Medicaid.  It coordinates policy development with the federal government, other state agencies, and external stakeholders. 

Florida Medicaid's Covered Services and HCBS Waivers

The link above takes you to a list of Florida Medicaid covered services that links to a summary of each covered service, a brief description of the requirements to receive the service, and additional resources and information.

Federal Authorities

Develops and maintains federal authorities, including waivers and the Florida Medicaid state plan.

Managed Care Policy and Contract Development

Develops and maintains policy, contracts and health plan reporting requirements relating to the Statewide Medicaid Managed Care (SMMC) program. 

Medical and Behavioral Health Coverage Policy

Develops and maintains primary and preventative care, specialized health services and behavioral health and health facilities policy.

Pharmacy Policy

Develops and maintains policy regarding pharmacy services and the Florida Medicaid preferred drug list.

Program Policy

Develops and maintains eligibility guidelines, dual eligible policy, third party liability, the Children's Health Insurance Program, general provider information, and eligibility and reimbursement protocols, including the Provider General, UB-04 and CMS 1500 coverage policies.

Rules

Oversees the promulgation of all Medicaid rules, fee schedules and coverage policies into the Florida Administrative Code.

Additional Reference Information

The Policy Bureau partners with numerous federal and state agencies. Its most common partners are: