Statewide Medicaid Managed Care Waiver

Florida CHAIN Joins Advocates in Calling for Improvements to Managed Care Plan Network Adequacy Model Act

Florida CHAIN joined with national partners and advocates from states across the country this week to urge the National Association of Insurance Commissioners (NAIC) to revise their Managed Care Plan Network Adequacy Model Act to include strong consumer protections. Click here to read the letter. The Model Act is likely to be used as a […]

Florida CHAIN Weighs in on Federal Medicaid Regulations

Managed Care Organizations (MCOs) are health plans that attempt to control the cost and quality of care by coordinating medical and other health-related services. State Medicaid plans began to contract with independent MCOs in the 1980s as a strategy to control and predict their Medicaid expenditures. The number of Medicaid beneficiaries that receive their health care […]

GAO’s Review of 7 States Medicaid Managed Care Oversight by the States – Lack of Oversight

The GAO is primarily after the recovery of federal funds but they point to a major problem in that there has been little CMS and states’ oversight of the Medicaid managed care expenditures, their focus is with the fee for service systems.  The GAO reports that the states admit to it because it is too […]

Statewide Medicaid Managed Care Rollout Explained (Powerpoint)

This presentation answers many of the questions you may still have about the Statewide Medicaid Managed Care rollout.    Statewide Medicaid Managed Care rollout explained 05.29.15 v2  

Managed Medical Assistance (MMA) Program Under the SMMC

The Florida Medicaid program is implementing a new system through which Medicaid enrollees will receive services, the Statewide Medicaid Managed Care Managed Medical Assistance program. ALL Seniors who are receiving Medicaid coverage for long term care MUST select an MMA Plan too! If you do not select a MMA Plan, the State will select one […]

A Snapshot of the Florida Medicaid Managed Medical Assistance Program

A Snapshot of the Florida Medicaid Managed Medical Assistance Program This document from AHCA gives an overview of the Medicaid Managed Care Program and answers several frequently asked questions. Find out: who is NOT required to participate; who is NOT eligible to participate; and what region you’re in; and other useful information.

Continuity of Care Requirements in the Managed Medical Assistance Program

The Statewide Medicaid Managed Care (SMMC) program consists of two components: the Managed Medical Assistance (MMA) program and the Long-term Care (LTC) program. The MMA program provides medical services to infants, children and adults on Medicaid, while the LTC program provides home and community-based long-term care services to elders and adults with disabilities on Medicaid […]

Having Problems With New SMMC Program? Here’s How to Complain

You may encounter circumstances, such as your choices or the care you receive, where something is just not right. In these cases, you may have a complaint. Discussed in this section are a FEW of the areas where you may have a concern arise. It is possible you will not see a question or answer […]

Letter to CMS about proposed waiver applications for Medicaid managed Long Term Care

Click to read Florida CHAIN’s 7 page detailed letter to CMS dated February 18, 2011 asking that CMS reject Florida’s 1915 (b)(c) waiver applications for the proposed Medicaid managed Long Term Care program.

Questions and Answers about Federal Approval of Florida’s Statewide Medicaid Managed Care Experiment

What exactly is being approved? The federal Centers for Medicare and Medicaid Services (CMS) is granting final approval of Florida’s request to expand and intensify its existing Medicaid managed care experiment. Under “Statewide Medicaid Managed Care”, almost all Florida Medicaid recipients will be required to enroll in an HMO or HMO-like plan. How did we […]