These public meetings are being held to solicit public input from recipients, providers and all stakeholders and interested parties on the development of the three-year extension request for Florida’s 1115 Managed Medical Assistance (MMA) Waiver (...

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

The Agency for Health Care Administration announces a public meeting to which all persons are invited.

DATES AND TIMES: October 8, 2013, 1:00p.m. – 3:30p.m.; October 9, 2013, 1:00p.m. – 3:30p.m.; October 11, 2013, 1:00p.m. – 3:30p.m.

PLACES: October 8, 2013, 1:00p.m. – 3:30p.m.: Egypt Shriners, 4050 Dana Shores Drive, Tampa, FL 33634. To participate by phone, please call 1(877)809-7263 and enter the participant passcode 72390513#.

October 9, 2013, 1:00p.m. – 3:30p.m.: Florida International University, Kovens Center, 3000 N.E. 151 Street, North Miami, FL 33181. To participate by phone, please call 1[phone] and enter the participant passcode 78073166#.

October 11, 2013, 1:00p.m. – 3:30p.m.: Agency for Health Care Administration, Building 3, 1st Floor, Conference Room A, 2727 Mahan Drive, Tallahassee, FL 32308. To participate by phone, please call 1(877)299-4502 and enter the participant passcode 88742870#. The public meeting in Tallahassee will also be available via webinar. To participate by webinar, follow the directions outlined below:

1) Go to https://suncom.webex.com/suncom/k2/j.php?ED=233333852&UID=1622458687&HMAC=56ac1e48ed9515d674af636a2a2b29b3c6d37a42&RT=MiMxMQ%3D%3D.

2) Enter your name and email address (or registration ID).

3) Click "Join".

4) Follow the instructions that appear on your screen.

GENERAL SUBJECT MATTER TO BE CONSIDERED: These public meetings are being held to solicit public input from recipients, providers and all stakeholders and interested parties on the development of the three-year extension request for Florida’s 1115 Managed Medical Assistance (MMA) Waiver (previously known as Medicaid Reform Waiver), as approved by the Centers for Medicare and Medicaid Services (Federal CMS) on June 14, 2013. During the meetings, the following items will be discussed: the future of Florida’s 1115 MMA Waiver, legislation creating the MMA program passed during the 2011 Florida Legislative Session, overview of the existing waiver and description of the draft waiver extension request. There will be an opportunity for public comment at the meetings.

SUMMARY DESCRIPTION OF THE WAIVER: Florida’s 1115 Research and Demonstration Waiver was initially approved by Federal CMS October 19, 2005 to operate for the period from July 1, 2006 to June 30, 2010. Implementation of the waiver occurred in Broward and Duval Counties on July 1, 2006 with expansion to Baker, Clay and Nassau Counties occurring July 1, 2007. Federal CMS granted temporary extensions of the waiver until December 15, 2011, when final approval of the extension request was granted, for the period from December 16, 2011 to June 30, 2014.

On June 14, 2013, Federal CMS approved an amendment to the waiver that allows for implementation of an improved statewide model of managed care in 2014 and the continuation of the Low Income Pool program. The amendment also changed the name of the waiver to the Florida Managed Medical Assistance Waiver.

With the submission of the three-year waiver extension request, the state is seeking federal authority to extend Florida’s MMA Waiver for the period July 1, 2014 to June 30, 2017. The waiver is designed to implement a new statewide managed care delivery system without increasing costs and to continue the Low Income Pool program. The program is guided by principles designed to improve coordination and patient care while fostering fiscal responsibility.

The MMA program will provide primary and acute medical care for the majority of Medicaid recipients through high quality, competitively selected managed care organizations. Moving from a fee-for-service system to the MMA program, the program increases consumer protections as well as quality of care and access for Floridians in many ways including:

• Increases recipient participation on Florida’s Medical Care Advisory Committee and convenes smaller advisory committees to focus on key special needs populations;

• Ensures the continuation of services until the primary care or behavioral health provider reviews the enrollee’s treatment plan (no more than sixty calendar days after the effective date of enrollment);

• Ensures recipient complaints, grievances and appeals are reviewed immediately for resolution as part of the rapid cycle response system;

• Establishes Healthy Behaviors programs to encourage and reward healthy behaviors and, at a minimum, requires plans offer a medically approved smoking cessation program, a medically directed weight loss program and a substance abuse treatment plan;

• Requires Florida’s External Quality Review Organization to validate each plan’s encounter data every three years;

• Enhances consumer report cards to ensure recipients have access to an understandable summary of quality, access, and timeliness regarding the performance of each participating managed care plan;

• Enhances the plan’s performance improvement projects by focusing on six key areas with the goal of achieving improved patient care, population health and reducing per capita Medicaid expenditures;

• Enhances metrics on plan quality and access to care to improve plan accountability; and

• Enhances the state’s comprehensive continuous quality improvement strategy, focusing it on all aspects of quality improvement in Medicaid.

PUBLIC NOTICE AND PUBLIC COMMENT: OCTOBER 1, 2013 – OCTOBER 30, 2013

The Agency will conduct a 30-day public notice and comment period prior to the submission of the waiver extension request to Federal CMS. The Agency will consider all public comments received regarding the waiver extension request. The 30-day public notice and public comment period begins October 1, 2013 and ends October 30, 2013. To view a comprehensive description of the waiver extension request, please click the following link: http://ahca.myflorida.com/Medicaid/statewide_mc/pdf/mma/1115_Public_Notice_Document_Oct_1_2013.pdf

More information is available on the Agency’s website at the following link: http://ahca.myflorida.com/Medicaid/statewide_mc/index.shtml#FCA

To submit comments by postal service or internet e-mail, please follow the directions outlined below. When providing comments regarding the 1115 MMA Waiver extension request, please have ‘1115 MMA Waiver Extension Request’ referenced in the subject line.

Mail comments and suggestions to:

1115 MMA Waiver Extension Request

Office of the Deputy Secretary for Medicaid

Agency for Health Care Administration

2727 Mahan Drive, MS #8

Tallahassee, Florida 32308

You may also e-mail your comments and suggestions to: [e-mail].

A copy of the agenda may be obtained by contacting: Ms. Linda Macdonald at [phone] or via email at [e-mail].

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: Ms. Linda Macdonald at [phone] or via email at [e-mail]. 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).

For more information, you may contact: Ms. Linda Macdonald at [phone] or via email at [e-mail].