AGENCY FOR HEALTH CARE ADMINISTRATION
Proposed Amendment to Florida’s 1115 Managed Medical Assistance Waiver
The Agency for Health Care Administration (Agency) is seeking public input on a proposed amendment to Florida’s 1115 Managed Medical Assistance (MMA) Waiver.
DATE AND TIME: Tuesday, September 23, 2014, 2:00 p.m. – 2:30 p.m.
PLACE: Agency for Health Care Administration, Building 3, Conference Room A, 2727 Mahan Drive, Tallahassee, FL 32308
To participate by phone, please call: 1(888)670-3525 and enter the participant code: 3715274100#
DATE AND TIME: Monday, September 29, 2014, 1:00 p.m. – 2:00 p.m.
PLACE: Agency for Health Care Administration, 6800 North Dale Mabry Highway, Main Training Room, Tampa, FL 33614
To participate by phone, please call: 1(888)670-3525 and enter the participant code: 4201652735 #
GENERAL SUBJECT MATTER TO BE CONSIDERED: These public meetings are being held to solicit public input from recipients, providers, all stakeholders and interested parties regarding amending Florida’s 1115 MMA Managed Medical Assistance (MMA) Waiver (Project Number 11-W-002064) to allow certain populations who were previously excluded from the MMA program to voluntarily enroll. The proposed amendment will allow Medicaid-eligible recipients residing in group home facilities licensed under Section (s.) 393.067, Florida Statutes (F.S.), as well as Medicaid-eligible children receiving Prescribed Pediatric Extended Care (PPEC) services to voluntarily enroll in Florida’s MMA program, a component of the Statewide Medicaid Managed Care (SMMC) program. During the meetings, the following items will be discussed: an overview of the existing waiver and description of the draft waiver amendment request. There will be an opportunity for public comment at the meetings.
SUMMARY DESCRIPTION OF THE WAIVER AND PROPOSED AMENDMENT:
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. On December 15, 2011, the State received Federal CMS approval to extend the waiver for the period July 1, 2011 to June 30, 2014. On June 14, 2013, Federal CMS approved an amendment to the waiver that allowed 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. On July 31, 2014, the Agency received federal approval to extend the wavier for the period of July 31, 2014 until June 30, 2017.
The MMA program was fully implemented August 1, 2014 in accordance with Florida Law and the special terms and conditions of the waiver. The proposed amendment will allow for Medicaid-eligible recipients residing in group home facilities licensed under s. 393.067, F.S., as well as Medicaid-eligible children receiving Prescribed Pediatric Extended Care (PPEC) services to become eligible to voluntarily enroll in Florida’s MMA program, a component of the Statewide Medicaid Managed Care (SMMC) program. This amendment is being submitted to implement newly amended Florida Law (HB 5201), that allows recipients residing in a group home facility and children receiving PPEC services to voluntarily enroll in Florida’s MMA program upon federal approval.
This amendment will allow residents of group home facilities, to select an MMA plan and take advantage of the higher standards required of the plans while allowing these individuals access to care coordination and expanded benefits offered by the plans.
The purpose of the Florida Medicaid PPEC services is to enable recipients under the age of 21 years with medically-complex conditions to receive medical and therapeutic care at a non-residential pediatric center. Currently under Florida law, children receiving PPEC services are excluded from participating in the MMA program and, therefore, would be unable to receive services from an MMA plan such as the Children’s Medical Services Network.
The proposed amendment will allow for those children receiving PPEC services and currently enrolled in the Children’s Medical Services Network or another managed care plan to remain in that plan without disruption of services, ensuring their continuity of care and participation in the MMA program. It would also allow children not currently enrolled in a Medicaid managed care plan to select an MMA plan to take advantage of the higher standards required of the plans and the expanded benefits offered by the plans.
Public Notice and Public Comment Period: SEPTEMBER 17, 2014 – OCTOBER 17, 2014
The Agency will conduct a 30-day public notice and comment period prior to the submission of the proposed amendment request to Federal CMS. The Agency will consider all public comments received regarding the proposed amendment request. The 30-day public notice and public comment period begins September 17, 2014 and ends October 17, 2014. This public notice and public comment period is being held to solicit public input from recipients, providers and all stakeholders and interested parties on the development of the proposed amendment request to Florida’s 1115 MMA Waiver. The Agency is consulting with the Indian Health Programs located in Florida through written correspondence, to solicit input on the amendment request. On September 15, 2014, the Agency sent correspondence to the Seminole Tribe and Miccosukee Tribe requesting input on the amendment.
To view a comprehensive description of the waiver amendment request, please click the following link: http://ahca.myflorida.com/Medicaid/statewide_mc/pdf/mma/1115_Public_Notice_Doc_Final_9-17-2014.pdf
More information is available on the Agency’s website at the following link: http://ahca.myflorida.com/medicaid/statewide_mc/mma_fed_auth.shtml.
To submit comments by postal service or internet e-mail, please follow the directions outlined below. When providing comments regarding the proposed amendment to the 1115 MMA Waiver please reference “Proposed Amendment to 1115 MMA Waiver” in the subject line. Mail comments and suggestions to:
Proposed Amendment to 1115 MMA Waiver
Office of the Deputy Secretary for Medicaid
Agency for Health Care Administration
2727 Mahan Drive, MS #8
Tallahassee, Florida 32308
Email your comments and suggestions to: FLMedicaidWaivers@ahca.myflorida.com.
