Proposed Amendment to Florida’s 1115 Managed Medical Assistance Waiver SUMMARY DESCRIPTION OF PROPOSED AMENDMENT: The State is seeking federal authority to amend Florida’s 1115 Managed Medical Assistance (MMA) Waiver (Project Number 11-W-00206/4) to redesign the Low Income Pool (LIP) and extend the program from July 1, 2015 until June 30, 2017. The newly redesigned LIP program ensures access to care for low income populations that are not eligible to participate in Medicaid or other subsidized coverage programs and complements the MMA program by strengthening connections between critical safety net providers and the MMA program. The State contracted with Navigant Consulting Incorporated to conduct the Centers for Medicare and Medicaid Services (CMS) required study on the LIP program. The study concluded that the LIP program would need to continue in Florida even if all coverage options were fully exploited. In response to these findings and discussions with CMS, the redesigned LIP program contains the following features: • Reduced linkage of payments to local source of funding and • Continued focus on maintaining access and quality of care to vulnerable populations. The State is not requesting authority to make any changes to the MMA program as authorized under this waiver. The State is seeking waiver and expenditure authority to redesign and extend the LIP program until June 30, 2017. Specifically, the State seeks expenditure authority of Section 1115(a)(2) of the Social Security Act for expenditures for uncompensated care costs incurred by providers for health care services to uninsured and or underinsured, and associated projects to support such care through the redesigned LIP program. The request to redesign and continue funding of the LIP program is in response to discussions with the Centers for Medicare and Medicaid Services (CMS) about how best to structure the pool in light of new and different coverage opportunities for low income Floridians: Florida’s Medicaid program’s shift to the MMA program as well as opportunities available under the Affordable Care Act (ACA). To view the full description of the proposed amendment request please see the public notice document published on the Agency’s website at the following link: http://ahca.myflorida.com/medicaid/statewide_mc/mma_fed_auth_amend_waiver_2015-04.shtml PUBLIC NOTICE AND PUBLIC COMMENT PERIOD: The Agency for Health Care Administration (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 April 21, 2015 through May 22, 2015. 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. To submit comments by postal service or internet email, please follow the directions outlined below. When providing comments regarding the proposed amendment to the 1115 MMA Waiver, please have ‘Proposed Amendment to 1115 MMA Waiver’ referenced in the subject line. Mail comments and suggestions to: Proposed LIP 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. SUMMARY DESCRIPTION OF THE 1115 MMA 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 LIP program. The amendment also changed the name of the waiver to the Florida Managed Medical Assistance Waiver. On November 27, 2013, the Agency submitted another three-year waiver extension request to Federal CMS to extend Florida’s 1115 MMA Waiver for the period July 1, 2014 to June 30, 2017. With the submission of the three- year waiver extension request, the State is seeking federal authority to extend Florida’s 1115 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 LIP program. The program is guided by principles designed to improve coordination and patient care while fostering fiscal responsibility.