Florida Medicaid officers have introduced their intent to award six-year contracts to Florida Community Care and Simply Healthcare because the state assessments whether or not managed care can assist combine conventional well being care with home- and community-based companies.

The Company for Well being Care Administration (AHCA) introduced the contracts for Medicaid Areas D and I. Area D contains Hardee, Highlands, Hillsborough, Manatee and Polk counties. Medicaid Area I covers Miami-Dade and Monroe counties.

It’s not clear what number of entities responded to the Medicaid Invitation to Negotiate (ITN), which was initially dropped in November 2023. AHCA didn’t reply to Florida Politics’ repeated requests for info. The ITN required the state to barter with all entities that met a minimal analysis rating of 70%.

In response to the discover, AHCA solely negotiated with Florida Group Care, whose response to the ITN scored 983 factors, and Merely Healthcare, which submitted a response that earned 938 whole factors. There have been 1,000 whole factors obtainable.

Lawmakers gave the inexperienced gentle to check whether or not managed care is a viable supply system for folks with mental and developmental disabilities last year in SB 2510. The laws authorizes as much as 600 volunteers who’re 18 years of age and at present on the waitlist for companies within the present Medicaid iBudget Waiver program to enroll within the new pilot program.

The iBudget Waiver permits folks with mental or developmental disabilities to acquire the kinds of home- and community-based companies they require to reside exterior of an establishment. These companies, which might embody assist with courting and grooming, historically aren’t coated by Medicaid, which is why the state wanted a waiver to supply the care.

Advocates, members of the family and caregivers have beforehand opposed efforts to require managed look after folks with mental and developmental disabilities. Opponents have, previously, efficiently beat again efforts to require them to enroll in managed care plans.

Whereas lawmakers directed Medicaid officers to create the pilot program, it isn’t the one effort underway to enroll people with developmental and mental disabilities into managed care plans.

Underneath the phrases of the brand new Medicaid managed care ITN, the state will assign people with mental or developmental disabilities into Medicaid managed care plans, though these people can decide out afterward.

In response to the newest iteration of the timeline, AHCA is anticipated to announce the winners of the statewide Medicaid managed care on Feb. 23.

AHCA is also negotiating a Medicaid dental ITN and intends to announce which entities it intends to award contracts to on March 29. AHCA despatched a Medicaid alert in January asserting that Avēsis of Florida, DentaQuest of Florida, LIBERTY Dental Plan of Florida and Managed Care of North America had responded to the dental ITN.

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