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2014 Proposed Amendment to Florida’s 1115 Managed Medical Assistance Waiver

Federal Authorities

Managed Medical Assistance

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. 

Summary Description of Proposed Amendment Request

The Agency plans to submit an amendment to Florida’s 1115 MMA Waiver to the Centers for Medicare and Medicaid Services (Federal CMS).  The proposed amendment will allow for 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.  During Florida’s 2014 legislative session, HB 5201 was passed.  This bill allows children receiving PPEC services to voluntarily enroll in Florida’s MMA program upon federal approval.  This bill is subject to signature by Florida’s Governor, and this notice is subject to withdrawal if the bill does not become law.

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 to the 1115 MMA Waiver will allow for those children receiving PPEC services and currently enrolled in the Children’s Medical Services Network or another MMA 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. Currently under Florida law, children receiving PPEC services are excluded from participating in Florida’s MMA program and therefore are unable 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:  June 2, 2014 – July 1, 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 June 2, 2014 and ends July 1, 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.

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 have ‘Proposed Amendment to 1115 MMA Waiver’ referenced 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

E-mail your comments and suggestions to:  [email protected].