Florida Medicaid Reform Pilot Archive

Florida Medicaid Reform Pilot

Archive

Waiver History

Florida Medicaid Reform (2011-2014)

Approved 3-Year Extension of the 1115 Research and Demonstration Waiver

On December 15, 2011, the Centers for Medicare and Medicaid Services (Federal CMS) approved the 3-year waiver extension request the Agency submitted on June 30, 2010. The waiver extension period for Florida’s Section 1115 Research and Demonstration Waiver is December 16, 2011 through June 30, 2014. The following are links to the federal approval documents for the 3-Year waiver extension request.

CMS Approval Letter, 12/15/11 [ 297.4 kB ]
CMS’s Waiver Authorities and Special Terms and Conditions, 12/15/11 [ 199.2 kB ]

To view the Waiver Extension Request and related Documents for 06/30/10-12/15/11, please go to the 1115 Research and Demonstration Waiver Extension Request web page. The following is a link to view the clarification from CMS regarding Low Income Pool Tier-One Milestone, 12/13/11.

December 13, 2011 Clarification of Low Income Pool Tier-One Milestone [ 184 kB ]

Florida Medicaid Reform (2005-2011)

Approved 1115 Research and Demonstration Waiver Initial 5-Year Application

In 2005, the Florida Legislature passed Senate Bill (SB) 838, authorizing the Agency to seek an experimental, pilot, or demonstration project waiver, pursuant to section 1115 of the Social Security Act (SSA) to create a statewide initiative to provide a more efficient and effective service delivery system that enhances quality of care and outcomes in the Florida Medicaid program. To effectively implement the program, the Agency submitted a draft application to Federal CMS on August 30, 2005, requesting a section 1115 Research and Demonstration Waiver in order to waive statutory provisions under section 1902 of the SSA. The draft 1115 waiver application was posted on Agency's website on August 31, 2005.

On October 3, 2005, the Agency submitted the official waiver application to Federal CMS after posting the draft application for 30 days as required by SB 838. Federal CMS reviewed the application and after intensive negotiations with Florida, granted approval on October 19, 2005, to waive certain federal statutory provisions and move forward in reforming Medicaid as authorized by SB 838. To view the Approved 1115 Waiver Application, as well as the draft waiver application, you may visit the Approved 1115 Research and Demonstration Waiver Application web page.

In December 2005, the Agency submitted an implementation plan to the Florida Legislature, which summarized the implementation milestones and activities that had been undertaken and would be completed before beginning operation of the waiver on July 1, 2006. To view the Implementation Plan, you may visit the Florida Medicaid Reform Implementation Plan web page.

Beginning in January 2006 through June 2008, the Agency held a series of informational meetings/workshops on Medicaid Reform for providers, beneficiaries, and advocates in the demonstration counties of Broward, Duval, Baker, Clay, and Nassau prior to implementation of the waiver on July 1, 2006. To view the meetings/workshop schedules and handouts, you may visit the Medicaid Reform Meetings/Workshops web page.

Federal Reporting

Special Term and Condition #17

On September 12, 2013, the Agency submitted to Federal CMS Florida’s Medicaid managed care policies as required by newly amended STC #17 of Florida’s Section 1115 Managed Medical Assistance Waiver. The following is a link to view the letter to Federal CMS and the Medicaid managed care policies.

September 12, 2013 – Letter to CMS and Medicaid Managed Care Policies [ 595.4 kB ]

Special Term and Condition #14

On March 13, 2012, the Agency submitted to Federal CMS Florida’s Medicaid managed care policies as required by STC #14 of Florida’s Section 1115 Research and Demonstration Waiver. The following is a link to view the letter to CMS and the Medicaid managed care policies.

March 13, 2012 Letter to CMS - Medicaid Managed Care Policies [ 2.7 MB ]