MMA Physician Incentive Program (MPIP) - Year 1

October 1, 2016 - September 30, 2017

Physicians qualified to participate in the MMA Physician Incentive Program (MPIP) are the physician types listed below who meet plan-specific access and quality criteria. Year 1 of the MPIP included the following physician types:

• Board Certified Pediatricians
• Board Certified OB/GYNs

For additional information on each plan’s access and quality criteria for qualified providers in Year 1, please click the link below.

MPIP Year 1 Plan Program Summary [ 230.6 kB ]

MPIP Year 1: Qualified Providers

Below is a list of physicians by name, reported by the plans to the Agency, who met MPIP Year 1 qualifying criteria and received enhanced rates for services during the implementation year October 1, 2016 – September 30, 2017.

During each year of MPIP, plans are required to reassess physician eligibility for the program six months after implementation. For MPIP Year 1, plans were required to reassess eligibility for enhanced rates for dates of service beginning on or after April 1, 2017. This allowed providers who became qualified after the October 1, 2016 implementation date a second opportunity to become eligible for MPIP. The Year 1 qualified provider list, available at the link below, reflects the updated reassessment.

MPIP Year 1 Qualified Providers List [ 266 kB ]

If you are a provider contracted with a health plan to provide services and you feel that your name was omitted from the Qualified Providers List in error, please contact the plan directly. Plan contact information for providers can be found at the link below.

Health Plan Contacts for Providers [ 83.6 kB ]

For additional information on types of Pediatricians and Obstetricians excluded from the MMA Physician incentive program, please click the link below.

Excluded Providers

MPIP Year 1: Included Services and Enhanced Payments

Pediatricians and Obstetricians/Gynecologists

Included services are services for which a qualified provider will receive a MPIP enhanced rate payment. Included services are as follows:

• Primary care services provided to recipients under the age of 21 by a qualified pediatricians.
• Obstetric and gynecological services provided by qualified OB/GYNs.

For a complete list of included services, please click the link below. The list includes the Medicare rate associated with each code, and, for codes for which there is no Medicare rate, the enhanced rate to be paid to qualified providers.

MPIP Included Services [ 29.1 kB ]

For Community Care Plan (CCP), the included services are slightly different. A complete list of CCP’s MPIP included services can be found on CCP’s website at: http://ccpcares.org/providers/provider-resources.

Enhanced Payment

Payment to a qualified provider for included services will be made equivalent to the provider’s Medicare Specific Locality FFS rate that is in effect as of October 1, 2016, as established by the Agency, when a Medicare rate is available for the code associated with the included service. Payments to Qualified Providers may be made either through a capitated arrangement or on a fee-for-service arrangement, as defined by the health plan.

MPIP Year 1: Program Documents

• MMA Physician Incentive Program & Ad-hoc Request for Plan Proposals [ 896.6 kB ]
  • Attachment I: Plan MMA Physician Incentive Program Submission Form [ 130.7 kB ]
  • Attachment II: Florida Medicaid Cesarean Section Rate Calculation Specifications 2016 [ 174.1 kB ]
  • Attachment III: Agency Proposed Incentive Program Included Services [ 360.3 kB ]
  • Attachment IV: Incentive Proposal Estimated Value Template [ 246.7 kB ]