MMA Physician Incentive Program (MPIP) - Year 2

October 1, 2017- September 30, 2018

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 2 of the MPIP expanded participation to include the following physician types:

• Pediatric Primary Care Physicians (including General Practitioners and Family Practitioners)
• Board Certified OB/GYNs
• Board Certified Pediatric Cardiologists
• Board Certified Pediatric Endocrinologists
• Board Certified Pediatric Nephrologists
• Board Certified Pediatric Neurologists
• Board Certified Pediatric Psychiatrists

Beginning April 1, 2018, MPIP has expanded participation to include the following physician types:

• Board Certified Adolescent Medicine Specialists
• Board Certified Maternal/Fetal Specialists
• Board Certified Pediatric Allergists
• Board Certified Pediatric Cardiovascular Surgeons
• Board Certified Pediatric Critical Care Specialists
• Board Certified Pediatric Dermatologists
• Board Certified Pediatric Gastroenterologists
• Board Certified Pediatric General Surgeons
• Board Certified Pediatric Hematologists
• Board Certified Pediatric Hospitalists
• Board Certified Pediatric Infectious Disease Specialists

• Board Certified Pediatric Internal Medicine Specialists
• Board Certified Pediatric Neurology Surgeons
• Board Certified Pediatric Oncologists
• Board Certified Pediatric Ophthalmologists
• Board Certified Pediatric Orthopedic Surgeons
• Board Certified Pediatric Otolaryngologists
• Board Certified Pediatric Physical Medicine and Rehab Specialists
• Board Certified Pediatric Plastic Surgeons
• Board Certified Pediatric Pulmonologists
• Board Certified Pediatric Rheumatologists
• Board Certified Pediatric Thoracic Surgeons

For additional information on each plan’s access and quality criteria for qualified providers in Year 2, please click the link below.

MPIP Year 2 Plan Program Summary [ 520.6 kB ]

MPIP Year 2: Qualified Providers

Below is a list of physicians by name, reported by the plans to the Agency, who meet MPIP Year 2 qualifying criteria prior to the implementation date October 1, 2017. Qualified providers will begin to receive enhanced rates for dates of service beginning on or after the implementation date October 1, 2017.

During each year of MPIP, plans are required to reassesses physician eligibility for the program six months after implementation. For MPIP Year 2, plans will be required to reassess physician eligibility for enhanced rates for dates of service beginning on or after April 1, 2018. This allows providers who become qualified after the October 1, 2017 implementation date a second opportunity to become eligible for MPIP.  The Year 2 qualified provider list, available at the link below, will be updated after each reassessment.

MPIP Year 2 Qualified Providers List: October 1, 2017 - March 31, 2018 [ 936.5 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 physicians excluded from the MMA Physician Incentive Program, please click the link below.

Excluded Providers

MPIP Year 2: Included Services and Enhanced Payments

Pediatric Primary Care Physicians and Obstetricians /Gynecologists

Included services are services for which a qualified provider will receive an enhanced payment. For a complete list of included services for pediatric primary care physicians and OB/GYNs, please click the link below.

MPIP Included Services [ 18.7 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:
https://www.ccpcares.org/providers/providers-for-mma/provider-resources/links-to-resources.

Board Certified Pediatric Specialists

Included services are all medically necessary pediatric specialist services provided to recipients under the age of 21 by qualified physicians who are adolescent medicine specialists, pediatric allergists, pediatric cardiologists, pediatric cardiovascular surgeons, pediatric critical care specialists, pediatric dermatologists, pediatric endocrinologists, pediatric gastroenterologists, pediatric general surgeons, pediatric hematologists, pediatric hospitalists, pediatric infectious disease specialists, pediatric internal medicine specialists, pediatric nephrologists, pediatric neurologists, pediatric neurology surgeons, pediatric oncologists, pediatric ophthalmologists, pediatric orthopedic surgeons, pediatric otolaryngologists, pediatric physical medicine and rehab specialists, pediatric plastic surgeons,  pediatric psychiatrists, pediatric pulmonologists, pediatric rheumatologists, and pediatric thoracic surgeons.

Enhanced Payment

Payment to a qualified provider for included services will be equivalent to the Medicare Specific Locality fee-for-service rate that is in effect as of October 1, 2017, 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.

NOTE – The enhanced rates for included services are calculated by health plans, according to Medicare rates, effective October 1, 2017.

For included service codes for which there is no equivalent Medicare rate, the following attachment provides a formula and guidance for calculating the rate:  Attachment 6: Florida Managed Medical Assistance Physician Incentive Program (MPIP) Rate Calculation Guidance [ 265.5 kB ]

The enhanced rates for the vaccine administration codes are as follows:

• Please note: MPIP Enhanced Payment Rates are separate from the Medicaid Fee-for-Service Delivery System, the table displayed below is only applicable to MPIP fee schedules.

Program Documents

• MMA Physician Incentive Program & Ad-hoc Request for 2017 MPIP Plan Proposals [ 182.9 kB ]
  • Attachment 1: 2017 MMA Physician Incentive Program (MPIP) Plan Worksheet [ 25.1 kB ]
  • Attachment 2: 2017 MMA Physician Incentive Program (MPIP) Plan Worksheet Instructions [ 290.6 kB ]
  • Attachment 3: Florida Medicaid Cesarean Section Rate Calculation Specifications 2017 [ 176.6 kB ]
  • Attachment 4: Agency Proposed Incentive Program Included Services [ 217.8 kB ]
  • Attachment 5: Estimated Value of Enhanced Reimbursement [ 42.7 kB ]
  • Attachment 6: Florida Managed Medical Assistance Physician Incentive Program (MPIP) Rate Calculation Guidance