Medicaid Managed Care Plan Report Guide
The Medicaid Managed Care Plan Report Guide (Report Guide) is a companion to each Managed Care Plan’s Contract with the Agency for Health Care Administration. It provides details of plan reporting requirements including instructions, location of templates, and submission directions.
Beginning February 1, 2025, this Report Guide provides report guidance and requirements for the following types of Managed Care Plans:
- Comprehensive Plus Plan
- Managed Medical Assistance (MMA) Plus Plan
- Select Comprehensive Plan (Concurrent MMA and LTC Services)
- Dental Plans
These reports are specific to the Intellectual and Developmental Disabilities (IDD) Managed Care Pilot Program
SMMC Managed Care Plan Report Guide
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Report Summary Chart
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SMMC Contract Submission Requirements Summary Chart
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SMMC Managed Care Plan Reports
- Achieved Savings Rebate (ASR) Financial Reports
- ASR Claim Lags Template
- ASR Dental Claim Lags Template
- ASR Dental Financial Report
- ASR Financial Report
- Actual Value of Enhanced Payment (AVEP) Dental Provider Incentive Program (DPIP) Report
- Actual Value of Enhanced Payment (AVEP) MMA Physician Incentive Program (MPIP) Report
- Administrative Subcontractors and Affiliates Report
- Adverse and Critical Incident Summary Report
- Annual Chronic Disease Management Program Report
- Annual Fraud, Waste and Abuse Activity Report
- Annual Pharmacy Claims Reconciliation Report Template
- Appointment Wait Times Report
- Case Management File Audit Report
- Case Manager and Provider Training Report
- Case Manager Caseload Report
- Child Staffing Attendance Report
- Claims Aging
- Community Based Organization (CBO) Board Participation Report Summary
- Critical Incident Report- Individual
- Denial, Reduction, Termination or Suspension of Services Report
- Denied/Suspended/Terminated Provider Report
- Dental Provider Incentive Program (DPIP) Metrics Report
- Electronic Visit Verification Report
- Enhanced Care Coordination Report
- Enrollee Complaints, Grievances and Plan Appeals Report
- Enrollee Help Line Statistics Report
- Enrollee Roster and Facility Residence Report
- ER Visits for Enrollees without PCP/PDP Appointment Report
- Estimated Value of Enhanced Reimbursement (EVER)/Qualified Provider Dental Provider Incentive Program (DPIP) Report
- Estimated Value of Enhanced Reimbursement (EVER)/Qualified Provider MMA Physician Incentive Program (MPIP) Report
- Health Risk Assessment Report
- Healthy Behaviors Report
- Hernandez Settlement Agreement Survey
- Hernandez Settlement Ombudsman Log
- Hope Florida Reporting (Coming Soon)
- Institution for Mental Diseases (IMD) Reimbursement Report
- Inter-Rater Reliability (IRR) Report
- Managed Care Plan Training Report
- Marketing Agent Status Report
- Marketing/Public/Educational Events Report
- Medical Foster Care Services Report
- Member Satisfaction Improvement Report
- Missed Services Report
- MMA Physician Incentive Program (MPIP) Quality Measures Report
- Non-Emergency Transportation (NET) Timeliness Report
- Oral Health Risk Assessment Report
- Participant Direction Option (PDO) Roster Report
- PCP/PDP Appointment Report
- Performance Improvement Projects (PIP) Quarterly Progress Report
- Performance Measure Action Plan (Coming Soon)
- Performance Measures Report
- Plan-Specific Commitments Progress Report
- Provider Complaint Report
- Provider Network File
- Provider Network and Qualifications Report
- Quarterly Chronic Disease Management Program Report
- Quarterly Fraud and Abuse Activity Report
- Quarterly Pharmacy Claims Reconciliation Report Template
- Residential Psychiatric Treatment Report
- Service Authorization Performance Outcome Report
- Special Populations Care Coordination Report
- Supplemental HIV/AIDS Report
- Suspected/Confirmed Fraud and Abuse Reporting
- Suspected/Confirmed Recovered Fraud and Abuse Reporting
- Suspected/Confirmed Waste Reporting
- Unable to Provide Case Management Report
- Value-Based Purchasing Report (Coming Soon)
- Well Child Health Visit (CMS-416) and FL 80% Screening Report (Coming Soon)
