There are three different programs that makeup the Statewide Medicaid Managed Care. Fax: (850) 644-9301, Learn what our central mission is here at The Claude Pepper Center, A comprehensive section on the work we produce, Please contact us with any inquiries or questions, © 2020 College of Social Sciences & Public Policy, The Florida State University, Mental Health and the Criminal Justice System Documentary, Home & Community Based Services (In Home Care), Retirement Security of Minority Households, COVID-19 Impact on Vulnerable Populations, Putting Hard-Earned Improvements in Nursing Homes at Risk, Transformation of the U.S. Long Term Care System: Trends and Concerns, Dallas Morning News “Pain and Profit” Briefing by The Claude Pepper Center. The Agency for Health Care Administration is responsible for administering the Statewide Medicaid Managed Care (SMMC) program. Forty states now have Medicaid Managed Care involved in their long term care systems. Create a FL Medicaid Member Portal account to view or change your plan. Statewide Medicaid Managed Care (SMMC) is the program where most Medicaid recipients receive their Medicaid services. For managed care organizations to operate within a capitated rate, there may be a disincentive to provide the full complement of needed serves. In fact, Florida has one of the longest wait lists in the country as the state has successfully ratcheted down the institutional rate in Florida from 54% in 2014 to 43% in 2019. Log in to the FL Medicaid Member Portal to change your Health or Dental Plan. The managed care takeover of states’ Medicaid funded long term care (LTC) systems has generated several recurring concerns. Managed Medical Assistance (MMA) Program, Long-term Care (LTC) Program, and Dental Program. Click here to read about the review process. The multiple evaluations conducted by states such as Florida and those funded by the Centers for Medicaid and Medicare Services (CMS), as well as the recent critique of the Research Triangle Institute’s multi-state evaluations of the dual eligible managed care programs by Community Catalyst, the Commonwealth Foundation and CMS are hindered in their assessments of cost effectiveness by the continued lack of Medicaid encounter data not reported by the managed care companies. (National Governor’s Association, March 2019). Click here to learn more about Dental Plan and Program Information. We are witnessing unprecedented rollbacks in regulations that were established to protect our nation’s Elders. The possibility that incentivized payments could reduce services was a critical underlying concern. If you are unable to change Health or Dental Plans online at this time, there are several other options available to you. Medicaid is the primary payer for long term care services with Medicare only covering brief stays in long term care hospitals and skilled nursing home facilities. Click here to manage your members, view/change your plan, and choose to go paperless! Florida now has a growing wait list of over 70,000 frail seniors in need of home and community based services. Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Taylor, … In fact, Florida has one of the longest wait lists in the country as the state has successfully ratcheted down the institutional rate in Florida from 54% in 2014 to 43% in 2019. In fact, the April 19, 2010 St. Pete Times article by Steve Nohlgren was entitled “Florida House Ignores Own Analysts Who Warn of Pushing elderly to Managed Care.” The HMO’s convinced the Florida Legislature and the Governor that they could reduce nursing home admissions and produce a 5% savings by redirecting persons to community based care. Statewide Medicaid Managed Care. Many months later the elderly receiving long term care assistance or in need of such care are among the most vulnerable in the wake of the disaster. Click here to report a Medicaid-related complaint. This limitation of encounter data on service intensity continues through to 2020.
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