Medical Foster Care

Medical Foster Parents –
With so many changes throughout the state to Medical Foster Care implementation, billing and contact we wanted to help create a central place for information.  After a lot of work with Florida Coalition for Children, AHCA, Medical Foster Care and many of the insurance companies we have decided to become the hub for information on medical foster care billing, information releases and any other information necessary for this process to go smoothly.  
More meetings and discussions continue to help this process.  If you have general questions or would like to help guide the discussion please email me and we will help as best we can!
– Amanda Cruce, LCSW, PresidentFlorida FAPA

Below are the simplified Medical Foster Care billing instructions for all of the Medicaid MMA health plans:

MORE UPDATES:

From Florida Childrens Coalition:

Policy Update
We have already one significant stride with policymakers this year as it relates to medically fragile children and the families that care for them!

I want to thank FCC’s Executive Vice President and Chief Policy & Research Officer, Victoria Vangalis Zepp and FCC member, Shawn Salamida, President of FamiliesFirst Network of Lakeview for their leadership on this critical issue.

Last week they brought a group of families to Tallahassee to testify before the Senate Health Policy Committee during which lawmakers heard from the Agency for Health Care Administration (AHCA), Children’s Medical Services (CMS), Shawn Salamida, and several medically fragile children’s caregivers.

You can view their testimony here.

As a result of FCC’s advocacy, IRS filing for parents/caregivers of medically fragile children is no longer required based upon federal Difficulty of Care Act FCC provided. This is a huge win for Florida’s foster parents of medically fragile children.

This week, Victoria also facilitated a statewide call for more than 100 stakeholders serving medically fragile children along with the Florida AHCA Deputy Secretary Beth Kidder and stakeholders.

As a result of our efforts and discussions, AHCA’s leadership along with the health plans, have removed barriers and improved conditions on every issue we raised.

Hours after FCC’s call with the AHCA Secretary Mayhew and Medicaid Division Deputy Secretary Kidder and CMS, AHCA released two MFC Medicaid alerts of improved changes as a result of FCC Advocacy in Action!

Florida Medicaid Health Care Alerts From ACHA

February 08, 2019
Provider Type(s): All
 
Statewide Medicaid Managed Care: Continuity of Care Provisions
 
The Agency for Health Care Administration (Agency) contracts with Medicaid health and dental plans to provide services to health plan enrollees in the Statewide Medicaid Managed Care (SMMC) program. The Agency recently entered into new contracts with health and dental plans. As part of those contracts, the Agency achieved program changes that greatly benefit enrollees and providers.
The Agency is transitioning to the new contracts through a regional phased roll-out. Roll-out for phase three, the final phase, occured Friday, February 1, 2019.
Health and dental plans are required to ensure continuity of care (COC) during the transition period for Medicaid recipients enrolled in the SMMC program.  COC requirements ensure that when enrollees transition from one health plan to another, one service provider to another, or one service delivery system to another (i.e., fee-for-service to managed care), their services continue seamlessly throughout their transition.  The Agency has instituted the following COC provisions:
Health care providers should not cancel appointments with current patients. Health plans must honor any ongoing treatment that was authorized prior to the recipient’s enrollment into the plan for up to 60 days after the roll-out date in each region.  This includes if an enrollee has routine appointments.
Providers will be paid. Providers should continue providing any services that were previously authorized, regardless of whether the provider is participating in the plan’s network. Plans must pay for previously authorized services for up to 60 days after the roll-out date in each region, and must pay providers at the rate previously received for up to 30 days.
Providers will be paid promptly.  During the continuity of care period, plans are required to follow all timely claims payment contractual requirements.  The Agency will monitor complaints to ensure that any issues with delays in payment are resolved.
Prescriptions will be honored. Plans must allow recipients to continue to receive their prescriptions through their current provider, for up to 60 days after the roll-out date in each region, until their prescriptions can be transferred to a provider in the plan’s network.
More information about COC provisions can be referenced on the COC program highlight document and links to specific plan websites with continuity of care information, which is posted on the Agency’s website at www.ahca.myflorida.com/smmc.  Once on the page, click Program Changes, then the Outreach and Presentations link.
 
QUESTIONS? FLMedicaidManagedCare@ahca.myflorida.com
COMPLAINTS OR ISSUES? ON LINE http://ahca.myflorida.com/Medicaid/complaints/|  CALL 1-877-254-1055
 



February 13, 2019
Provider Type(s): All

Reminder: End of the Provider Enrollment Fax Line
As part of the Agency for Health Care Administration’s (Agency) work to move towards full automation, providers and Health Plans will see multiple enhancements made to the Florida Medicaid Secure Web Portal in the next few weeks.
As of February 04, 2019, the fax line (1-866-270-1497) designated for all provider enrollment-related submissions was ended.
Providers and their authorized delegates are encouraged to utilize the following enhancements available in the newly redesigned Florida Medicaid Secure Web Portal:
Complete address updates in real-time using the Change of Address Wizard.
Submit Electronic Data Interchange (EDI) agreements electronically using the EDI Agreement panel.
Submit provider file change requests using the File Upload panel to upload documents such as the National Provider Identifier (NPI) Registration form, New Service Type or Address form, specialty changes, and more.
Update Electronic Funds Transfer (EFT) bank account information using the EFT Designation Wizard.
Update group membership details in real-time using the Members of My Group and Group Membership panels.
Providers are encouraged to review the Self-Service section on the Quick Reference Guidespage of the public Web Portal often for the most up-to-date information regarding these changes. Providers may also contact the Provider Enrollment Contact Center at 1-800-289-7799, Option 4, for assistance.

QUESTIONS? FLMedicaidManagedCare@ahca.myflorida.com
COMPLAINTS OR ISSUES? ON LINE http://ahca.myflorida.com/Medicaid/complaints/|  CALL 1-877-254-1055

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