Medicaid managed care on final roll-in


  • July 31, 2014
  • /   News Service of Florida
  • /   government

News Service of Florida

More than three years after lawmakers approved the controversial plan, Florida's new Medicaid managed-care system will take effect Friday in the final three regions of the state, including Escambia and Santa Rosa counties.

The Agency for Health Care Administration has gradually phased in the system, which requires almost all Medicaid beneficiaries to enroll in HMOs or another type of managed care known as provider-service networks.

That phase-in process involved first enrolling beneficiaries who need long-term care and then enrolling the broader Medicaid population in 11 different regions.

The system will take effect Friday for people in the broader Medicaid population in Escambia, Santa Rosa, Okaloosa, Walton, Brevard, Orange, Osceola, Seminole, Indian River, Martin, Okeechobee, Palm Beach and St. Lucie counties.

AHCA awarded contracts to varying numbers of managed-care plans in the regions.

As an example, it awarded contracts to two standard health plans --- HealthEase of Florida Inc. and Prestige Health Choice — in the region that includes Escambia, Okaloosa, Santa Rosa and Walton counties. There are also specialized plans for beneficiaries with conditions such as HIV/AIDS.

The Republican-controlled Legislature and Gov. Rick Scott approved the statewide managed-care system in 2011, arguing that it would help control Medicaid costs and would better coordinate care for patients.

Critics, however, have long raised concerns that the system will lead to managed-care plans squeezing the amount of care provided to beneficiaries.

For more information about the programs, click here.

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