Managed care plans have questions about Medicaid bid, but state won’t say what they are
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The agency will post answers to the questions by 5 p,m. May 20.

Florida health care officials have received questions from Medicaid managed care plans that may be interested in providing health care to the millions of Floridians who rely on the safety net program for their care.

But the agency isn’t immediately making those inquiries available to the public for review.

Florida requires most of its Medicaid beneficiaries to enroll in managed care plans to receive their benefits. The managed care plans are tasked with providing all Medicaid covered services, with the exception of dental care. That makes the multiyear contracts, awarded on a competitively bid basis, the most lucrative in the state, worth tens of billions to the Medicaid managed care plans that submit winning bids.

The state Agency for Health Care Administration (AHCA) released a five-page request for information (RFI) on May 6. Entities with experience in the Medicaid managed health care and Medicaid managed long-term care industries were asked to provide AHCA with some innovative ideas and best practices to improve Medicaid for the patients who receive the care as well as the providers who render the services.

The RFI asked potential vendors to provide information on 12 different areas of interest, ranging from achieving cost savings throughout the statewide Medicaid managed care program to maximizing home- and community-based placement and services through proactive aging-in-place strategies.

If plans had questions about the information they were being asked to submit or didn’t understand what the state was asking for, they were required to submit the questions in writing by 5 p.m. on May 13.

Sources confirmed questions were submitted to AHCA by the 5 p.m. deadline, but AHCA did not respond to Florida Politics’ repeated requests to obtain a copy of the questions the plans submitted.

AHCA officials pushed the Legislature in the 2022 Session to embrace changes to the state’s mandatory Medicaid managed care law. AHCA proposed the changes as a means to make the upcoming procurement administratively easier. To that end, lawmakers agreed to eliminate a requirement that the agency issue separate Medicaid bids in each Medicaid managed care region. Additionally, lawmakers agreed to reduce the number of Medicaid regions from 11 to nine.

According to the RFI, the agency will provide answers to timely submitted questions by 5 p.m. May 20. The answers will be posted to the MyFloridaMarketPlace website where the RFI was initially posted.

Christine Jordan Sexton

Tallahassee-based health care reporter who focuses on health care policy and the politics behind it. Medicaid, health insurance, workers’ compensation, and business and professional regulation are just a few of the things that keep me busy.

One comment

  • It's Complicated

    May 17, 2022 at 2:49 pm

    #1 question plans have for AHCA: “What percentage of services provided are we allowed to outright ‘stiff’ those providers for?”

Comments are closed.


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