Providers offer state insight on improving Medicaid managed care program

TALLAHASSEE, FLA. 11/30/21-Tom Wallace, Medicaid director for the Florida Agency for Health Care Administration, speaks during the House Health Care Appropriations Subcommittee, Tuesday at the Capitol in Tallahassee. COLIN HACKLEY PHOTO

The state Agency for Health Care Administration said it wanted to hear from providers about ways the state could improve its mandatory Medicaid managed care program.

And the providers obliged.

More than 50 entities — ranging from managed care plans to statewide medical associations to a national health care accrediting organization — want to provide the state with insight on the upcoming Medicaid managed care procurement.

AHCA received 54 responses to the Request for Information it posted in May. Insurance companies and managed care providers that responded include Aetna; AmeriHealth Caritas Florida, Inc; Chrysalis Health; Community Care Plan; Community Health Choices; Humana Medical Plan, Inc.; MCNA Insurance Company; Molina Healthcare of Florida, Inc; Simply Healthcare Plans, Inc and Sunshine State Health Plan.

The Florida Hospice & Palliative Care, Florida Hospital, Florida Medical, Florida Pharmacy, and Florida Behavioral Health associations also submitted electronic responses to the agency’s request. So did the Florida Associations of Community Health Centers, Health Plans and Managing Entities.

While those groups advocate for health care providers, the state also heard from Florida Health Justice Project and the Florida Policy Institute, which focus their efforts on beneficiaries.

NCQA also submitted a response to the RFI. Launched in the 1990s with a focus on managed care plans, NCQA now also studies medical providers and practices and how well they provide scientifically recommended care.

Existing Medicaid managed care contracts are set to expire on Dec. 31, 2023.  The contracts are the largest in the state, worth tens of billions to providers submitting winning proposals.

To have the massive program rebid and new contracts in place by Jan. 1, 2024, the state will begin the lengthy re-procurement process before the end of the year, possibly as early as October.

To help prepare, the state issued a five-page Request for Information asking those with experience in the Medicaid managed health care and Medicaid managed long-term care industries to provide the state with innovative ideas and best practices to improve Medicaid for patients who receive care and providers who render services.