AHCA awards Medicaid managed care program contracts

By Jarrod Fowler, MHA, FMA Director of Healthcare Policy and Innovation

What’s happening: The Agency for Health Care Administration (AHCA), which regulates state Medicaid managed health plans, has announced its intention to award contracts to five health plans operating across the state.

Why it matters: State health plan contracts are awarded and expire periodically. It is crucial that the plans selected to receive these contracts have the ability to fulfill their contractual obligations and that the state monitors these plans closely for compliance.

What the FMA is doing: The FMA monitors all changes to the Statewide Medicaid Managed Care (SMMC) Program. As a matter of policy enacted by the FMA House of Delegates, one of our key goals is to pursue legislative and regulatory changes that make Medicaid more attractive to physicians. These include increasing Medicaid payments – a goal the FMA is working toward achieving – as well as ensuring adequate networks, fair prior authorization policies, and eliminating inappropriate claim denials.

The bottom line: Clearly, more work needs to be done. As with all managed care plans, the FMA will monitor feedback from our members to help us determine if any additional actions can be taken to improve the Medicaid program or to redress issues with specific plans or claims. Members who need assistance with Medicaid-related issues or have questions about applicable laws, regulations, and policies surrounding the Medicaid program can contact us directly at membership@flmedical.org.