Florida Agency for Health Care Administration Medicaid Managed Care Guidance Statement: Documentation Accepted for Plan Provider Networks

The Florida Agency for Health Care Administration issued the following Guidance Statement on June 21, 2012:

Pursuant to section 409.966 (3)(a)7., F.S., the Florida Agency for Health Care Administration, as part of its evaluation of vendors responding to the Long-Term Care Managed Care Invitation to Negotiate, shall consider evidence that the eligible plan has written agreements or signed contracts or has made substantial progress in establishing relationships with providers before the eligible plan submits a response.

If signed contracts have not yet been secured between the eligible plan and network providers, the Agency will accept signed letters of agreement and signed letters of intent showing that providers are willing to contract with the plan should it win a bid. Once Long-Term Care Managed Care contracts are awarded by the Agency, and prior to the Agency’s approval for the eligible plan’s operation in a specific region, all signed contracts must be in place between the eligible plan and its network providers.
Letters of intent must include, at a minimum, the following elements:

• Name of network provider;
• Network provider’s National Provider Identification (NPI) number and license number, if applicable;
• Tax identification (ID) number;
• Provider type;
• List of services to be provided;
• Service area (county and region) to be covered; and
• Provider signature and date of signature.

For more information about the Statewide Medicaid Managed Care program, visit http://ahca.myflorida.com/Medicaid/statewide_mc/index.shtml