Florida Is Looking For Managed Care Providers For Billions Of Dollars In Contracts

Florida is taking substantial steps forward with a sequence of contracts that will shape the future of our $38 billion Medicaid program, which serves millions of low-income or disabled residents. Florida Agency for Health Care Administration (AHCA) recently shared an invitation to negotiate (ITN) that highlights the delivery of behavioral health services. The agency aims to award contracts to "nationally accredited plans that offer an enhanced delivery system and integration of behavioral and physical health services."

The ITN also presents "plus plans," intended to allow family members to receive services from a single Medicaid managed care plan that covers Managed Medical Assistance (MMA), Long Term Care (LTC), and specialty plans. This approach aims to advance the continuity of coverage for families and people, removing the need to change plans to access specialty services or split families among various plans.

The Existing Managed Care Contracts

The current managed care contracts in Florida are set to expire at the end of 2023, and the determined timeline charted in the ITN aims to confirm new contracts before the end of December 2023. Managed care plans are obligated to submit their bids by August 15, with discussions expected to occur from October 2 to November 17. AHCA hopes to grant the six-year contracts, worth billions of dollars, on December 11.

Notably, the ITN could lead to substantial changes for Medicaid managed care plans and their participants, as plans not selected may be effectively locked out of the program for six years unless they join with another health plan.

This marks the third time Florida has competitively bid on its Medicaid Managed Care program, and AHCA is utilizing past experience to inform the networks it intends to contract with. The ITN requires plans to submit proposals for various services, such as comprehensive long-term care plans, MMA plans, and specialty services.

Other Changes Are Underway

Aside from the ITN modifications, other changes are underway for Florida's Medicaid managed care program. A 2022 law lowered the number of Medicaid regions from 11 to nine and allowed contracts to be awarded on either a statewide or regional basis. Although, AHCA must still sign contracts with at least one provider service network (PSN) in each region.

The objectives of the overhauled program include guaranteeing timely access to medically necessary services, offering families the freedom to choose appropriate managed care plans, supporting healthy behaviors and chronic disease management, providing openings for self-sufficiency, and enabling seniors to age in their preferred location. The ITN aims to achieve high-quality outcomes while encompassing costs and delivering enhanced health services to Florida's Medicaid enrollees.