Due to a delay in verifying the Medicaid weekly funding, provider payments will not be available until November 17. Please note that the “Payment Issue Date” on the remittance advice and all other generated information will remain the same. If you need assistance or have questions about provider payments, please contact the Provider Services Contact Center at 1-800-289-7799, option 7. This is a one-time delay with the regular weekly Thursday payment schedule. Due to the holiday falling on the regular weekly Thursday schedule, payment will be made on November 22.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Eleven entities have responded to the statewide Medicaid Managed care invitation to negotiate, including all of the health plans that currently participate in the program. Two of the respondents, ImagineCare and Sentara Care Alliance, do not currently participate in the program. The Agency of Health Care Administration is soliciting comments from providers who have experience with the 11 respondents. The comments are a component of the Invitation to negotiate and are considered when the state decides which entities to award contracts. Providers have until 5:00 pm on November 9 to electronically submit their comments to the state. The agency will only consider comments submitted by providers in the same region as the plan. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Agency for Health Care Administration (Agency) announces that it is soliciting comments from providers which it will consider as part of the re-procurement of the Statewide Medicaid Managed Care (SMMC) program. (See Section 409.966(3)(a)(8), F.S.)  

The Invitations to Negotiate (ITNs) and information about the re-procurement, including anticipated timelines and instructions for submission of provider comments, can be found on the Department of Management Services’ Vendor Bid System at: MyFloridaMarket Place Vendor Information Portal.  

Key dates to note are: 

October 27, 2023: Anticipated Posting of ITN (invitation to negotiate) Respondent Names for Provider Comment 

November 9, 2023: Deadline for Receipt of Provider Comments, due by 5:00 PM 

The reference number for the SMMC program ITN is AHCA (Agency for Health Care Administration) ITN 010-22/23.  

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Gov. Ron DeSantis (R) and members of the Florida Cabinet approved rules to implement several provisions of the Prescription Drug Reform Act (SB 1550). The rules increase accountability among pharmaceutical middlemen known as pharmacy benefit managers (PBMs). As signed by the Governor earlier this year, SB 1550 institutes the most comprehensive reforms to Florida’s prescription drug market in state history. Additional information on the bill can be found here.

Also in Florida, the Agency for Health Care Administration (Agency), along with its fiscal agent, Gainwell Technologies, is introducing enhancements implemented as part of the new NPI initiative. A new Taxonomy Master List (TML) Tip Sheet, an updated Provider Master List (PML) Tip Sheet and an updated Pending Provider List (PPL) Tip Sheet is now available. The updated PML and PPL test examples are now available. The release of the updated PML and PPL changes will occur on October 26, 2023. After the release, a copy of the former version of the PML and PPL will remain archived on the Registration page of the Managed Care section of the Florida Medicaid Public Web Portal for reference. The release of the updated TML changes occurred on September 28, 2023. The release will replace the current version of the TML on the Florida Medicaid Public Web Portal. To access a copy of the new TML Tip Sheet and the updated PML and PPL Tip Sheets, please visit the Florida Medicaid Public Web Portal at mymedicaid-florida.com, navigate to the Agency Initiatives tab, and select NPI Initiative.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Gov. Ron DeSantis (R) and members of the Florida Cabinet approved rules to implement several provisions of the Prescription Drug Reform Act (SB 1550). The rules increase accountability among pharmaceutical middlemen known as pharmacy benefit managers (PBMs). As signed by the Governor earlier this year, SB 1550 institutes the most comprehensive reforms to Florida’s prescription drug market in state history. Additional information on the bill can be found here. 

Also in Florida, the Agency for Health Care Administration (Agency), along with its fiscal agent, Gainwell Technologies, is introducing enhancements implemented as part of the new NPI initiative. A new Taxonomy Master List (TML) Tip Sheet, an updated Provider Master List (PML) Tip Sheet and an updated Pending Provider List (PPL) Tip Sheet is now available. The updated PML and PPL test examples are now available. The release of the updated PML and PPL changes will occur on October 26, 2023.  After the release, a copy of the former version of the PML and PPL will remain archived on the Registration page of the Managed Care section of the Florida Medicaid Public Web Portal for reference. The release of the updated TML changes will occur on September 28, 2023.  The release will replace the current version of the TML on the Florida Medicaid Public Web Portal. To access a copy of the new TML Tip Sheet and the updated PML and PPL Tip Sheets, please visit the Florida Medicaid Public Web Portal at mymedicaid-florida.com, navigate to the Agency Initiatives tab, and select NPI Initiative. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Gov. Ron DeSantis (R) signed Executive Order 23-171, declaring a state of emergency in preparation for Tropical Storm/Hurricane Idalia. The Agency for Health Care Administration (AHCA) has contacted the Medicaid Managed Care Plans, to ensure they are making the necessary preparations pre- and post-storm, including allowing for early prescription refills. Fee-for-service recipients are also eligible for early refills. The Department of Health has also issued Emergency Order 23-002, which allows for mobile pharmacies and an extension of the PDMP (Prescription Drug Monitoring Program) reporting requirements. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Gov. Ron DeSantis (R) signed Executive Order 23-171, declaring a state of emergency in preparation for Tropical Storm/Hurricane Idalia. The Agency for Health Care Administration (AHCA) has contacted the Medicaid Managed Care Plans, to ensure they are making the necessary preparations pre– and post–storm, including allowing for early prescription refills. Fee-for-service recipients are also eligible for early refills. The Department of Health has also issued Emergency Order 23-002, which allows for mobile pharmacies and an extension of the PDMP (Prescription Drug Monitoring Program) reporting requirements. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Consumers can purchase qualifying disaster preparedness supplies exempt from tax during the two 2023 Disaster Preparedness Sales Tax Holidays, May 27- June 9, 2023, and August 26-September 8, 2023.

Also in Florida, the Board of Pharmacy is developing amendments to Rule 64B16-27.650 regarding additional immunizations or vaccines which may be administered.

Finally in Florida, the Board of Pharmacy proposes amending Rule 64B16-28.108 regarding dispensing medication to a blind or visually impaired patient. More information can be found here.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

On May 3, Gov. Ron DeSantis (R) signed into law Senate Bill 1550. Effective July 1, 2023, The Prescription Drug Reform Act codifies the Governor’s actions from last year to require accountability among pharmaceutical middlemen, empower consumers through increased choice among pharmacies and create transparency in prescription drug price increases. More information from the Governor’s office can be found here. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.