As part of the Agency for Health Care Administration’s (Agency) quality initiatives, the Agency requested that each Medicaid health plan develop provider resource guides with direct service lines, escalation contacts, and after-hours instructions covering a wide range of service areas. The following service areas can be found in each plan’s resource guide: 

• Behavioral Health 
• Case Management 
• Community Resources 
• Perinatal Care 
• Pharmacy 
• Subcontracted Services 
• Transportation  
• Utilization Management 

The Agency’s goals with this initiative are to improve communication and coordination between plans and providers, and more specifically: to reduce readmissions by improving communication among health plans and providers; to improve members’ access to timely and appropriate services post-discharge; and to streamline the coordination of behavioral health services for members, especially those with substance use disorder (SUD) and opioid use disorder (OUD). 

Each plan’s resource guide has been posted publicly on their respective websites, but may be easily accessed from the Florida Medicaid Health Plan Resources page on the Agency’s website. The Agency encourages providers to explore the resource guides for the health plans with which they contract and to utilize them to coordinate services for members they serve. 

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

The Agency for Health Care Administration (Agency) is in the process of updating the 2022 fee schedules, which includes updates to procedure codes and reimbursement rates for services provided in the fee-for-service Medicaid delivery system. The Agency’s fee schedule drafts are available on the Agency’s website here.  

Prior to initiating the rule making process, the Agency is requesting feedback from providers regarding inconsistencies or discrepancies that may be present in the draft fee schedules. Feedback may be provided through this survey link. The link will be active until 5:00pm EST on February 7, 2021. 

The purpose of this exercise is to identify any errors in the fee schedules. It is not an opportunity to request increases in the reimbursement rates, unless there is a valid concern that an error occurred in developing this year’s rates.

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

Effective January 1, 2022, the UnitedHealthcare of Florida, Inc., and UnitedHealthcare Insurance Company Dual-Eligible Special Needs Plans (D-SNP) changed their names to Care Improvement Plus South-Central Insurance Company d/b/a UnitedHealthcare Dual Complete. All member benefits, provider networks, and plan telephone numbers remain the same. United Healthcare continues to be responsible for the services provided to members of United Healthcare Dual Complete Plan including Medicare and Medicaid services. The website will remain www.UHCCommunityPlan.com  

Contact numbers: Member and Provider Services: 1-844-560-4944  

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

The Department of Health has issued a Notice of Meeting/Workshop Hearing. The Board of Pharmacy will conduct a workgroup meeting to discuss white bagging and brown bagging pharmacy practices, February 9, 2022, 1:00 p.m. ET at the DoubleTree by Hilton Hotel Deerfield Beach – Boca Raton, 100 Fairway Dr., Deerfield Beach, FL 33441.

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

Rule 64B16-28.108 related to labeling of Medicinal Drugs by pharmacy permits has been revised by the Board of Pharmacy and became effective November 28, 2021.  The revision is primarily for Institutional Class II, Modified Class II Type B, or Class III permits that are labeling patient specific medications.

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

Governor Ron DeSantis joined by Florida Speaker Chris Sprowls and Senate President Wilton Simpson to sign legislation that will protect Floridians from losing their jobs due to COVID-19 vaccine mandates and protect parents’ rights to make healthcare decisions for students. The bills were passed through a Special Session of the Florida Legislature and are effective upon the Governor’s signature. The legislation signed today is the strongest anti-mandate action taken by any state in the nation. Read about the legislation HERE.

Also in Florida, Agency for Health Care Administration Secretary Simone Marstiller issued the following statement in support of Florida’s challenge against the Biden Administration’s Centers for Medicare and Medicaid Services (CMS) rule mandating that health care workers receive the COVID-19 vaccine:

“The recent CMS rule issued by Biden Administration will not only damage our stretched health care industry but impact our most vulnerable and their ability to receive the health care they need,” said Secretary Simone Marstiller. “Tying Medicare and Medicaid funding to a vaccination mandate – funding that pays for medical care for elderly, disabled, and low-income individuals – is a blatant overreach of power that must be challenged. Thanks to the leadership of Governor DeSantis and Attorney General Moody, Florida is doing just that, to protect Florida jobs, ensure access to care, and empower individuals in making personal health care decisions for themselves and their families.”

Finally in Florida, the Florida HIE will be hosting a webinar on Tuesday, December 7^th at 12:00pm EST. Learn about how the Encounter Notification Service (ENS) provides benefits to providers and patients across Florida. You may register here.

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

The Florida Board of Pharmacy proposed to amend regulations under FAC 64B16-30 to clarify the disciplinary guidelines, the range of penalties, and the list of aggravating and mitigating circumstances. Comment Due Date: 10-25-2021.

Also in Florida, the Florida Board of Pharmacy proposed to amend regulations under FAC 64B16-26 to update incorporated forms for licensure and immunization administration. Comment Due Date: 10-25-2021.

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

The Agency for Health Care Administration (Agency) announced a CME learning opportunity free of cost for eligible providers. The Agency aims to reduce the impact of substance use disorders in Florida by increasing the capacity of health care providers to screen, briefly intervene, and refer to treatment (SBIRT) individuals with substance use disorder. In this online CME program, providers will learn how to use SBIRT in their daily practices. This learning event particularly emphasizes SBIRT practice tips in the evaluation and management of pregnant women. The CME is available to providers online from the University of Florida at the following link.

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

Reminder, Effective October 1, 2021, fee-for-service pharmacy claims must identify prescribers by their National Provider Identifier (NPI) and the prescribers must be actively enrolled with Florida Medicaid or the claims will be denied at the point of sale. Prescribers must be enrolled with Florida Medicaid in accordance with Title 42, Code of Federal Regulations, Section 455.410(b). For more information related to the Florida Medicaid NCPDP D.0 Payer Specifications, please reference the D.0. Specs (Updated 07/07/2021) available on the Pharmacy Information page of the Web Portal.

Also in Florida, as part of Constitutional Amendment No. 2 passed by voters in the 2020 election, Florida’s minimum wage is set for a notable increase. Effective September 30, 2021 the state minimum wage will increase from $8.65 per hour to $10.00 per hour (a 13.5% increase). In accordance with the amendment, the minimum wage is set for annual increases on the path to a $15 minimum wage by September 30, 2026. The requirement applies to both public and private employers, regardless of size. In addition to increasing pay, Florida employers also face posting obligations to reflect the new amounts, posters that comply with the posting requirement can be found here.

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