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Medicaid is a medical assistance program that provides access to health care for low-income families and individuals. Medicaid also assists the elderly and people with disabilities with the costs of nursing facility care and other medical and long-term care expenses. In Florida, the Agency for Health Care Administration (Agency) is responsible ...
As champions of this mission, we are responsible for the administration of the Florida Medicaid program, licensure and regulation of Florida's health facilities and for providing information to Floridians about the quality of care they receive.
General Policies - Rules that are universally applicable to the Florida Medicaid program. Service-Specific Policies - Rules for individual Florida Medicaid covered services and waiver programs. Other Policies - Rules pertaining to other aspects of the Florida Medicaid program.
Information about Medicaid eligibility criteria for the aged, blind and disabled, and children and family programs can be obtained from the Department of Children and Families (DCF) Web site or the DCF region / circuit office closest to you.
Most Florida Medicaid recipients are enrolled in the SMMC Program. The SMMC program has three components, the Long-Term Care (LTC) program, the Managed Medical Assistance (MMA) program, and the Dental Program.
The Bureau of Recipient and Provider Assistance is responsible for the development, coordination and oversight of recipient facing operations performed by Florida Medicaid.
Performance Measure Data Submissions for Medicaid. The Agency monitors the Medicaid health plans’ performance through a combination of HEDIS, Adult and Child Core Set, and Agency-defined performance measures. These can be used to compare the performance of Medicaid health plans.
Florida Medicaid’s Covered Services and HCBS Waivers. The list below provides direct links to a general overview for each of the covered services. For specific policy and limits information, please see the Medicaid coverage policies and fee schedules by visiting the Agency Website
Provider Enrollment is responsible for enrolling qualified providers to receive Medicaid reimbursement for services rendered to Medicaid Fee-For-Service recipients. Florida Medicaid's Web Portal solution provides communication and self-service tools to the provider community.
Find your Complaint Status here. If you need help submitting a complaint, you can call our Medicaid Helpline at 1-877-254-1055 (TDD 1-866-467-4970). Staff are available to help you Monday through Friday, 8:00am to 5:00pm EST. Medicaid Helpline staff can also help you check on the status of a complaint submission.