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There are three different programs that makeup the Statewide Medicaid Managed Care. Managed Medical Assistance (MMA) Program, Long-term Care (LTC) Program, and Dental Program. Learn about Health and Dental Plans available in our area. Compare different benefits and providers offered by the plans.
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.
Medicaid managed care provides for the delivery of Medicaid health benefits and additional services through contracted arrangements between state Medicaid agencies and managed care organizations (MCOs) that accept a set per member per month (capitation) payment for these services.
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In Florida, the Agency for Health Care Administration (Agency) is responsible for Medicaid. The Agency successfully completed the implementation of the Statewide Medicaid Managed Care (SMMC) program in 2014. Under the SMMC program, most Medicaid recipients are enrolled in a health plan.
In Florida, most Medicaid recipients are enrolled in the Statewide Medicaid Managed Care program. The program has three parts: Managed Medical Assistance, Long-Term Care, and Dental. People on Medicaid will get services using one or more of these plan types:
More than two-thirds of all Medicaid beneficiaries nationally receive most or all of their care from risk-based managed care organizations (MCOs) that contract with state Medicaid programs...
The Agency for Health Care Administration (AHCA) administers the Statewide Medicaid Managed Care (SMMC) Long-Term Care program, sets coverage policy, and gets those eligible for services enrolled in a LTC plan.
The two main delivery system models are fee-for-service, where the Medicaid agency directly pays providers or groups of providers, and capitated managed care, where the Medicaid agency pays an external managed care organization, who then pays providers for covered services.
CCP has managed the Medicaid benefits for Florida Medicaid beneficiaries since 2000 and is currently a managed care plan with a Florida Medicaid contract in Broward County. The new SMMC contract will expand CCP’s Medicaid geographic footprint from one to 19 Florida counties and CCP anticipates its membership will more than double.