Governor Rick Scott announced on February 4 that the U.S. Department of Health and Human Services’ (HHS) Centers for Medicare and Medicaid Services (CMS) approved one of the state’s two pending Medicaid waivers late Friday. The Governor urgently requested approval of the long-term care waiver and a waiver for the Statewide Medicaid Managed Care Program when he met with HHS Sec. Kathleen Sebelius on January 7thin Washington, DC. The approved waiver, called a 1915 (b/c) waiver, allows the Agency for Health Care Administration (AHCA) to move forward with the implementation of the Statewide Medicaid Managed Care (SMMC) Long-term Care program. Governor Scott sent a letter to HHS Secretary Sebelius today, calling for the urgent approval of the state’s second pending waiver, according to Lane Wright, spokesperson for the Office of Gov. Rick Scott.
Governor Scott said, “I am appreciative that HHS approved one of our two important Medicaid waivers, and that they have done so before the February 7th deadline. The additional flexibility provided through this waiver helps improve our current system, and HHS approval allows us to begin implementing changes to our current Medicaid program," said Scott.
“The second pending waiver does not have a deadline for HHS to respond to the state’s request for approval. Given the major decisions facing the future of our Medicaid program under the president’s healthcare law, I am asking HHS to take immediate action on our second waiver request related to the Statewide Medicaid Managed Care Program," said Scott.
“We need HHS’s immediate action to determine what flexibility we will have within our current Medicaid program and its impacts on the cost, quality and access to healthcare. Our state is facing unprecedented decisions that demand unprecedented attention from federal health officials," said Scott.
AHCA Secretary Liz Dudek said, “I am thankful for Governor Scott’s leadership in helping us usher through this very important waiver approval that will allow the Agency to take the next steps toward improving Florida’s long-term care system. The Agency will continue collaborating with the Department of Elder Affairs and the many stakeholders who are so passionate about simplifying and enriching this service delivery model.”
The 1915(b) waiver allows Florida to enroll individuals in managed care plans statewide and to allow for selective contracting of those plans. The Agency has, through competitive selection, chosen the five health plans it will contract with for the Long-term Care Managed Care program, according to Wright.
The 1915(c) waiver focuses on home and community-based services and allows Florida to identify and allow qualified individuals to receive “long-term care” in their home or other community setting in lieu of a nursing home. Recipients who qualify to enroll in a long-term care plan will receive information from AHCA at least 90 days ahead of when any change will take effect, according to Wright.
The Statewide Medicaid Managed Care program was designed to: Emphasize patient centered care, personal responsibility and active patient participation; Provide for fully integrated care through alternative delivery models with access to providers and services through a uniform statewide program; and Implement innovations in reimbursement methodologies, plan quality and plan accountability, according to Wright.