Medical Care Advisory Committee. March 20, 2018
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1 Medical Care Advisory Committee March 20, 2018
2 Procurement Update Statewide Medicaid Managed Care (SMMC) June 2017 Dec Jan Feb.-April 2018 May 2018 Invitations to Negotiate (ITN) posted Evaluation of responses Negotiations Award contracts (tentative) June-Sept Fall/ Winter 2018/2019 Readiness (tentative) Recipient transition (tentative)
3 Procurement Update Prepaid Dental Health Plan (PDHP) Sept Feb.-April 2018 May 2018 Invitations to Negotiate (ITN) posted Evaluation of responses Negotiations June 2018 August 2018 Award contracts (tentative) Readiness (tentative) Fall/ Winter 2018/2019 Recipient transition (tentative)
4 Medicaid Enterprise System (MES) The Agency is in the process of implementing new system architecture, which will meet federal conditions and standards: Modularity Standard Leverage Condition Interoperability Condition Where we are now: Executed a contract with Strategic Enterprise Advisory Services (SEAS) vendor The Agency has been provided with a draft strategic plan Beginning procurement for the System Integrator and Enterprise Service Bus 4
5 Waiver Consolidation Effective January 1, 2018: Project AIDS Care (PAC) Waiver recipients who meet nursing facility level of care requirements and continue to need long-term care (LTC) services transitioned into the LTC program Recipients of the Traumatic Brain Injury/Spinal Cord Injury and Adult Cystic Fibrosis Waivers transitioned into the LTC program Commitment to Continuity of Care Recipients will experience no break in services or care coordination while transitioning from one service delivery system to another, one health plan to another, or from one service provider to another. 5
6 Legislative Session 2018: Nursing Homes Nursing Home Prospective Payment System (Effective Oct. 1, 2018): $9.7 million Funding provided for transition payments related to the implementation of the NPPS. $128.5 million Funding was provided to fund nursing home rate enhancements by increasing the quality incentive pool and increased direct care reimbursement. The Agency must apply a transition methodology to nursing home rates and place a cap on the rate changes to ensure that any losses are mitigated to the extent possible with the transition funding provided. Nursing Home Supplemental Quality Incentive Payments: Unexpended funding in Specific Appropriations 217 and 218 of Chapter , Laws of Florida is appropriated to the Agency for Supplemental Quality Incentive payments to nursing homes that meet certain quality requirements. 6
7 Legislative Session 2018: Other Elimination of Retroactive Eligibility: Working People with Disabilities (Buy-In Program): Seek federal approval to allow elimination of retroactive eligibility period for non-pregnant adults. This results in a total reduction of $98.4 million. Investigate program called Working People with Disabilities, for adults who receive services under Florida s Medicaid waiver programs. Submit a report by November 1, 2018, to the Governor, House, and Senate that includes the estimated cost and the status of the SPA/Waiver. Implementation of the program is subject to Legislative approval. Preadmission Screening and Resident Review (PASRR) Program: Florida Medical Schools Quality Network (FMSQN): Received $1.5 million to implement, operate, and coordinate all aspects of the PASRR program. Received $1 million to contract with the Florida Medical Schools Quality Network to develop quality metrics for medical school faculty practices. 7
8 Legislative Session 2018: Rate Changes $3.4 million for a rate increase for Neonatal Intensive Care Units and Pediatric Intensive Care Units. $5.2 million for a rate increase for Prescribed Pediatric Extended Care Center (PPEC) services. $1.3 million for a rate increase for delivery epidural services. $14.9 million to increase the personal needs allowance for nursing facility residents from $105 to $130 per month. $11.5 million for a rate increase to the Intermediate Care Facilities for Developmentally Disabled. 8
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