Having trouble reading this newsletter? Click HERE to view it in your browser.

December 14, 2018

THE SMMC NEWLY COVERED SERVICES AND AGENCY PROVIDED PROGRAM SNAPSHOT

SMMC New Contract Period Started December 1, 2018 for Regions 9, 10, 11


Based on feedback from the health plans and providers, it appears the rollout has progressed relatively smoothly. Please ensure the eligibility of all residents with Medicaid LTC coverage is checked and were assigned as expected. Including those who were previously assigned to health plans continuing to do business in the region.
Below is a breakdown of the health plan Medicaid LTC membership for regions 9, 10 and 11:



According to the SMMC Newly Covered Services provided by the Agency on December 10, 2018. There are multiple newly covered services now covered under the new SMMC contract. Under the new SMMC contract, the Agency has focused on fully integrated health care. As such, health plans will be responsible for covering services previously paid for through the fee-for-service program. These services include:
• Early Intervention Services
• Medical Foster Care
• Nursing Facility Services
• Child Health Services Targeted Case Management

Continuity of Care does apply with the transition of these newly covered services. The Agency has instituted the following COC provisions:

The Agency is providing updates to the SMMC program regularly that are being relayed onto you as available. One of these updates, is the newly updated Snapshot of the Florida Statewide Medicaid Managed Care Program that includes details of the program in a quick reference format.

Further detail on Member Portal can be found here.

If you have questions, please contact Dana McHugh via email or by calling her at (850) 339-2909.


RIPPED FROM THE HEADLINES

Medicare Cuts Payments to Nursing Homes Whose Patients Keep Ending Up In Hospital - The federal government has taken a new step to reduce avoidable hospital readmissions of nursing home patients by lowering a year’s worth of payments to nearly 11,000 nursing homes. It gave bonuses to nearly 4,000 others. Read more...

Health plan updates

CVS Health has Completed its Acquisition of Aetna. The combination of CVS Health and Aetna is a transformative moment for our company and our industry. Read more...

Florida Community Care Provider Handbook.  Florida Community Care is a new LTC+ health plan in Florida. Their website address is www.fcchealthplan.com and their provider handbook can be found here. Read more...

Copyright 2018 — Publication of FAHA H&S
Chair: Brian Robare
President/CEO: Steve Bahmer
Principal/Editor: Dana McHugh

Copyright Information: Copies of the articles and other information in this publication may be non-commercially reproduced for the purpose of educational or scientific advancement. Otherwise, no part of this publication may be reproduced or utilized in any form, or by any means, mechanical or electronic, including photocopying, microfilm and recording, or by any information storage and retrieval system, without the written permission of the managing editor. For permission to reproduce, contact the principal/editor via email or phone at (850) 999-6034. 

The information provided via this newsletter is provided “as is” without representations or warranties, express or implied. LeadingAge Florida makes no representations or warranties in relation to the legal information on this website.