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September 6, 2018

IMPROVEMENTS TO THE RECIPIENT AND PROVIDER EXPERIENCE IN THE NEW SMMC CONTRACTS

Medicaid New SMMC Five-Year Contract Begins January 1, 2019

The Agency for Health Care Administration (AHCA) is providing updates on their website in preparation of the upcoming shift to the Statewide Medicaid Managed Care (SMMC) program new contract period. A recent update explains the improvements to the recipient and provider experience within this new SMMC contract. These improvements include benefit design for the recipients and increased enhancements for the provider.

Examples of these improvements provided by the Agency are as follows:

Improvements to the transportation benefit and less administrative burden for providers related to credentialing timelines appear to be the most relevant to long-term care providers.

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

 


AHCA Upcoming Webinar: SMMC Program Overview

The Agency will host a public webinar explaining updates of the new SMMC program on September 12, 2018. This webinar will include descriptions of the benefits offered under this program. With the new contracts, recipients enrolled with the SMMC health plans and providers within the health plan networks will experience new improved program enhancements. 

To accommodate as many people as possible on the webinar, AHCA has requested that organizations consolidate participation. For those interested in attending, please register using this link.


SMMC Program Roll-out: Recipient Letters Mail Out Approximately 45 days Prior to Regional Roll-out

The Agency transitions to the new contracts with a regional phased roll-out. Recipients will receive letters confirming their assigned health plan 45 days prior to the region roll-out. Below is a chart showing the roll-out over three months and the approximate mailings for recipients.

Please inform the family members or applicable guardian to watch for these letters. Information will be provided within the letter explaining how to hange the assigned enrollment if the recipient is interested in changing their assigned health plan.


RIPPED FROM THE HEADLINES

Telemedicine Headed for Boom with CHRONIC Care Act. Medicare is about to loosen its purse strings on telemedicine. Starting in 2020, Medicare will be allowed to pay providers for more telemedicine services for Medicare Advantage enrollees who have chronic medical conditions. About a third of all Medicare beneficiaries, or 19 million people, are in these managed care plans. Read more...

Health plan updates

Prepare Now for Portal Closure. On October 3, 2018, Humana is retiring its secure medical provider portal. To continue or begin working with Humana online, prepare now by registering for the Availity Provider Portal and participate in training at no cost. Read more...

Amerigroup Florida and Better Health will continue as Simply Healthcare Plans, Inc., in the new SMMC MMA and LTC programs. Amerigroup FL and Better Health merged into Simply Healthcare Plans in October 2017. Amendments will be added to current Amerigroup, Better Health and Simply contracts to add new lines of business and update status to participating under Simply Healthcare Plans, Inc. 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. 

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