Request for Letter of Intent from Potential Medicaid Reform Providers

During the 2005 Special Session, the Legislature passed HB3B authorizing implementation of Medicaid Reform.  The target implementation date is July 2006 in Duval and Broward Counties.  The Agency has received requests for information from providers about plan and provider group participation in Medicaid Reform in these areas.  The Agency may contract with HMOs, Provider Service Networks (PSN), and other licensed insurers. Attachment I, posted on the Medicaid Reform website, http://ahca.myflorida.com/Medicaid/medicaid_reform/index.shtml, provides a draft list of the services for which the plan will be responsible.  HMOs and licensed insurers will be reimbursed on a capitated basis.  PSNs may be reimbursed on a capitated or fee-for-services basis with a shared saving option for up to three (3) years.  Many current Medicaid providers have expressed interest in participating in Reform.

In Duval and Broward, the Agency will issue an application for plans to serve the TANF or SSI (non-dually eligible) population or both.  In addition, the Agency will seek to contract with specialty plans for individuals with HIV/AIDS and children with chronic conditions.  As required under s. 409.91188 F.S., any capitated plan to serve individuals with HIV/AIDS must be a licensed HMO.  The plan to serve children with chronic conditions may be a HMO, PSN or Health Insurer.

To help all parties interested in Reform, the Agency is asking those organizations or provider groups interested in establishing a new Medicaid Reform plan to submit a letter of intent.  This letter is non-binding.  It should specify the name of your organization, the type of plan (HMO, PSN, Health Insurer), target population (TANF, SSI-non-dually eligible, both, or a specialty population) and the proposed county of operation.  The resulting list of potential plans will serve as a resource for both plans and providers as organizations are formalized and provider networks are developed.  The list also will ensure your organization is included on the interested parties list and allow the Agency to efficiently target outreach and provide additional information to potential Plan and Provider groups. 

Please submit the letter of intent to Medicaid, Bureau of Health Systems Development, 2727 Mahan Drive, Mail Stop #20, Tallahassee, FL  32308.  We would like to publish a list of potential plans by February 15, 2006.  This non-binding letter of intent is informative only. Plans may apply to participate in reform areas whether they submit a letter of intent or not.

Should you have any questions or concerns please contact Heidi Fox at (850) 487-2355.