FLORIDA MEDICAID A Division of the Agency for Health Care Administration
Florida Medicaid Health Care Alert February 2015
Provider Type(s): 08, 23, 81, and 67
Medicaid Fee-for-Service Monitoring
Monitoring is being conducted to provide feedback to providers regarding their adherence to Medicaid requirements for recipients who are not enrolled in a Medicaid managed care plan.
The Medicaid Fee-for-Service Monitoring Unit has begun conducting monitoring reviews of service providers for the following programs:
Adult Cystic Fibrosis (ACF) Waiver
Project AIDS Care (PAC) Waiver
Traumatic Brain Injury and Spinal Cord Injury (TBI/SCI) Waiver
Early Intervention Services (EIS)
Certified School Based Services Match
Medical Foster Care (MFC)
Providers will be contacted by telephone or e-mail for notification of the date of review and will receive a letter detailing the documentation the Monitoring Unit will review. A copy of the monitoring tool, based on state and federal Medicaid policy, for the specific service will accompany the letter. After the review, a monitoring report/summary will be sent to the provider.
Medicaid Provider Agreement (5)(e) and section 409.907(3)(e), Florida Statutes, requires Medicaid providers to send, at the provider’s expense, all Medicaid-related information, which may be in the form of records, logs, documents, or computer files, and other information pertaining to services or goods billed to the Medicaid program, including access to all patient records to the Agency for Health Care Administration, Attorney General, or Federal Government entity.
Please direct questions about Medicaid policies to your local Medicaid field office. The Medicaid field offices’ addresses and phone numbers are available on the Field Offices Web page.
The Florida Medicaid program has created an e-mail alert system to supplement the present method of receiving Provider Alerts information and to alert registered subscribers of “late-breaking” health care information. An e-mail will be delivered to your mailbox when Medicaid policy clarifications or other health care information is available that is appropriate for your selected area and provider type.