Medicaid Managed Care Program (MMA) – 6 diagnosis not required to enroll in MMA
In 2011 when the Legislature passed the bill on Medicaid reform, the bill included that children with the 6 diagnosis that the Agency for Persons with Disabilities (APD) serves through their waiver (autism, cerebral palsy, Down’s syndrome, spina bifida, intellectual disabilities and Prader-Willi syndrome) were not required to enroll in Medicaid Managed Care program (MMA)
Individuals on the Developmental Disabilities (iBudget) waiver and on the developmental disabilities waiver waitlist (if enrolled in Medicaid) are not required to enroll in an MMA plan. However, waiver enrollees can choose to enroll in an MMA plan when the program begins in their region in 2014. Enrollment in an MMA plan will not affect the recipient’s waiver services. These individuals will receive their letters approximately 60 days before Medicaid Managed Assistance is implemented in each region. If the recipient chooses not to enroll in an MMA plan, he/she will continue to receive their medical services on a fee-for-service basis. Once the MMA Program is implemented in a Region, the MediPass program will be discontinued.
Eligibility for the waiver begins at age 3. Children under the age of 3 who are not on the iBudget waiver or the waitlist (if enrolled in Medicaid) and who are not an excluded or voluntary population under MMA will have to enroll in an MMA plan.
I encourage members to review the PowerPoint training materials that the Agency has published regarding this topic at: http://ahca.myflorida.com/Medicaid/statewide_mc/pdf/mma/Developmental_Disabilities_Waiver_Services_2014-01-21.pdf
Also, there are some FAQs on this topic that can be reviewed at: http://ahca.myflorida.com/Medicaid/statewide_mc/faqs.shtml