ISSUE: Should Medicaid Providers be given proper notification in advance of changes made to the Medicaid Provider Handbook.

DISCUSSION: Chapter 409, Florida Statutes, governs the way the State handles Medicaid. It allows for the Agency for Health Care Administration to set forth the methodologies by which it will reimburse Medicaid providers. Those methodologies, which include reimbursement methods and fee schedules, are published in the Agency’s Florida Medicaid Provider General Handbook, Coverage and Limitations Handbooks, and Reimbursement Handbooks. The authority granted to the Agency to implement provider reimbursement methodologies is so broad that it has allowed for a system to develop in which the provider community has little or no input. The Agency is not required to hold public workshops on changes to the handbooks, and they may apply changes retroactively; applying retroactive changes even to reimbursement rates. Such measures create confusion and instability in the industry that cares for Medicaid recipients.

POSITION: The Florida Retail Federation supports giving Medicaid providers advance notice of changes to claims submissions and rate reductions, as well as giving providers adequate opportunity for input prior to rule changes.