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Florida Statutes § 409.9122

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“Mandatory Medicaid managed care enrollment; programs and procedures under the social welfare law”

The Agency for Health Care Administration must enroll in a managed care plan or MediPass all Medicaid recipients. Medicaid recipients must receive clear and easily understandable information on:

  • The concept of managed care;
  • Information on the comparative performance of managed care plans and Medipass;
  • Recipients’ right to choose their managed care coverage; and
  • Recipients’ right to complain, file a grievance, or change managed care plans or Medipass providers.

The Agency for Health Care Administration must establish quality-of-care standards for managed care plans and MediPass.

The Agency for Health Care Administration must operate the Medicaid Encounter Data System to collect, process, store and report on covered services to all Medicaid recipients enrolled in prepaid managed care plans.

Managed care plans must submit financial and medical data to the Agency for Health Care Administration.

The Agency for Health Care Administration is responsible for releasing information on medical services provided, financial data, and plan performance to the public. However, the agency must ensure the confidentiality of personal health information.


Current as of June 2015