There are two Medicaid Managed Care Programs which recently have begun rolling out across the state by the Agency for Health Care Administration (AHCA). These programs will impact your services, both medical and support services, if you sign up for them.
The first program is called the Managed Medical Assistance (MMA) program – this program has to do with your medical services. The second is called the Statewide Medicaid Managed Care (SMMC) – Long Term Care Program. This has do with the actual services you receive like Personal Care, Respite, and Support Coordination just to name a few. Individuals with intellectual and developmental disabilities are considered a “voluntary” group for these programs. The Arc of Florida has written an Alert for each program. This is Alert Number 2 “SMMC”. Please visit our website: http://www.arcflorida.org for “Alert 1 – MMA”.
The State of Florida, Agency for Health Care Administration, is mandated to offer a “Managed Care” option to a number of groups of individuals including individuals with intellectual and developmental disabilities who receive services from the Agency for Persons with Disabilities (APD). Anyone served by APD is considered part of a “voluntary” group for this program as stated in Florida’s law. Voluntary means you have the option to continue your services just like you are right now – you do not have to change anything – you do not have to go into managed care.
As an individual served by the Agency for Persons with Disabilities (APD) you are either currently served on the iBudget Medicaid Waiver, or you are on a “waitlist” to receive services through the iBudget Waiver. The Medicaid Waiver was designed over 30 years ago to help support individuals with intellectual and developmental disabilities to live in Florida’s communities. The Medicaid Waiver program in Florida for people served by APD is called, “iBudget”. There are 25 services provided through the iBudget program. iBudget helps to keep people out of institutions by providing necessary services. The iBudget also allows you to pick all of your service providers including your Waiver Support Coordinator.
Your support coordinator helps you to coordinate all of your services; however, he or she cannot also provide your support services like supported employment or supported living. Your Support Coordinator can only provide support coordination to you.
The Statewide Medicaid Managed Care (SMMC) program has recently been implemented by the Agency for Health Care Administration. It is a different way to receive services. If you sign up with SMMC, you have to choose a “Plan”. These are much like insurance companies. They would manage all of your care and services. You would no longer have a support coordinator. You would have a care coordinator who works for the “Plan”. We understand that there is currently a waiting list for SMMC. To find out more about the SMMC program you can go to: http://www.flmedicaidmanagedcare.com
Some individuals may sign up for SMMC by Accident. If you feel you accidently signed up, you can call the AHCA number on the back of this Alert and tell them you want to be taken out of SMMC and want to go back on the iBudget waiver. Make certain you write down the name of the person you talk to. You can ask for assistance from your Waiver Support Coordinator to contact the SMMC program.