Florida Agency for Persons with Disabilities

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Update on iBudget Handbook

The Agency for Persons with Disabilities (APD) and the Agency for Health Care Administration (AHCA) have reviewed and revised the iBudget handbook over the past several weeks based on public input.

The handbook is in final rule drafting with a public workshop anticipated to be noticed for mid-August.

After the rule workshop, AHCA and APD will meet to discuss all comments received, and then will proceed promptly to move to final rule promulgation which will include a public hearing.


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FACT SHEET ALERT 2 – SMMC

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.


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FACT SHEET ALERT 1 – MMA

MANAGED MEDICAL ASSISTANCE (MMA) LETTERS RECENTLY SENT BY THE AGENCY FOR HEALTH CARE ADMINISTRATION – MEDICAID OFFICE
WHAT IT MEANS TO INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES WHO RECEIVE SERVICES THROUGH THE AGENCY FOR PERSONS WITH DISABILITIES (APD)

There are two Medicaid Managed Care Programs which may impact your services. The first is called the Managed Medical Assistance (MMA) program. The second is called the Statewide Medicaid Managed Care (SMMC). Individuals with intellectual and developmental disabilities are considered a “voluntary” group for these programs. The Arc of Florida has written an Alert for each of these. This is Alert Number 1 “MMA”.

The State of Florida has recently begun sending letters to individuals with intellectual and developmental disabilities, who are served by the Agency for Persons with Disabilities, regarding a new Medicaid Managed Medical Assistance Program. This program is also called “MMA.” Individuals with intellectual and developmental disabilities, served by the Agency for Persons with Disabilities, are considered a “voluntary” group for the MMA program. Voluntary means you have the option to continue your medical care just as you are currently receiving it – you do not have to change anything – you do not have to go into MMA, or, it also means that if you are not happy with your current medical services, you can select a MMA program.

Some of the letters sent were in error and make you believe you must enroll in the new MMA program. This is incorrect. If you enrolled in MMA because you thought you had to, but would like to go back to the way you had your medical care provided, you should call 1-877-711-3662 or you can call your local Medicaid office – they are listed on the back of this sheet. You can ask for assistance from your Waiver Support Coordinator to contact the MMA program.

Also, some individuals may automatically get put into MMA who do not want to be in that program. You DO NOT have to go into the MMA program. If this happens to you, please call 1-877-711-3662 and tell them you want to go back to the way you were receiving your Medical services through Medicaid. You can also contact your local Medicaid office – they are listed on the back of this sheet. You can ask for assistance from your Waiver Support Coordinator to contact the MMA program to let them know you do not want to be in the MMA program.

If you think you would like to try the MMA program to receive your medical services, please know that your other services, provided through the iBudget Medicaid Waiver, will stay the same. There were some rumors that if you went onto MMA you would lose your iBudget Medicaid Waiver services – this is not true. However, if you do go on the MMA program you may have to switch doctors and where you go to get some of your other medical services. If you are on the “APD Waitlist” and are Medicaid eligible, you can enroll in the MMA program. Again, please carefully review what services are offered in your county by the different companies providing MMA before you decide to switch to MMA.

If you want to learn more about what the MMA program might be able to provide to you, you will either need to call 1-877-711-3662 or you can go on-line to see what is available in the area you live in. There will be several companies, who are like insurance companies, who have a list of the medical services they will provide. Study this list carefully! You can ask for assistance from your Waiver Support Coordinator to help you understand the list and what services you can get from each company.

To study the list of services on-line you can go to: http://www.flmedicaidmanagedcare.com or call Choice Counseling at 1-877-711-3662 – this phone number is available Monday – Thursday 8 a.m. – 8 p.m. and Friday 8 a.m. – 7 p.m.