Medicaid Waiver Extension

Florida's Medicaid Waiver allows the state to provide services not typically covered by Medicaid, while receiving matching federal funds to support patient care. Florida has several Medicaid Waiver programs providing care to people with disabilities, seniors and others.

The extension of Florida's Section 1115 Medicaid Waiver for the five-county Medicaid Managed Care pilot was approved in December of 2011, and runs through June 30, 2014. With the help of Florida's Congressional delegation, a Medical Loss Ratio (MLR) was included in the extension, giving greater transparency and accountability for how managed care organizations spend their money. Such protections will better safeguard vulnerable beneficiary populations and the financial integrity of the program. This will ensure that any organization managing their care, whether it is a health maintenance organization (HMO) or a provider service network (PSN), is accountable to the state and federal governments, and taxpayers for the care they provide.

At the state level, during the 2011 State Legislative Session, a bill was passed to expand Medicaid managed care to all 67 Florida counties beginning in 2014. The State of Florida, in February of 2013, received conditional approval for the program expansion through a new Section 1115 Medicaid Waiver.

FHA supported the approval of the new Medicaid Waiver, and believes it is imperative to secure adequate funding for a supplemental payment program with strong safeguards, such as an MLR, in order for the program to be sustainable over the long-term. FHA also supports securing supplemental funding similar to the current $1 billion Low Income Pool (LIP) program that ensures adequate financing for the program and its beneficiaries.     

For more information, contact FHA Senior Vice President Karen Zeiler.