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Maryland Physicians Care (MPC) Provider Relations Representatives Maryland Physicians Care

ROI Calculator for Partnerships to Address Social Determinants of Health

ROI Forecasting Calculator for Quality Initiatives

Return on Investment Calculator (R.O.I.) for College Mental Health Services and Programs

Comprehensive Medicaid Actuarial Data (FL)

Medi-Cal Managed Care Enrollment Report

Opioid Settlement Distribution: Colorado Regions

CAQH Index Benchmarks & Time Spent on Administrative Work in Healthcare

Medi-Cal Managed Care Quality Improvement Reports (CA)

Eligibility: Contract Language (Payer v Provider) and Sample to Use

Agency: Florida Agency for Health Care Administration

Market: Florida

Line of Business: Medicaid

Market: Florida

Line of Business: Medicaid

Agency: Florida Agency for Health Care Administration

Source: Medicaid Actuarial Services

Advanced financial and statistical support relating to Capitation Rates, Risk Adjustment Models, and Payment Methodologies.

Medicaid Actuarial Services

For Institutional Reimbursement rates, please click here.

Institutional Reimbursement

For Institutional Reimbursement rates, please click here.

Medicaid Actuarial Services

This post is useful for those seeking information on Medicaid actuarial services and related rates in Florida.

  • Outlines Medicaid actuarial services provided by the Bureau, including advanced financial and statistical support for Capitation Rates, Risk Adjustment Models, and Payment Methodologies.
  • Provides information on Managed Medical Assistance (MMA), Long-Term Care (LTC), and Dental Capitation Rates for various years.
  • Includes a link to a Special Needs Plan Revenue and Expense Schedule Statement Template Tool.

Unit Responsibilities include:

  • Support of Capitation Rate Development and Adjustment
  • Management of External Actuarial Service Contracts
  • Monitoring Medicaid Program Changes
  • Trend Analysis
  • Rate Impact Analysis

Medicaid Actuarial Services

This post is useful for those seeking information on Medicaid actuarial services and related rates in Florida.

  • Outlines Medicaid actuarial services provided by the Bureau, including advanced financial and statistical support for Capitation Rates, Risk Adjustment Models, and Payment Methodologies.
  • Provides information on Managed Medical Assistance (MMA), Long-Term Care (LTC), and Dental Capitation Rates for various years.
  • Includes a link to a Special Needs Plan Revenue and Expense Schedule Statement Template Tool.

For Institutional Reimbursement rates, please click here.

SMMC Capitation Information

Managed Medical Assistance (MMA)

Long-Term Care (LTC)

Dental

Medicare Dual Eligible Special Needs Plans (D-SNPs) and Fully Liable Medicare Advantage Plans

Special Needs Plan Revenue and Expense Schedule Statement Template Tool [ excel 160.5 kB ] Effective July 1

The Birth Count Query System is a highly useful online tool provided by the Florida Department of Health. It offers a plethora of data on birth counts in Florida, and can be accessed easily through this link: https://www.flhealthcharts.gov/FLQUERY_New/Birth/Count.

This comprehensive tool is an excellent resource for researchers and analysts who are interested in delving deeper into birth trends in Florida. The system provides data that is updated regularly, offering a wealth of information on birth counts across different areas of the state, as well as various demographics. By using this system, researchers and analysts can gain valuable insights into the factors that affect birth rates in Florida, and can make informed decisions based on the data provided by the tool. Additionally, the system can also be used to identify areas where further research is needed, helping to drive innovation in the field of birth rate analysis.

House Bill 7051, the package of policing reforms negotiated this spring by members of Florida’s Legislative Black Caucus and Republican leaders, was signed into law late Tuesday by Gov. Ron DeSantis, along with 93 other approved bills. The reforms take effect immediately and would impact not only minorities but other people facing trouble with the law.

Policing reforms to reduce violence against minorities and others take effect immediately

by Laura Cassels, Florida Phoenix
June 30, 2021

New limits on use of force by police, new training standards, and greater focus on identifying dangerous police practices are now in effect in Florida, though Black legislative leaders say those efforts don’t go far enough.

House Bill 7051, the package of policing reforms negotiated this spring by members of Florida’s Legislative Black Caucus and Republican leaders, was signed into law late Tuesday by Gov. Ron DeSantis, along with 93 other approved bills. The reforms take effect immediately and would impact not only minorities but other people facing trouble with the law.

State Rep. Fentrice Driskell, a key sponsor of the reforms, said they constitute a first step toward safer relations between police and people of color in Florida and that the bipartisan legislative effort is worthy of celebration.

“I’m very glad to see the governor sign this into law. The entire Legislature should be proud of it,” Driskell, a Hillsborough County Democrat, told the Phoenix in a phone interview.

That said, the new policing law doesn’t ban chokeholds and vascular neck restraints but limits the use of them to encounters when an officer “perceives an immediate threat of serious bodily injury or death to himself, herself, or another person.” That kind of restraint was used of by former Minneapolis policeman Derek Chauvin, now convicted of murder, to kill George Floyd, an unarmed, handcuffed suspect in his custody.

The killing of Floyd in May 2020, recorded on video seen around the world, ignited national and international protests against police brutality and inspired a movement for policing reform.

Members of the Black Caucus, led by Rep. Driskell and Sen. Randolph Bracy, an Orlando Democrat, said when the reforms were approved in the final days of the 2021 legislative session, they were considered a good first step for preventing deadly encounters between police and the policed.

The reforms do not include, for instance, requirements that Florida law enforcement officers use bodycams and dashboard cameras to record their activities, as was sought by Black Caucus members and their allies.

“Police reform is long overdue in this state and this country. … People of color are disproportionately affected and in some horrifying cases have cost someone their life,” House Co-leader Bobby DuBose, a Broward Democrat, said in a press statement on Wednesday.  “We will continue having conversations with our communities and law enforcement agencies to propose new legislation at the state and federal levels to ensure there is fair and just policing for all.”

Sen. Bobby Powell, a Palm Beach Democrat and chair of the Florida Legislative Black Caucus, said [This law] acknowledges there is a systemic issue in the hiring, training and accountability of law enforcement and correctional officers. I am hopeful that this is the first step of many towards substantial change.”

On Wednesday, Police Chiefs Association President and Satellite Beach Police Chief Jeff Pearson praised the new law in a statement to the Phoenix:

“In the wake of George Floyd’s murder last year, the Florida Police Chiefs Association established a Subcommittee on Accountability and Social Change that hosted over 23 meetings with community leaders to determine how law enforcement can better serve communities. Their recommendations largely formed the basis for HB 7051.”

Pearson wrote that the new law “approaches reform correctly — factual and balanced, ever mindful of the dedication and sacrifice of law enforcement officers, but equally committed to public safety and accountability.”

Pearson said the subcommittee is working to finalize a detailed report of additional recommendations “that law enforcement and community leaders can use to continue making progress together.”

The new law also:

/Requires an officer who observes another officer engaging or attempting to engage in excessive use of force to intervene;

/Require law enforcement agencies to report quarterly to the Florida Department of Law Enforcement on use-of-force incidents that result in serious bodily injury, death, or the discharge of a firearm at a person;

/Require applicants for law-enforcement, corrections or probation jobs to disclose their history of any pending criminal, civil, or administrative investigation;

/Require a law enforcement or correctional agency to maintain records on why an officer was terminated, resigned or retired;

/Requires the Criminal Justice Standards and Training Commission to establish standards for police training in use of force, and requires agencies to develop policies in proportional use of force and de-escalation techniques;

/Establishes that an officer has a duty to render medical assistance to a person in custody who is injured by an officer’s use of force;

/Requires instruction on recognizing symptoms and characteristics of a person with a substance abuse disorder or mental illness and how to appropriately respond;

/Requires independent reviews of officers’ use of force resulting in a death or the intentional firing of a firearm resulting in injury or death;

/Prohibits children younger than seven from being arrested, except if the child commits a forcible felony.

The Police Chiefs Association is holding its annual summer conference in Plantation. Association President Pearson will step down, and his successor, Stephan Dembinsky, director of the Daytona Beach Shores Public Safety Department, will be installed as the new president tonight, said association spokesman William Stander.

Rep. Driskell was invited to speak at the conference but was unable to attend.

The Florida Sheriffs Association has not yet responded to a request for comment.

Florida Phoenix is part of States Newsroom, a network of news outlets supported by grants and a coalition of donors as a 501c(3) public charity. Florida Phoenix maintains editorial independence. Contact Editor Diane Rado for questions: info@floridaphoenix.com. Follow Florida Phoenix on Facebook and Twitter.

During the 2019 legislative session, Florida passed Chapter 2019-137, Laws of Florida, which establishes standards of practice for telehealth services, including patient evaluations, record-keeping, and controlled substances prescribing. The law also authorizes out-of-state health care practitioners to perform telehealth services for patients in Florida. Signed by the Governor on June 25, 2019, this law became effective on July 1, 2019.

Out-of-state health care practitioners must be registered with the Florida Department of Health to perform telehealth services for patients in Florida.

Health care providers must be licensed within their scope of practice by the appropriate licensing body to practice telehealth in Florida.

Providers must also use two-way, interactive communication tools, such as live video, instead of email or audio-only communication. If you use Medicaid, your telehealth provider must be registered with the Florida Medicaid program to receive reimbursement for telehealth services. Florida doesn’t require private insurers to cover telehealth, so check with your insurance company to determine if you’re eligible for the service. Some of these regulations may be altered during the COVID-19 pandemic.

In Florida, telehealth providers are permitted to prescribe medications if the medications aren’t listed as controlled substances.

Controlled substances shall not be prescribed through the use of telemedicine except for the treatment of psychiatric disorders. This provision does not preclude physicians from ordering controlled substances through the use of telemedicine for patients hospitalized in a facility licensed pursuant to Chapter 395, F.S.

Telemedicine Rule, Rule 64B8-9.0141, F.A.C.

However, there is one important exception to this rule: If you need a controlled substance to manage a mental health condition, your telehealth provider is allowed to prescribe it.

Before prescribing medication, your telehealth provider must conduct an evaluation and explain the risks and benefits of the medication to you.

Filling out a questionnaire before your telehealth appointment isn’t enough to satisfy the evaluation requirement, so you should expect the provider to ask multiple questions about your symptoms and health history.

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