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)
- 2022/2023 MMA Capitation Rates (October 2022 – September 2023) [
152.2 kB ] - 2021/2022 MMA Capitation Rates (October 2021 – September 2022) [ 422.8 kB ]
- 2020/2021 MMA Capitation Rates (October 2020 – September 2021) [ 423.5 kB ]
- 2019/2020 MMA Capitation Rates (October 2019 – September 2020) [ 460 kB ]
- 2018/2019 MMA Capitation Rates (SMMC Implementation – September 2019) [ 405.3 kB ]
- Interim MMA Capitation Rates (October 2018 – SMMC Implementation) [ 391 kB ]
- 2017/2018 MMA Capitation Rates (October 2017 – September 2018) [ 442.6 kB ]
- 2016/2017 MMA Capitation Rates (September 2016 – September 2017) [ 264.9 kB ]
- 2015/2016 MMA Capitation Rates (September 2015 – August 2016) [ 89.8 kB ]
- 2014/2015 MMA Capitation Rates (July 2014 – August 2015) [ 306.6 kB ]
- 2014 MMA Capitation Rates (May 2014 – June 2014) [ 85.7 kB ]
Long-Term Care (LTC)
- 2022/2023 LTC Capitation Rates (October 2022 – September 2023) [ 107.9 kB ]
- 2021/2022 LTC Capitation Rates (October 2021 – September 2022) [ 401 kB ]
- 2020/2021 LTC Capitation Rates (October 2020 – September 2021) [ 396.9 kB ]
- 2019/2020 LTC Capitation Rates (October 2019 – September 2020) [ 398.8 kB ]
- 2018/2019 LTC Capitation Rates (SMMC Implementation – September 2019) [ 395.4 kB ]
- Interim LTC Capitation Rates (October 2018 – SMMC Implementation) [ 395.5 kB ]
- 2017/2018 LTC Capitation Rates (October 2017 – September 2018) [ 394.6 kB ]
- 2016/2017 LTC Capitation Rates (September 2016 – September 2017) [ 157.4 kB ]
- 2015/2016 LTC Capitation Rates (September 2015 – August 2016) [ 55.9 kB ]
- 2014/2015 LTC Capitation Rates (September 2014 – August 2015) [ 70.1 kB ]
- 2013/2014 LTC Capitation Rates (August 2013 – August 2014) [ 55.7 kB ]
Dental
- 2022/2023 Dental Capitation Rates (October 2022 – September 2023) [ 58.7 kB ]
- 2021/2022 Dental Capitation Rates (October 2021 – September 2022) [ 378.9 kB ]
- 2020/2021 Dental Capitation Rates (October 2020 – September 2021) [ 378.9 kB ]
- 2019/2020 Dental Capitation Rates (October 2019 – September 2020) [ 59.8 kB ]
- 2018/2019 Dental Capitation Rates (SMMC Implementation – September 2019) [ 374.9 kB ]
Medicare Dual Eligible Special Needs Plans (D-SNPs) and Fully Liable Medicare Advantage Plans
Special Needs Plan Revenue and Expense Schedule Statement Template Tool [ 
160.5 kB ] Effective July 1