On March 9, 2020, Governor Ron DeSantis issued Executive Order Number 20-52 declaring a state of emergency related to the 2019 novel coronavirus (COVID-19). During this state of emergency, Florida Community Care (FCC) is committed to ensure there are no gaps in care for its Medicaid enrollees, while implementing procedures and the use of routine screenings to prevent further spread of COVID-19. As a resulting, we are following the Agency for Health Care Administration (AHCA)guidance on provider payment and authorization requirements.

FCC’s payment provisions include the following:

• Waiver of Prior Authorization Requirements
• Waiver of Limits on Services
• Waiver of Cost Sharing
• Provider Enrollment and Credentialing
• Claims Submission Instructions

For additional information, please click on the link below to view the payment provision notice.

UPDATE:

Consistent with Phase 2 of Governor Ron DeSantis’ Plan for Florida’s Recovery, the Agency is reinstating prior authorization requirements for the following Florida Medicaid services that were waived in response to COVID-19:

• Hospital services (including long-term care hospitals)
• Nursing facility services
• Physician services
• Advanced practice registered nursing services
• Physician assistant services
• Home health services
• Ambulance transportation
• Durable medical equipment and supplies

Florida Community Care (FCC) is implementing this change effective for dates of service on or after June 19, 2020 when prior authorization is required for the service.

Behavioral Health Exception

FCC will continue to waive prior authorization requirements and services limits (frequency and duration) for Medicaid-covered behavioral health services covered. This includes community behavioral health services, inpatient behavioral health services, and targeted case management services. FCC will continue this flexibility until further notice.

General Information

For more information on the Agency’s efforts related to COVID-19, please visit: http://ahca.myflorida.com/covid-19_alerts.shtml.