CORONAVIRUS ALERT: Florida Community Care is closely monitoring updates related to the 2019 Novel Coronavirus (COVID-19) with the Florida Agency for Health Care Administration (AHCA) and the Centers for Disease Control (CDC). CLICK HERE FOR THE LATEST INFORMATION FROM THE AHCA.
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:
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:
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.
In February of 2020, the Florida Department of Health declared a public health emergency resulting from the COVID-19 virus.
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Local Coverage Article Manual Wheelchair Bases
Local Coverage Determination (LCD); Commode Chair
Local Coverage Determination (LCD); Walker
Local Coverage Determination (LCD); Oxygen & Oxygen equipment
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Local Coverage Determination (LCD); Pressure Reducing Support Surfaces - Group 1
All CMS Benefit Policy Manuals
CMS Coverage Determination Part 1
Medicare Benefit Policy Manual- Chapter 7 (Home Health Services)
Medicare Benefit Policy Manual- Chapter 8 (SNF-Coverage of Extended Care)
Medicare Benefit Policy Manual- Chapter 9 (Coverage of Hospice Services Under Hospital Insurance)
Medicare Benefit Policy Manual- Chapter 15 (Covered Medical and Other Health Services)
CMS Manual System- Home Health Certification & Recertification Policy Changes
Authorizations
Case Management Authorizations:
If you are a long-term care provider that needs authorization please contact your case manager or call FCC at 1-833-FCC-PLAN Ext. 2
The Availity Portal offers health care professionals free access to real-time information and confirmation of claims submissions.