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Utilization Management/Prior Authorization

Provider Notices

Please check back every week for important notices

Provider COVID-19 Notice

In February of 2020, the Florida Department of Health declared a public health emergency resulting from the COVID-19 virus.

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.


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.

Provider Documents


Submit Utilization Management/ Prior Authorizations by:

Provider Portal

Fax: 305.675.6138

Phone: 1.833.322.7526, Option 5


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

Provider Resources

SMMC Resource Guide Submission Guidance

This reference guide provides a list of the departments at Florida Community Care Plan that may be helpful in assisting with coordination and authorization of services that a member may need.

Managed Medical Assistance (MMA) Service Authorization Requirements

FCC Managed Medical Assistance Benefits and Services (MMA) Prior Authorization Program.

Availity Access

The Availity Portal offers health care professionals free access to real-time information and confirmation of claims submissions.

At Availity, you can:

  • Submit Claims


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