Welcome to Medicaid!
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Justin Senior
Acting Deputy Secretary for Medicaid
Phone: (850) 412-4000
Medicaid is the medical assistance program that provides access to health care for low-income families and individuals. Medicaid also assists aged and disabled people with the costs of nursing facility care and other medical expenses. Eligibility for Medicaid is usually based on the family’s or individual’s income and assets.
In Florida the Agency for Health Care Administration (AHCA) is responsible for Medicaid. We are the equivalent of the corporate head office. The Department of Children and Families acts as our agent by enrolling people in Medicaid. We contract with other state agencies and private organizations to provide the broad range of services that Medicaid offers its participants.
AHCA is also the lead agency for the Children’s Medical Insurance Programs (Title XXI–SCHIP). In Florida, this program is known as the Florida KidCare program and is the state's children health insurance program for uninsured children.
Medicaid serves approximately 3.19 million people in Florida, with over half of those being children and adolescents 20 years of age or younger. Estimated expenditures for Fiscal Year 2011-12 (July 2011 through June 2012) are approximately $20.3 billion.
To meet the needs of Medicaid participants, we have approximately 114,000 Florida Medicaid enrolled individuals and facilities offering health care services. If you are a medical provider interested in serving Medicaid recipients, an online enrollment application is available for your convenience at our Fiscal Agent Web Portal. Medicaid's fiscal agent processes approximately 135 million claim lines every year.
At times, individuals confuse Medicaid and Medicare, but Medicare is a separate program. Medicaid is a partnership between the states and the federal government, with each paying about half the cost. Each state operates its own Medicaid program under a state plan that must be approved by the federal Centers for Medicare and Medicaid Services or CMS. The Plan outlines current Medicaid eligibility standards, policies and reimbursement methodologies to ensure the state program receives matching federal funds. Additional information regarding coverage and reimbursement can be found in the Medicaid handbooks and fee schedules.
Per federal regulations, certain services must be offered by all states, but each can place some limits on the services. There are also optional services that a state may choose to offer, variations in eligibility groups, different limits on income and assets to decide eligibility, and differences in how much states pay their Medicaid providers. For more information about Medicaid covered services view the Summary of Services.
The Deputy Secretary of Medicaid oversees the Divisions of Medicaid Operations and Medicaid Finance. The Assistant Deputy Secretary for Medicaid Operations is responsible for oversight of the Bureaus of Medicaid Services, Health Systems Development, Pharmacy Services, and the eleven Medicaid area offices throughout the state that provide local management of provider networks and assist beneficiaries to navigate the health care system. The Assistant Deputy Secretary for Medicaid Finance is responsible for the oversight of the Bureaus of Program Analysis, Quality Management, and Contract Management.
•Fiscal Agent
•Fraud and Abuse
•Florida Medicaid Reform Pilot
•Reports of Medicaid Eligibles
•Managed Care Enrollment Reports
•Services Available through Medicaid
•Servicios Disponibles a través de Medicaid
•Children’s Quality Demonstration Grant (CHIPRA grant)
•Medicaid Procurements
•Fall 2011 Medicaid Provider Bulletin
10/11/2011
•Intergovernmental Transfer (IGT) Workgroup
•Organ Transplant Advisory Council
•Medical Care Advisory Committee
