Attention PAC Waiver Providers
PAC Waiver has transitioned to Managed Care, effective January 1, 2018. For additional information, please visit the Agency’s website for information on Florida Medicaid’s PAC Waiver Changes :Florida Medicaid PAC Waiver changes (Click Here)
Attention Home Health Providers
Home health administrators, directors of nursing, billing staff, as well as other designated individuals are encouraged to attend training on the Electronic Visit Verification (EVV) System.
Please visit the EVV Training page to sign up for training session date(s) and time(s) that best fits your schedule.
Hurricane Irma Update from eQHealth Solutions:
Given the recent events of Hurricane Irma, we would like to share that eQHealth Solutions is fully operational at this time.
We are working closely with AHCA to ensure that your needs are met, and we invite you to notify us immediately should you encounter any difficulties with our systems or processes. Please dial 855-444-3747 for Customer Support.
Our thoughts go out to those affected by Hurricane Irma, and we’re committed to providing you with the support you need during recovery
Hurricane Irma - Message from AHCA:
Attention DME Providers-Recipients over the age of 21
When requesting authorization for a DME item please make sure you are referencing the Florida Medicaid Fee Schedule for the appropriate HCPCS Code. We have recently seen an increase of reviews submitted with the A9900 code. Please note A9900 is a -Misc DME Supply, accessory, and/or service component of another HCPCS Code .
(Example: briefs, diapers, protective underwear, pull-ons, liners, shields, guards, pads, wipes and undergarments)
You can reference the FL DME Imitations Handbook for additional information pp2-8.
PDN and PCS Providers
There have been recent changes to the Florida Medicaid Policy for Personal Care Services and Private Duty Nursing. You can find this policy by clicking on one of the links below.
FL Medicaid Coverage Policy for Personal Care Services
FL Medicaid Coverage Policy for PDN Services
One of the biggest changes is that you are now be able to request up to 180 days for all admission requests. Please make sure that if you are requesting 180 days that the prescription for services match your request.
Attention DME Providers
If you are entering a DME request please make sure you are referencing the Florida Medicaid Fee Schedule for Prior Authorization Requirements. If you do not have a copy of the Fee Schedule you can find them on our website on the following link.
Florida DME Fee Schedule
Prior Authorization numbers
When referencing the Fee Schedule if the code you are requesting has a “PA” this means the code requires prior authorization and once approved you will receive your authorization letter with a PA#.
If the code you are requesting only states “Medical Necessity” this means the code requires prior authorization however it does not require a PA #. This means a PA# will NOT generate when you receive your authorization letter. To avoid a denial on your claims make sure to include your authorization letter with your claim submission.