Florida Agency for Health Care Administration Managed Care Behavior Health Discussion Group Reviews Proposed Provider Record Review Standardization Tool

The Florida Agency for Health Care Administration ("AHCA") Managed Care Behavior Health Discussion Group ("Group") met on July 18, 2011. 

Carol Barr Platt, the Group’s coordinator, prefaced the meeting with an announcement that the Group will not discuss the Medicaid Managed Care Reforms passed during Florida’s 2011 Legislative Session. 

Instead, the Group first discussed a conflict found in the Medicaid manual, in which both AHCA and managed care plans are required to approve targeted case management training programs.  It is AHCA’s position that managed care plans must approve targeted case management training programs and that its position will be reflected in all future AHCA contracts. 

The group then discussed a proposed tool to standardize provider record review.  Some concern was expressed by managed care plan representatives and providers that the criteria in the tool needs to be defined in order for the tool to be reliable.  AHCA will distribute the tool for public comment. 

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