February 18, 2024  – Florida is on the verge of implementing a managed care pilot program specifically designed for individuals with intellectual and developmental disabilities. This initiative, greenlit by lawmakers last year, is aimed at testing the viability of a managed care system in delivering comprehensive care for people with intellectual and developmental disabilities.

Florida Medicaid officials have announced their intent to award Florida Community Care with a six-year contract. The final decision, however, is pending until Wednesday, allowing for potential challenges to the award. This announcement follows a competitive bidding process, with Florida Community Care and Simply Healthcare as the sole respondents. After a thorough vetting process, Florida Community Care outscored Simply Healthcare, 983 and 938 points out of 1,000, respectively.

The pilot program will unfold in Medicaid Regions D and I, encompassing several counties from Hardee to Monroe. This initiative emerges from legislative efforts encapsulated in SB 2510, which received the legislative green light last year. The legislation authorized up to 600 volunteers aged 18 and above, that are currently on the waitlist for the Medicaid iBudget Waiver program, to partake in this managed care pilot program.

The iBudget Waiver program provides access to home- and community-based services for those with intellectual or developmental disabilities.  These services offer support for daily living activities, such as help with eating and grooming, that are not typically covered by Medicaid. 

This move towards managed care has not been without its detractors. Advocates, caregivers, and family members have previously voiced strong opposition to mandating managed care for this vulnerable population. They cite concerns over the potential impact on the quality and continuity of care. Despite these challenges, the pilot program represents a concerted effort to integrate these individuals into managed care plans, with provisions allowing for opt-out options.

As Florida awaits the final award announcement, this pilot program stands as a testament to the state’s commitment to exploring innovative care delivery models for its most vulnerable citizens to allow them to live independently at home. The initiative is part of a broader effort, with the Agency for Health Care Administration (AHCA) also engaging in negotiations for a Medicaid dental managed care contract, expected to be announced by the end of March.