Provider Type(s): ALL

Tropical Storm Nicole - Key Medicaid Information for Fee-for-Service and Managed Care Providers

Florida Medicaid recipients maintaining access to critical Medicaid services (e.g., durable medical equipment and supplies, home health services,hospital services, nursing facility services, chemotherapy, dialysis services, etc.) is imperative during the disaster period. To this end, the Agency will ensurereimbursement for critical Medicaid services provided in good faith to eligible recipients whoreside in the counties impacted by Tropical StormNicole.

Please continue providing services:

• The Agency will waive all prior authorization requirements for critical Medicaid servicesbeginning November 9,2022, untilfurther notice.
  • Early prescription refill edits have been lifted for all maintenance medications (Note: This does not apply to controlled substances).
• If a recipient requires critical Medicaid services beyond limits stated in policy to maintain safety and health, providers can furnish the service.
• The Agency is postponing all Preadmission Screening and Resident Review (PASRR) processes until further notice.
  • Retroactively performed screenings or resident reviews must document the reason for delay in the completion of PASRR requirements.
  • The Agency is waiving the PASRR process for recipients who evacuated due to an evacuation order or power outage and are admitted and discharged during the storm.

Additional information for providers is located on the Agency’s website, http://www.ahca.myflorida.com/.Click the Storm Informationbanner at the top of the page for more information.

Governor Ron DeSantis’ emergency executive orders that identify impacted counties are available onlineat https://www.flgov.com/2022-executive-orders.