Prior Year Health Plan Policy Transmittals

2014 Policy Transmittals

14-01 Pharmacy Encounter Data Validation Study [72KB, PDF] February 13, 2014
14-02 Primary Care Physician (PCP) Ad Hoc Reporting [186KB, PDF] February 17, 2014
14-03 0510 Codes [309KB, PDF] April 2014
14-04 PDHP Dental Utilization Data [175KB, PDF] 3/20/14

2013 Policy Transmittals:

13-01 CHCUP Encounter Data Ad Hoc Request [257 KB, PDF] 1-9-13
13-02 HMOs and PSNs - Payment for Services Furnished by Certain PCPs [100KB, PDF] 2-5-13
13-03 PDHPs Ad Hoc - Provider Network Verification System Report [55KB, PDF] 4-1-13
            13-03 PNV File Specifications [543KB, PDF] 1-22-13
13-04 HMOs and PSNs - Balanced Budget Act (BBA) Hospital Claims [120KB, PDF] 4-1-13
13-05 MMC ProviderPreventableConditions, HealthCare-AcquiredConditions [153KB, PDF] 6-6-13
           13-05 Attachment I PPC, HCAC [46KB, PDF] 6-6-13
13-06 MMC Policy Transmittal [87KB, PDF] 7-5-13
           13-06 Antitrust and Florida Managed Medicaid: Reforms to Ensure Quality Services and Competition [637KB, PDF]
           13-06 Attachment I, FAHCS Letter [1.97MB, PDF]
           13-06 White Paper Pages 1 - 32 [5.07MB, PDF]
           13-06 White Paper Pages 33 - 73 [3.34MB, PDF]
           13-06 White Paper Pages 74 - 117 [2.69MB, PDF]
           13-06 White Paper Pages 118 - 180 [5.64MB, PDF]
           13-06 White Paper Pages 181 - 230 [4.52MB, PDF]
13-07 ACA Primary Care Physician Fee Increase and Ad Hoc Data [159KB, PDF] 7-19-13
           13-07 MPA SFTP Instructions [487KB, PDF] 7-19-13
13-08 Public Records Request [45KB, PDF] 7-19-13
13-09 Submission Requirements for Policies and Procedures and other Contract Items [64KB, PDF] 7-25-13
13-10  Diagnosis Related Group Requirements and Q&A [81KB, PDF] 8-14-13
           13-10 Attachment I -DRG Implementation [726KB, PDF] 8-14-13
13-11 Cochlear Implant Coverage [74KB, PDF] 9-13-13
13-12 County Billing and Inpatient Discharge Report [54KB, PDF] 8-28-13
13-13 Behavioral Health Annual 80-20 Expenditure Report Clarification [54KB, PDF] 8-19-13
13-14 ACA Primary Care Physicians Fee Increase [103KB, PDF] 10-2-13
           13-14 Attach I - PCP Fee Increase Summary Information [29KB, XLSX] 10-2-13
           13-14 Attach II - PCP Fee Increase Encounter Data File Layout [16KB, XLSX] 10-2-13
13-15 MediKids and Primary Care Physicians Fee Increases [53KB, PDF] 10-31-13
13-16 ACA Primary Care Physician Fee Increase Self-Attestation for Calendar Year 2014 Eligibility [92KB, PDF] 12-3-13

2012 Policy Transmittals

12-01 HMO and 12-01 PSN Requesting an Expansion  [167 KB, PDF] 1-24-2012
12-02 PSN Updated Paper Claims Submission Information [449 KB, PDF] 9-6-2012
12-02 HMO and 12-03 PSN Changes to Hospital ER, Primary Care and Home Health Visits [88 KB, PDF] 12-20-2012

2006 Policy Transmittals

06-01 Hernandez Settlement Agreement [90KB, PDF] January 1, 2006