State Medicaid agencies are required by the Social Security Act, section 1932 (c), to provide for an annual external, independent evaluation of quality outcomes, timeliness of and access to services. In compliance with federal requirements, the Agency for Health Care Administration contracts with Health Services Advisory Group, Inc., an external quality review organization (EQRO), to provide a quality review of its Medicaid managed care programs.
To comply with the Code of Federal Regulations (CFR) at 42 CFR 438.364, Health Services Advisory Group has provided a comprehensive annual report that describes the manner in which the data from all external quality review activities were aggregated and analyzed, and conclusions drawn as to the quality, timeliness and access to care provided by Florida’s Medicaid managed care plans during State Fiscal Year (SFY) 2015 - 2016.
The following is a link to view the Annual Technical Report of External Quality Review Results, which was finalized in April 2017.Annual Technical Report of External Quality Review Results April 2017 [4.9MB PDF]
For more information on Florida Medicaid Quality in Managed Care, please contact: