How to Become a Florida Medicaid Health Plan

Welcome, prospective health plan! We are pleased you are interested in contracting with the Agency for Health Care Administration to provide comprehensive health care services to Medicaid recipients. On these pages you will find the information you need to become a Florida Medicaid health plan, which includes health maintenance organizations, provider service networks, and specialty plans.  Just follow the steps below.

Applications received after April 1, 2012, are not likely to be fully reviewed and processed prior to the release of the procurement documents for Statewide Medicaid Managed Care.

1. Review Chapter 409, Florida Statutes which is the enabling statute for the Medicaid Program:
   • Section 409.912 – Cost-effective purchasing of health care.
   • Section 409.9122 – Mandatory Medicaid managed care enrollment; programs and procedures.
   • Section 409.91211 – Medicaid managed care pilot program.
   • Section 409.91212 – Medicaid Managed Care Fraud.
   • Section 409.913 – Oversight of the integrity of the Medicaid program.
   • Section 409-9124 – Managed care reimbursement.
   • Section 409.920 – Medicaid Provider Fraud.
   • Section 409.9201 – Medicaid Fraud.
   • Section 409.9203 – Rewards for reporting Medicaid Fraud.
2. Download these materials or Application tools:
   • Medicaid Health Plan application [577KB PDF]
   • Model Health Plan contract
   • Additional required documents and resources for application submission
3. Contact the Division of Medicaid, Bureau of Health Systems Development at (850) 412-4004, to schedule a teleconference or meeting with Agency staff.
4. Attend a Medicaid Health Plan application workshop(s). The schedule of workshops if available on the workshop page.
5. Submit completed application and all required supporting documents.

The following links have more information about current Health Maintenance Organizations and Provider Service Networks:

• Health Maintenance Organizations (HMOs)
• Provider Service Networks (PSNs)