florida

Humana Managed Medical Assistance (MMA) program provider materials

Humana has contracted with the Agency for Health Care Administration (AHCA) to provide services to Medicaid beneficiaries through Humana Managed Medical Assistance (MMA) plans. Medicaid provides health care coverage for income-eligible children, seniors, disabled adults and pregnant women. It is funded by both the state and federal governments.

Provider Materials

Humana MMA health care provider communications and AHCA information bulletins

The following materials provide the latest Humana MMA plan information for health care providers:

  • Affordable Care Act Primary Care Fee Increase – Section 1202 of the Patient Protection and Affordable Care Act (ACA) authorized a physician fee increase effective for dates of service from Jan. 1, 2013, through Dec. 31, 2014. Since the federal government has not extended this increase, Florida Medicaid physician fees no longer include the ACA rates effective Jan. 1, 2015.
    Medicaid managed care plan providers should refer to their contract with each plan to determine whether this change will impact reimbursement.
  • Healthy Behaviors – The following Healthy Behaviors programs are offered to MMA members:
    • Smoking cessation
    • Substance abuse
    • Humana Family Fit
    • Mom’s First
    • First baby well visit
    • Lead screening and well-child visit
    • Children’s nutrition
    • Adolescent well-child visit
  • Smoking cessation – As part of our Healthy Behaviors program, Humana has contracted with Psychcare to provide a telephonic smoking cessation counseling program for Humana MMA members. Members may self-refer or be referred by their health plan or physician by calling 1-800-221-5487.
    Psychcare will facilitate member enrollment via its Encompass Program, assigning the member a care coordinator or care manager. Members will be engaged in treatment with community practitioners, online and face-to-face support groups, as well as other resources that facilitate a smoke-free lifestyle. This combination of counseling and medication has shown to provide the greatest likelihood of successful treatment.
    Find useful information for primary care physicians regarding treating tobacco use and dependence from the Agency for Healthcare Research and Quality Agency.
  • Guidance for Prescribing a Psychotropic Medication for a Child in the Medicaid Program (66.7Kb) – This letter was distributed in September 2011 to pediatricians and family practice primary care physicians who treat pediatric Medicaid patients in South Florida. The letter advises physicians about a change in Florida law that requires health care providers to have express and informed consent from a parent or legal guardian when prescribing psychotropic (psychotherapeutic) medication for a child in the Medicaid program.
  • Coverage of Topical Fluoride Varnish for Children with Medicaid (57.9Kb) – This communication was distributed to pediatricians, primary care providers and family medicine physicians in the South Florida market in June 2011 to describe a change in plan benefits for Humana Family Medicaid members.

Long-term services and supports (LTSS) provider portal

Long-term services and supports (LTSS) providers who need information regarding eligibility, authorizations and claims status can access the LTSS provider portal.