Hurricane Helene – 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 State of Emergency. Pursuant to the Agency notification, AmeriHealth Caritas Florida will ensure reimbursement for critical Medicaid services provided in good faith to eligible recipients who reside in the counties impacted by Hurricane Helene.

Please continue providing services:

  • AmeriHealth Caritas Florida will waive all prior authorization requirements for critical Medicaid services beginning September 25, 2024, through December 4, 2024.
    • 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.
  • All Preadmission Screening and Resident Review (PASRR) processes are postponed until further notice by the Agency.
    • 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, Florida Agency for Health Care Administration. Click the Hurricane banner at the top of the page for more information.

To read Governor Ron DeSantis’ emergency executive order that identify impacted counties, click here.

Additional questions from providers may be directed to the Florida Medicaid Contact Center at 1-877-254-1055.