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Medicaid & BHOS Resources


Medicaid Provider General Handbook

The Agency for Health Care Administration (AHCA) is holding a series of public hearings relating to the Florida Medicaid Provider General Handbook and the Community Behavioral Health Handbook. You may obtain more information by writing to:

Agency for Health Care Administration
2727 Mahan Drive, Building 3
Bureau of Medicaid Services
Tallahassee, FL 32308

You may obtain a schedule of public meetings by visiting the AHCA Web site at: http://www.ahca.myflorida.com/#pm.


Overview

In the Florida, only those Department of Juvenile Justice (DJJ) residential commitment programs that are low- or moderate-risk levels and operated by private providers are considered Medicaid-allowable programs.  In order for a residential program to provide Behavioral Health Overlay Services (BHOS) that are reimbursed by Medicaid, that program must first be "deemed essential" by DJJ as a BHOS for a specified number of beds.  That provider must then begin the Medicaid and BHOS certification processes with Florida's Agency for Health Care Administration (AHCA).  Each residential program has a description page on this web site that includes whether or not that program provides BHOS services.

Conference Calls

Quarterly, DJJ hosts a statewide conference call for residential program Medicaid liaisons with liaisons from the Department of Children & Families (DCF) and AHCA.  The schedule is as follows and all calls begin at 10 a.m. (Eastern):

  • Wed., Feb. 13, 2013; 
  • Wed., May 8, 2013; 
  • Wed., Aug. 14, 2013; and
  • Wed., Nov. 13, 2013.

Contacts & Lists

Not all Medicaid-allowable programs are "deemed essential" BHOS providers.

For providers or agencies that need general information about DJJ-Child In Care Medicaid, BHOS or Medicaid-allowable programs, please contact:


Lytha Belrose

Statewide Medicaid Liaison

Florida Department of Juvenile Justice
Office of Residential Services

2737 Centerview Drive
Tallahassee, FL 32399-3100

(850) 717-2538
(850) 414-2264

Need To Know

The following is provided to assist potential and existing DJJ residential commitment program providers with questions about Medicaid, BHOS, enrollment and current information that affects juvenile justice-involved youths.

Upcoming changes ...

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires the use of a standard code set to indicate the diagnoses for the care provided to all patients.  This is especially important for providers who bill for Medicaid services. Effective October 1, 2014, the standard code set that is required for diagnosis codes is changing to the updated International Classification of Diseases, Tenth Edition (ICD-10). Diagnosis codes are used in almost every clinical and administrative process and system,which will necessitate changes in many areas of health care policy, payment, and reporting. Read more about the schedule of changes in the letter from AHCA Secretary Dudek to DJJ Secretary Walters. Also, find more information about the ICD-10 online at http://www.cms.gov/Medicare/Coding/ICD10/index.html?redirect=/ICD10.

How to ...

Manually Process Medicaid

If JJIS is down or your e-mail program is not working and you are unable to process Medicaid forms electronically, please click on the following forms, print them, complete them, and fax them to the appropriate offices.