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New flexibility during Public Health Emergency

  • No Medicaid terminations. Medicaid eligibility for current recipients will be maintained from March through the last day of the month of the state of emergency (unless no longer resident or voluntary terminations). This means no Medicaid recipient will lose Medicaid eligibility during the state of emergency.

  • Redetermination/recertification times extended 6 months for beneficiaries due to recertify in April or May.

  • Application time extended 120 days. During this state of emergency, individuals applying for Medicaid may be unable to submit all the documentation required to process their application. Beginning with applications received in February 2020, the timeframe for individuals to submit any necessary paperwork will be extended to 120 days from the date the application was received. If the Medicaid application is approved, the individual’s Medicaid eligibility effective date will still be the first day of the month that the initial application was received.

  • Coverage of all medically necessary services due to COVID-19, including testing and treatment.

  • No limits on services that must be exceeded to maintain the health and safety of recipients diagnosed with COVID-19 or when necessary to maintain a recipient safely in their home.

  • No prior authorization requirements for hospital, physician, advanced practice registered nursing, physician assistant, home health services, and durable medical equipment and supplies.

  • Waiver of copayment for all services.

  • No limits on early prescription refills, except for controlled substances.

  • Coverage of 90-day supply of maintenance prescriptions when available at pharmacy.

  • Reimbursement of out of state providers providing medically necessary services to Florida Medicaid beneficiaries.

  • 120-day extension of time to request fair hearings.

  • Delay of fair hearings only in those instances when the recipient is continuing to receive services pending the outcome of the hearing.