Agency for Health Care Administration

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What is the purpose of the agency?

The agency's purpose is to assure better health care for all Floridians. The Florida Legislature created the Agency for Health Care Administration as part of the Health Care Reform Act of 1992 (Ch. 92-33, Laws of Florida). The agency is responsible for administering the Medicaid Program, licensing and regulating health facilities, and providing information to Floridians about the quality of the health care they receive. The agency's secretary is appointed by the Governor, subject to confirmation by the Senate.

What are the major program activities and services of the agency?

The Agency for Health Care Administration's major program activities are administered by two divisions.

Medicaid Health Care Services provides health care coverage to low-income individuals who meet Medicaid and Florida KidCare eligibility requirements.
Health Quality Assurance ensures quality health care services by licensing and inspecting health care facilities, investigating complaints against health care facilities, and working to ensure the integrity of Florida's Medicaid Program.In addition, the agency operates the Florida Center for Health Information and Transparency, which is responsible for collecting, compiling, coordinating, analyzing, and disseminating health-related data and statistics.

How is the agency organized?

The agency has designated 11 service areas. Medicaid field offices within the 11 service areas serve Medicaid providers and beneficiaries. The agency's Tallahassee central office coordinates Medicaid and health care regulation policy. There are eight Health Quality Assurance field offices within the 11 service areas that offer quality assurance services and serve as local liaisons for providers.

How are these activities funded?

The majority of the agency's budget pays for direct health care services for Medicaid and KidCare clients. Another portion pays for health care regulation activities, such as licensing and inspecting health care facilities, providing consumer assistance, investigating complaints, and regulating managed care organizations.

Fiscal Year: 2020-21

	Fund	Dollars	Positions
AGENCY FOR HEALTH CARE ADMINISTRATION
	PROGRAM: ADMINISTRATION AND SUPPORT	31,443,226	255.00
PROGRAM: HEALTH CARE REGULATION
	HEALTH CARE REGULATION	94,119,936	653.50
PROGRAM: HEALTH CARE SERVICES
	CHILDREN'S SPECIAL HEALTH CARE	660,559,104	.00
	EXECUTIVE DIRECTION AND SUPPORT SERVICES	284,898,514	621.00
	MEDICAID LONG TERM CARE	7,022,194,939	.00
	MEDICAID SERVICES TO INDIVIDUALS	22,317,451,019	.00
TOTAL		30,410,666,738	1,529.50

Source: www.transparencyflorida.gov

Updates

Establishing a Canadian Prescription Drug Importation Program. The 2019 Legislature enacted Chapter 2019-99, Laws of Florida, which directs AHCA to establish a Canadian Prescription Drug Importation program to import safe and effective prescription drugs from Canada that have the highest potential for cost savings to the state's public programs. State programs specifically include the Florida Medicaid, the Department of Corrections, the Department of Health's central pharmacy, county health departments or free clinics, developmental disabilities centers, and contracted treatment centers. The law directs AHCA to contract with a vendor responsible for developing the Wholesale Prescription Drug Importation Lists with drugs that have the highest potential cost savings and identify and contract with Canadian suppliers who are in full compliance with relevant Canadian federal and provincial laws and regulations and who have agreed to export prescription drugs identified on the list. The Initial Wholesale Drug Importation list must be developed by December 1, 2019. The law also requires the vendor to ensure that all suppliers, importers distributors, and participants in the program comply with Title II of the federal Drug Quality and Security Act; assist AHCA in the preparation of the required annual report of the program operations; and provide to the AHCA annual financial audits of its operations and quarterly financial reports specific to the program including information on the performance of its subcontractors and vendors. By July 1, 2020, AHCA must submit a request to the United States Secretary of Health and Human Services for approval of the program under 21 U.S.C. s. 257 384(l). Within 6 months after receiving federal approval AHCA must begin operating the program.

Where can I find related OPPAGA reports?

A complete list of related OPPAGA reports is available on our website.

Where can I get more information?

Other Reports
The Auditor General reports on agency operations are available on its website.
Websites of Interest
Florida Health Finder
Florida Health Information Network (FHIN)
Performance Information
Performance measures and standards for the department may be found in its Long Range Program Plan.

What are the applicable statutes?

Section 20.42, Florida Statutes.

Whom do I contact for help?

Consumer Call Center Complaint Hot Line, 1-888-419-3456
Website