Office of Program Policy Analysis and Government Accountability
Office of Program Policy Analysis and Government Accountability

Agency for Health Care Administration

For assistance, call 1-888-419-3456 or visit https://ahca.myflorida.com/MCHQ/Field_Ops/CAU.shtml

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.

How is the agency organized?

The agency has designated 11 Statewide Medicaid Managed Care service areasChapter 2022-42, Laws of Florida, realigned the state's 11 region structure into 9 regions, effective January 2025.AHCA's Division of Medicaid plans, develops, organizes and monitors program planning, coverage and reimbursement policies and oversees provider and consumer relations. 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 Medicaid services. 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: 2023-24
Fund Dollars Positions
AGENCY FOR HEALTH CARE ADMINISTRATION
PROGRAM: ADMINISTRATION AND SUPPORT
39,540,272
261.00
PROGRAM: HEALTH CARE REGULATION
HEALTH CARE REGULATION
85,368,322
659.50
PROGRAM: HEALTH CARE SERVICES
CHILDREN'S SPECIAL HEALTH CARE
563,401,290
.00
EXECUTIVE DIRECTION AND SUPPORT SERVICES
440,822,400
623.00
MEDICAID LONG TERM CARE
9,197,202,971
.00
MEDICAID SERVICES TO INDIVIDUALS
30,456,576,267
.00
TOTAL
40,782,911,522
1,543.50

Updates

Health Appropriations. The 2023 Legislature enacted Ch. 2023-243, Laws of Florida, which conforms statutes to funding decisions related to Health Care in the General Appropriations Act for Fiscal Year 2023-24.

The law amends

  • s. 296.37, Florida Statutes, to increase the income threshold above which a resident in a State Veterans' nursing facility would be required to contribute to his or her account from $130 to $160 per month;
  • s. 409.814, Florida Statutes, to clarify that the premiums paid under Florida Kidcare's full-pay program are based on the combined-risk premium;
  • s. 409.908, Florida Statutes, to increase the nursing home prospective reimbursement methodology for the Quality Incentive Program Payment Pool from 6% to 10% of the September 2016 non-property related payments of included facilities;
  • s. 409.909, Florida Statutes, to create the Graduate Medical Education Slots for Doctors Program; and
  • s. 409.967, Florida Statutes, to provide for a portion of the Statewide Medicaid Managed Care achieved savings rebate to be repaid to the federal government.

The law creates s. 409.9855, Florida Statutes, which

  • establishes a Medicaid long-term care managed care pilot program in certain counties to integrate health care services, long-term care services, and home and community-based services for persons with developmental disabilities;
  • requires the Agency for Health Care Administration to seek federal approval to implement the pilot program and requires the plans to begin providing service coverage upon authorization and availability of sufficient state and federal resource; and
  • clarifies that the Agency for Health Care Administration may not require a home health agency that does not provide skilled home health services and only provides private duty nursing service and attendant nursing care services, to meet the requirements of Medicare certification for participation in the Medicaid 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?

The Agency for Health Care Administration, Complaint Administration Unit, 1-888-419-3456 or 1-800-955-8771 (Florida Relay Service)
Website