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To report suspected Medicaid Fraud, please call the Attorney General toll-free at 1-866-966-7226. Find out if you are eligible for a reward. Callers may request to remain anonymous.

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2020 Medicaid Open Enrollment is Here
Latest updates on COVID-19 from the Florida Department of Health
Emergency Status System

Agency News

February 5, 2021

    • Governor Ron DeSantis Appoints Simone Marstiller as Secretary of the Agency for Health Care Administration and Shevaun Harris as Secretary of the Department of Children and Families (flgov.com)

January 28, 2021

    • Agency for Health Care Administration Applauds Governor DeSantis’ Prioritization of Patient-Centered Health Care System in Florida Leads Budget Recommendations [242KB PDF]

January 28, 2021

    • Governor Ron DeSantis Announces His “Florida Leads” Budget Proposal for FY 2021-2022 (flgov.com)

January 26, 2021

    • Florida Surpasses 1 Million Seniors Vaccinated (flgov.com)

January 25, 2021

    • ICYMI: Florida on Track to Offer Vaccine to Every Long-Term Care Facility Resident and Staff Member by February 1 (flgov.com)

January 23, 2021

    • Governor Ron DeSantis: Florida Putting Seniors First and Leading the Nation in Vaccinations for Those 65+ (flgov.com)

January 20, 2021

    • Florida Leads the Nation in Vaccines for Ages 65+ with Seniors First Approach (flgov.com)

January 15, 2021

    • Governor Ron DeSantis Applauds Federal Approval to Continue the Low-Income Pool Program (flgov.com)

January 12, 2021

    • CDC to Reverse Course and Follow Florida’s Lead Prioritizing “Seniors First” for Vaccinations (flgov.com)

January 12, 2021

    • Governor Ron DeSantis Provides Update on Florida’s COVID-19 Vaccine Distribution and Accountability (flgov.com)

January 11, 2021

    • Governor Ron DeSantis Highlights Florida Leading in Prioritizing Seniors (flgov.com)

January 9, 2021

    • Governor Ron DeSantis Provides Update on COVID-19 Vaccine Distribution Efforts (flgov.com)

January 7, 2021

    • Governor Ron DeSantis Highlights Vaccination Efforts in Indian River County (flgov.com)

January 7, 2021

    • ICYMI: Governor Ron DeSantis Highlights Vaccination Efforts in Manatee County (flgov.com)

January 6, 2021

    • Governor Ron DeSantis Announces Miami Hard Rock Stadium is Opening as the First State-Supported Vaccination and Testing Site (flgov.com)

January 6, 2021

    • Governor Ron DeSantis Announces Two New Vaccination Sites Operated by Sacred Heart Hospital (flgov.com)

January 4, 2021

    • Governor Ron DeSantis Announces Four New Actions to Increase Vaccinations, Reaffirms Commitment to Putting Florida “Seniors First” (flgov.com)

December 30, 2020

    • IN CASE YOU MISSED IT: Governor Ron DeSantis Provides Week Three Update of COVID-19 Vaccine Plan and Affirms Florida’s Commitment to Prioritizing Seniors 65+ (flgov.com)

December 3, 2020

    • Florida’s Medicaid Program Reaches Highest Quality Ratings Ever [197KB PDF]

December 2, 2020

    • Governor Ron DeSantis Provides Update on COVID-19 Vaccine Distribution Plan (flgov.com)

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Agency Alerts

  • Hospital and Physician COVID-19 Testing Criteria for Elderly and Medically Frail [159KB PDF]
  • Medicaid Coverage of Services During the State of Emergency Related to COVID-19 [580KB PDF]
  • COVID-19 Transfer Communication Tool [225KB PDF]
  • COVID-19 Facility Visitor Screening Toolkit [239KB PDF]
  • CDC Infection Prevention and Control Guidelines [169KB PDF]
  • Novel Coronavirus Update for Health Care Facilities and Providers [160KB PDF]
  • New ICD-10-CM code for the 2019 Novel Coronavirus (COVID-19) [89KB PDF]
  • ICD-10-CM Official Coding Guidelines – Supplement Coding encounters related to COVID-19 Coronavirus Outbreak [76KB PDF]
  • Information for Healthcare Facilities Concerning 2019 Novel Coronavirus Illness [111KB PDF]
  • UPDATED: Detection and Reporting of 2019 Novel Coronavirus (2019-nCoV) [196KB PDF]
  • The Commission for Florida Law Enforcement Accreditation Invites Public Comment on AHCA’s Office of the Inspector General’s Investigations Unit [132 KB PDF]
  • Important Message from Secretary Mayhew on the Importance of Reporting to the Emergency Status System [245 KB PDF]
  • Guidelines for the Surveillance, Investigation, and Control of Legionnaires’ Disease in Florida [365 KB PDF]
  • Reportable Diseases/Conditions in Florida [344 KB PDF]
  • The Agency’s Long Range Program Plan and Legislative Budget Requests can be viewed via the Florida Fiscal Portal.
  • Sign Up for Medicaid Health Care Alerts ∼ The Florida Medicaid program has an e-mail alert system to supplement the present method of receiving Provider Alerts information and to notify registered providers or interested parties of "late-breaking" health care information.
  • Sign up for Health Care Alerts ~ This service allows subscribers to receive an email alert for selected licensure and managed care updates, and other health care alerts.

Areas of Interest

Medicaid

Medicaid is the medical assistance program that provides access to health care for low-income families and individuals.

Regulation

The Division of Health Quality Assurance protects Floridians through oversight of health care providers.

About Us

Our Agency was statutorily created by Chapter 20, Florida Statutes as the chief health policy and planning entity for the state.

Contact Us

For questions or information, you may contact the Agency for Health Care Administration by feedback form or by phone toll-free at (888) 419-3456.

Facility Locator

The Florida Agency for Health Care Administration created FloridaHealthFinder.gov to provide easy access to health care information.

Report Fraud

You can help protect your tax dollars by reporting suspected fraud by phone, through the Internet or by regular mail.

Medicaid

Report A Complaint
Submit A Question

Medicaid is the medical assistance program that provides access to health care for low-income families and individuals. Medicaid also assists the elderly and people with disabilities with the costs of nursing facility care and other medical and long-term care expenses.

In Florida, the Agency for Health Care Administration (Agency) is responsible for Medicaid. The Agency successfully completed the implementation of the Statewide Medicaid Managed Care (SMMC) program in 2014. Under the SMMC program, most Medicaid recipients are enrolled in a health plan. Nationally accredited health plans were selected through a competitive procurement for participation in the program.

  • Statewide Medicaid Managed Care Program

    In 2011, the Florida Legislature created Part IV of Chapter 409, Florida Statutes, directing the Agency to create the Statewide Medicaid Managed Care (SMMC) program. The SMMC program has two key components: the Managed Medical Assistance program and the Long-term Care program.

  • Medicaid Finance and Analytics

    The Assistant Deputy Secretary for Medicaid Finance and Analytics is responsible for the oversight of the Bureaus of Medicaid Program Finance and Medicaid Data Analytics.

  • Medicaid Operations

    The Assistant Deputy Secretary for Medicaid Operations is responsible for the Bureaus of Medicaid Plan Management Operations, Medicaid Fiscal Agent Operations, and Recipient and Provider Assistance, and Enrollment Broker Operations.

  • Medicaid Policy and Quality

    The Assistant Deputy Secretary for Medicaid Policy and Quality oversees the Bureaus of Policy and Quality.

  • Program Coordination

    The Program Coordination Section is responsible for the development and implementation of infrastructure to support project/initiative tracking and accountability, and project management and process improvement efforts for the Division of Medicaid. The Program Coordination Section is also responsible for the coordination and support of Division of Medicaid activities including correspondence, public records, Medicaid provider alerts and the Quarterly Medicaid provider bulletins, maintenance of the Florida Medicaid provider Training e-Library, coordination of the Medical Care Advisory Committee and other cross divisional activities.

Please click on the link below to view a high level organizational chart of the Medicaid Division. This organizational chart will help you navigate our site.

Florida Division of Medicaid 2019

Licensure & Regulation

The Division of Health Quality Assurance protects Floridians through oversight of health care providers. The Division is funded with more than $49 million in state and federal funds. Health Quality Assurance licenses and/or certifies and regulates 40 different types of health care providers, including hospitals, nursing homes, assisted living facilities, and home health agencies. In total, the Division licenses, certifies, regulates or provides exemptions for more than 42,000 providers.



  • Bureau of Central Services

    Provides services and support to the other five bureaus within the Division of Health Quality Assurance. The Bureau of Central Services is comprised of four units: The Background Screening Unit, The Financial Analysis Unit, The Central Intake Unit, and the Training and Support Unit. These units are responsible for the receipt and distribution of all health care facility applications and associated fees; the background screening of facility owners, administrators, and personnel; the financial analysis of health care facilities; and the data support and training within the Division of Health Quality Assurance.

  • Bureau of Field Operations

    Completes onsite surveys to determine compliance with state licensure requirements, but also compliance with federal certification requirements for certified facilities. Additionally, this bureau is responsible for handling consumer complaints. View our map to find your local field office.

  • Bureau of Health Facility Regulation

    Handles health care licensure, Medicare and Medicaid certification, and regulation for hospitals, ambulatory surgical centers, home health agencies, hospices, clinical laboratories, nursing homes, assisted living facilities and all other types of health care providers. The Bureau also includes the health care risk manager licensure program, the organ donor education/registry program, and commercial managed care programs, and is the location of the certificate of need (CON) program, which reviews applications for new facilities and certain specialized services at hospitals, nursing homes, hospices and intermediate care facilities for the developmentally disabled.

  • Office of Plans & Construction

    The Office of Plans and Construction is primarily responsible for ensuring that hospitals, nursing homes, ambulatory surgical centers, and Intermediate Care Facilities for the Developmentally Disabled (ICF/DD) are safe, functional, and provide safety-to-life for the patients and residents.

  • Florida Center for Health Information and Policy Analysis

    The Florida Center for Health Information and Policy Analysis (Florida Center) is responsible for collecting, compiling, analyzing and disseminating health related data. Promotes the adoption of electronic health record systems through health information exchange, electronic prescribing and personal health records software in partnership with health care stakeholders statewide. The Florida Center collects adverse incident reports from hospitals, ambulatory surgery centers, HMOs, nursing homes, and assisted living facilities.

About the Agency

Our Agency was statutorily created by Chapter 20, Florida Statutes as the chief health policy and planning entity for the state. We are primarily responsible for the state's estimated $25.2 billion Medicaid program that will serve a projected 4.27 million Floridians in SFY 2016-17, the licensure of the state's 48,500 health care facilities and the sharing of health care data through the Florida Center for Health Information and Policy Analysis.

This year we are working to continue to reduce the number of uninsured across the state, to enhance our ability to target fraudulent providers, to reduce unnecessary regulation, and to reduce administrative costs in order to ensure that dollars go to serve patients and more.

Contact Us

  • To file a health care facility complaint, call (888) 419-3456, or complete the Health Care Facility Complaint Form. Search our FloridaHealthFinder.gov site to see if the facility you have concerns about is one that is regulated by our Agency.

  • To file a Medicaid fraud and abuse complaint, call (888) 419-3456, or complete the Medicaid fraud complaint form.

  • To request a publication, call (888) 419-3456. Many publications are available for viewing and printing on our AHCA Publications page.

  • For more information on our hotline, please visit Consumer Complaint, Publication and Information Call Center.

  • To contact specific bureaus or department, including those which license Florida health care providers, please look Inside AHCA for the department you require

  • For more information on AHCA, please visit Consumer Information.

  • For questions or information, you may contact the Agency for Health Care Administration by feedback form or by phone toll-free at (888) 419-3456.

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