Florida Healthy Kids Award
Simply Healthcare Plans, Inc. (Simply) has officially been awarded a Florida Healthy Kids (FHK) statewide contract. Effective January 1, 2020, Simply will offer coverage to FHK-eligible children in all 11 regions, representing 67 counties.
FHK’s mission is to ensure the availability of child-centered health plans that provide comprehensive, quality health care services. The program has a subsidized plan for children ages 5 through the end of age 18 whose families exceed the income eligibility threshold for Medicaid, as well as full-pay options available for those who don’t qualify for subsidized coverage.
The FHK plan is designed specifically with kids in mind and provides children with access to the services they need at each unique stage of growth and development. Health services are delivered through our network of local doctors, specialists, hospitals, pharmacies and other health care providers.
Provider news
The latest articles and announcements on claims filings, products, benefits, administrative updates, new and revised procedures and guidelines, prescription information, and more.
Medicaid/Florida Healthy Kids updates
Coverage of medication-assisted treatment drugs
Steps have been implemented in an effort to remove barriers for providers in the authorization process and facilitate member access to MAT drugs.
Expedited authorization requests downgraded to standard timeframes
As of September 1, 2021, the following services will be processed as standard only.
Resource guide: Member Medicaid Recertification
The Department for Children and Families will soon start the Medicaid recertification process for beneficiaries. Here is what you need to know:
Urgent — Medical device recall Philips Respironics respiratory equipment
Philip Respironics announced a voluntary recall for certain Continuous Positive Airway Pressure (CPAP), BiLevel Positive Airway Pressure (BiLevel PAP) and mechanical ventilator devices that may impact your patients.
Growth Hormone Authorization Requests
As of September 1, 2021, the length of all growth hormone authorizations, for children and adults, will be shortened to six months.
Medicare updates
Our new relationship with American Specialty Health
Simply and CHA are contracting with American Specialty Health Group, Inc.* (ASH) to provide quality acupuncture and chiropractic services
Reminder: provider incentive for medication reconciliation
Did you know that Simply pays $25 when a member’s medications post-hospital discharge has been reconciled with the current medication list in outpatient medical record?
2020 SNP Models of Care Annual Evaluations
Looking for the secure portal?
For Medicaid services provided before the rollout of the new Statewide Medicaid Managed Care and Managed Medical Assistance contract or Medicare services providers before January 1, 2019, please visit the previous Simply provider portal.
For services provided after the new Medicaid and Medicare plan rollouts, please visit the Availity portal.
Don't have an Availity account? Register for free now!
Need help with Availity? Learn more
Availity access
The Availity Portal offers health care professionals free access to real-time information and instant responses in a consistent format regardless of the payer.
At Availity, you can:
Request Authorizations.
Submit Claims.
Confirm Eligibility.
Don't have an Availity account? Register for free now!
Featured resources
Pharmacy Information
Search for up-to-date drug information, including hundreds of brand-name and generic medications.
Maternal Child Program
When it comes to our pregnant members, we are committed to keeping both mom and baby healthy. We encourage all our moms-to-be to take part in the Taking Care of Baby and Me® program, a comprehensive, proactive case management and care coordination program for all expectant mothers and their newborns.
Behavioral health provider
We work collaboratively with hospitals, group practices and independent behavioral health care providers, community and government agencies, human service districts and other resources to successfully meet the needs of members with mental health, substance use, and intellectual and developmental disabilities.
NCQA Health Plan Recognition
The National Committee for Quality Assurance has awarded an accreditation status of Accredited for service and clinical quality that meets the basic requirements of NCQA’s rigorous standards for consumer protection and quality improvement.
NCQA Health Plan Accreditation surveys include rigorous on-site and off-site evaluations of over 60 standards and selected HEDIS® measures. A team of physicians and health plan experts conducts accreditation surveys. A national oversight committee of physicians analyzes the team’s findings and assigns an accreditations level based on the performance of each plan being evaluated to NCQA’s standards.
