Florida’s Agency for Health Care Administration (AHCA) has announced two upcoming public hearings on a proposed amendment to the state’s Medicaid Managed Medical Assistance (MMA) 1115 Waiver — specifically concerning the Family Home Health Aide (FHHA) Services Program, also known as the Home Health Aide for Medically Fragile Children Program. 

AHCA is seeking federal approval from the Centers for Medicare & Medicaid Services (CMS) to amend its MMA Section 1115 Demonstration to strengthen the FHHA program in two key ways:

• Implement an Income Disregard for Family Caregivers – This provision would ensure that income earned by family caregivers under the FHHA program is excluded from Medicaid eligibility determinations. This change protects families by allowing them to receive compensation for providing authorized care to their medically fragile children without risking the loss of Medicaid coverage.
• Expand the Home Health Workforce by Adding a New Eligible Provider Type – The amendment would allow private duty nursing (PDN) specialty providers — specifically those enrolled as Provider Type 65 with Specialty Code 221 — to bill Medicaid for FHHA services, thereby increasing the pool of available providers and improve access to care for children with complex medical needs.

These updates are designed to fix barriers that have hindered the program’s success since its launch in 2023 and to close persistent care gaps for medically fragile children enrolled in Medicaid.

HCAF played a leading role during the 2025 legislative session that resulted in the passage of SB 1156, which corrected critical flaws in the original 2023 law that created the FHHA program. The proposed amendment reflects the key policy reforms secured through this legislation.

Next Steps

Before these changes can take effect, AHCA must secure CMS approval — and provider input is a critical part of the process. AHCA will hold two in-person public hearings, and provider participation is strongly encouraged:

Monday, July 28, 2025
1:00-2:00 PM
AHCA Headquarters
2727 Mahan Dr.
Tallahassee, FL 32308

Tuesday, July 29, 2025
1:00-2:00 PM
Zora Neale Hurston State Building
400 W. Robinson St.
North Tower, Room N-109
Orlando, FL 32801

Providers may also submit written comments by August 16, 2025 via mail or email:

Agency for Health Care Administration
RE: Managed Medical Assistance Amendment
2727 Mahan Dr., MS #20
Tallahassee, FL 32308
FLMedicaidWaivers@ahca.myflorida.com (Please reference “Managed Medical Assistance” in the subject line.)

HCAF will be present at both hearings to advocate on behalf of Florida’s Medicaid home health provider community and to ensure policymakers fully understand the operational challenges agencies face. We are committed to holding AHCA and CMS accountable for implementing the program improvements secured through SB 1156 — and we encourage providers to join us in this effort by attending a hearing, submitting comments, or sharing your insights with HCAF.