The Florida Agency for Health Care Administration (AHCA) has released its 2025 status report on the Intellectual and Developmental Disabilities Comprehensive Managed Care (ICMC) Program, providing the first comprehensive look at implementation, enrollment, and operations following the program’s transition from a regional pilot to statewide availability.

The report was submitted pursuant to section 409.9855(6)(b), Florida Statutes, and reflects data through December 1, 2025, covering both the pilot phase and the initial months of statewide expansion. 

Program Background and Legislative Authority

The ICMC Program was originally created during the 2023 Legislative Session through Senate Bill 2510, which authorized a voluntary pilot allowing adults with intellectual and developmental disabilities to receive comprehensive medical services and home- and community-based services (HCBS) — similar to those provided under the Developmental Disabilities Individual Budgeting (iBudget) Waiver — through a single Medicaid managed care plan.

During the 2025 Legislative Session, lawmakers enacted House Bill 1103, which amended section 409.9855, Florida Statutes, to authorize statewide expansion of the program and additional program refinements. Federal authority for the waiver was approved by the Centers for Medicare & Medicaid Services (CMS) effective April 1, 2024, with statewide expansion beginning October 1, 2025.

As part of the transition, AHCA rebranded the program in August 2025 from the “IDD Pilot” to the ICMC Program to better reflect its purpose and statewide scope. 

Managed Care Plan Selection and Statewide Operations

Following a legislatively authorized competitive procurement, Florida Community Care (FCC) was selected as the managed care plan responsible for delivering services under the ICMC Program. FCC initially operated the pilot in Regions D and I beginning October 1, 2024, and now serves as the single statewide plan following statutory amendments that extended its contract through expansion. 

Under the ICMC model, eligible individuals receive Managed Medical Assistance (MMA), Long-Term Care (LTC), and developmental disability waiver services through one integrated managed care delivery system.

Eligibility and Enrollment Growth

To qualify for the ICMC Program, individuals must:

• Be 18 years of age or older
• Have a developmental disability as defined in Chapter 393, Florida Statutes
• Meet Medicaid eligibility criteria
• Require an institutional level of care (intermediate care facility for individuals with intellectual disabilities)

Initial statewide expansion was limited to individuals in iBudget waiver pre-enrollment categories, with additional enrollment opportunities scheduled to begin July 1, 2026, for individuals already enrolled in the iBudget or LTC waivers. 

As of December 1, 2025, enrollment totaled 869 participants statewide, up from 702 on October 1, 2025, demonstrating steady early growth following expansion. AHCA reports that CMS approved an increase in waiver capacity to 2,108 participants statewide for the second year of operations, with the possibility of further increases if funding allows. 

Participant Demographics and Diagnoses

Enrollment demographic data show:

• 60% male and 40% female participation
• The largest age cohort is 22-29 years old, accounting for more than half of enrollees
• The most common diagnoses among participants include autism (pervasive developmental disorder), followed by cerebral palsy, intellectual disability, and Down syndrome

These data reflect a relatively young adult population transitioning into long-term supports and services. 

Participant Direction Option and Service Access

In response to participant feedback during the pilot, statutory changes added a Participant Direction Option (PDO) to the ICMC Program. Similar to Consumer Directed Care Plus (CDC+) under the iBudget waiver, PDO allows participants to self-direct certain services and select qualified providers, including family members.

PDO-eligible services now include:

• Personal care and personal supports
• Homemaker and companion services
• Life skills development
• Intermittent, skilled, and private duty nursing

FCC is responsible for authorizing and delivering all covered services, while AHCA monitors access through network adequacy reviews, complaints, and case file audits. 

Complaints, Disenrollment, and Program Stability

Since program inception, AHCA reports very low complaint volume, consisting of:

• One provider complaint
• Four recipient complaints, primarily related to requests for disenrollment

Participants may voluntarily disenroll at any time, with different pathways depending on length of enrollment and prior waiver participation. Early disenrollment data show that reasons included provider network availability, plan contact issues, and participant preference for prior managed care arrangements.

Overall, the data suggest relative program stability during both the pilot and early statewide rollout.

Oversight, Evaluation, and Next Steps

AHCA conducts ongoing internal oversight of the ICMC Program, including quarterly audits of person-centered planning, service authorization, incident reporting, and provider capacity. Preliminary findings from the pilot year indicate strong performance in care planning, provider qualifications, and participant safeguards.

In addition, AHCA has begun procurement of an External Quality Review Organization (EQRO) to conduct an independent evaluation of access, quality, and costs, with findings due to the Legislature by October 1, 2029.

Looking ahead, the next major milestone is the July 1, 2026 enrollment expansion, which will allow individuals currently enrolled in the iBudget or Long-Term Care Waivers to transition into the ICMC Program. 

Why This Matters for Providers

For providers serving individuals with intellectual and developmental disabilities, the ICMC Program represents a significant structural shift toward integrated managed care delivery. As enrollment continues to grow, provider participation, network adequacy, and operational readiness will remain central to the program’s long-term success.

HCAF will continue monitoring implementation, provider impacts, and evaluation findings as AHCA advances the program statewide.