As Florida prepares to launch the next six-year phase of its Statewide Medicaid Managed Care (SMMC) program on January 1, 2025, an administrative law judge has scheduled a September hearing in response to lawsuits filed by two health plans challenging their exclusion from new managed care contracts. Judge Robert Cohen issued a notice on Monday, August 12, setting the hearing dates for September 4-6 and September 9-13 in Tallahassee.

The health plans in question, AmeriHealth Caritas Florida, Inc. and Sentara Care Alliance, LLC, are contesting decisions by the Agency for Health Care Administration (AHCA) to deny them contracts for managing care for Medicaid recipients. In April, AHCA announced its intent to award contracts to five health plans, with three additional plans added in July. These multi-year contracts, which cover approximately 3.1 million Medicaid recipients enrolled in managed care plans, represent a financial commitment of tens of billions of dollars.

AmeriHealth Caritas and Sentara are challenging various aspects of the year-long procurement process that led to these contract awards. Notably, another health plan, ImagineCare LLC, withdrew its challenge earlier this month.

The current SMMC system, established by lawmakers in 2011, mandates that most Medicaid recipients enroll in managed care plans. Since its inception, the AHCA has conducted three major contracting processes, including the most recent one, which began in 2023 and concluded this spring. In prior rounds, contracts were awarded across 11 regions of the state; however, the latest process reduced the number of regions to nine.