Provider materials and tools

Physician Incentive Programs

Magellan Complete Care’s Physician Incentive Programs are designed to promote the delivery of the high quality of care and increase positive outcomes. Below are the overviews that are a part of the MMA Physician Incentive Program (MPIP). If you qualified, you will receive a separate communication.

For Board Certified Pediatricians

To be eligible to participate in this physician incentive program, you must first be Board Certified in Pediatrics by the American Board of Pediatrics or the American Osteopathic Board of Pediatrics, practicing as a Primary Care Physician. In addition, you must also achieve both of the following access and quality measures for Magellan Complete Care’s Medicaid members.

 

Qualifications for Pediatric Primary Care Physicians

(Including pediatricians, family practitioners and general practitioners)


 

 

 

 

 

 

 

 

 

For Board Certified OB/GYNs

To be eligible to participate in this physician incentive program you must be Board Certified in Obstetrics and Gynecology by the American Board of Obstetrics and Gynecology or the American Osteopathic Board of Obstetrics and Gynecology. In addition, you must also achieve both of the following access and quality measures for Magellan Complete Care’s Medicaid members.

 

Qualifications for OB/GYNs

 

 

 

 

 

 

 

 

 

 

For Pediatric Specialists

All pediatric specialty types regardless of board certification.

 

Payments

Payments to Fee-For-Service (FFS) providers will be made using a Medicare fee schedule for covered services upon submission of a clean claim for dates of service beginning on or after October 1, 2018.

 

Excluded Providers

  • Non-Participating providers—Providers without a contractual arrangement with the plan to offer Included Services.
  • Federally Qualified Health Centers (FQHCs)—Services provided in an FQHC may not be included in the MMA Incentive Program, regardless of whether or not the service is billed by the FQHC as an FQHC service or by the rendering provider using their own Medicaid ID.
  • Rural Health Clinics (RHCs)—Services provided in an RHC may not be included in the MMA Incentive Program, regardless of whether or not the service is billed by the RHC as an RHC service or by the rendering provider using their own Medicaid ID
  • County Health Departments (CHDs)—Services provided in a CHD may not be included in the MMA Incentive Program, regardless of whether or not the service is billed by the CHD as a CHD service or by the rendering provider using their own Medicaid ID.

 

If you have any questions visit MCCofFL.com, reach out to your Provider Relations Services team or call us at 1-800-424-8584.