Florida Medicaid Health Information Network Powered by Availity

In 2008, the Agency for Health Care Administration initiated a project to use Medicaid claims data to give clinicians access to patient specific Medicaid claims information at the point of care. The Agency selected Availity, LLC to implement the project and demonstrate the value of the approach under a no cost contract. In November of 2009, the Florida Medicaid Health Information Network was launched, and it is now available for Medicaid treating providers.

Using the secure network portal, providers can access patient specific claims-based data, along with patient eligibility and a patient look up tool. The data includes prescription history, lab event history, hospital visits, diagnoses, and any other paid Medicaid claims information retroactive 18 months. The information comes directly from the Medicaid Management Information System (MMIS), to the Decision Support System (DSS), and is extracted and stored in a database maintained by the Agency’s Division of Information Technology.

The following link offers direct access to the Availity Portal home page where providers can register and log into the Florida Medicaid Health Information Network powered by Availity. Once registered, providers will have access to the Availity Care Profile; a claims-based electronic health record for Medicaid enrollees.

To access the data, providers must have explicit authorization from the patient, except in a medical emergency where the patient or family is unable or unavailable to consent.

For more information, please visit Availity’s website: http://www.availity.com/

Explicit Consent Requirements

To view Medicaid data in the Availity claims-based electronic health record, health care providers must obtain and maintain on file a patient authorization form from each patient that provides consent for the use and release of all medical and billing records, including explicit consent for the use and release of sensitive data. Sensitive data included in the claims-based records may reveal mental health, substance abuse, HIV/AIDS, sexually transmitted diseases, and abortion-related claims. Displaying this information provides a more complete patient record but its release requires explicit patient consent.

The link below offers an example of an authorization form that meets the requirement for obtaining explicit consent.

http://fhin.net/PSresourceCtr/FLPSproject/FLconsentFinalFull060410.pdf (653KB)

Providers may also use their own authorization form but must be sure to include language, such as the language provided below, to assure that the patient has given explicit consent:

I voluntarily authorize and give my permission to allow disclosure of all my health information including any information about sensitive conditions.  Records that may be released include all information regarding my health history, hospitalization, tests and outpatient care. This information may relate to sensitive health conditions including, but not limited to:

• Drug alcohol or substance abuse
• Mental health or developmental disabilities (excluding psychotherapy notes)
• Sickle Cell Anemia
• Birth control and family planning
• Sexually transmitted disease, HIV/AIDS, tuberculosis
• Genetic diseases or tests

Frequently Asked Questions

For additional information regarding the Medicaid Health Information Network, including access information, patient full disclosure, and additional information concerning the privacy and security of patient health records, please see the frequently asked questions document below.

Medicaid Health Information Network FAQ .pdf (108KB)

Updates