Florida Behavior Analysis Services – Overpayments

The Florida Agency for Health Care Administration (Agency), Medicaid Program Integrity (MPI) has and is undergoing review of several Behavior Analysis Services providers regarding their Medicaid reimbursement claims for services rendered. MPI is reviewing said claims in order to insure compliance with the program’s Florida Medicaid Behavior Analysis Services Coverage Policy dated October 2017, including proper documentation and eligibility of treating providers.

The MPI review consists in part on the eligibility of providers, specifically, registered agent technicians (RBTs), to insure proper “vetting” of the RBT’s qualifications to render services to Medicaid recipients under the supervision of the a lead analyst as well as the documentation requirements of Provider/employers.

Mr. Rafael Gaitan, Esq. (Ralph Gaitan) has successfully challenged MPI overpayments and has assisted numerous providers in reducing their overpayment exposure and saving them hundreds of thousands of dollars as well as lifting others from payment suspensions. If you are a provider experiencing a Medicaid audit, it is recommended that you contact Ralph Gaitan, Esq., an experienced healthcare attorney, at rg@ragaitanlaw.com or (786) 440-8115) so that he can assist your company in preparing for and responding to the audit on a timely basis and/or for exercising, if necessary, your right to appeal Final Audit Report findings and possible resulting overpayment. Please note that all appeals of MPI audits must be filed within 21 days of receiving the Final Audit Report (FAR).