Attention Behavior Analysis Providers – The July 1, 2020, Deadline for Medicaid Compliance is Rapidly Approaching.

Do you own or operate a Behavior Analysis group provider? If yes, are you ready for the July 1, 2020 deadline? as it is rapidly approaching.  All Behavior Analysis group providers will need to establish proof of compliance with the health clinic license requirements in order to continue receiving payments from the Florida Medicaid program and to avoid additional noncompliance sanctions and/or overpayments.  Our firm can assist group providers apply for licensure as a health care clinic or apply for the exemption from licensure.  However, it is important for providers to understand the distinctions between licensure and having an exemption from licensure.  See our earlier blog post at https://ragaitanlaw.com/to-be-or-not-to-be-that-is-to-be-licensed-as-a-florida-health-care-clinic-or-to-file-for-exemption-form-licensure/

It is imperative that Behavior Analysis group providers have an exemption from licensure or have a health care clinic license application filed no later than May 1, 2020 or well before the compliance date. Additionally, if you are group wholly owned (100%) by health care practitioners as set forth under Florida Statutes 400.9905(4)(g) of the Health Care Clinic Act, the chances are that unless the group is owned by a physician licensed under Chapters 458 or 459 of Florida Statutes that the qualified health care practitioner will also need to be certified as a Board Certified Behavior Analyst (BCBA) or a Board Certified Behavior Analyst Doctoral (BCBA-D) with the Behavior Analyst Certification Board in order to receive the exemption from licensure. Note that the qualified health care practitioner must supervise the business activities of the group and must be legally responsible for the group’s compliance with all federal and state laws.

Groups that do not qualify for an exemption from licensure as a health care clinic will need to file for an application with the Agency for Health Care Administration (AHCA) and will need to appoint via a written agreement a Medical or Clinical Director who can fulfill the statutory requirements imposed on the group.

Our firm can assist and provide legal guidance to the group in applying for either a health care clinic license or filing for the exemption as well as assisting the group on the legal differences between a Medical Director and a Clinical Director. If you need assistance, please contact Mr. Rafael (Ralph) Gaitan, Esq., who is experienced in these matters. Mr. Gaitan can be reached at (786) 440-8115 or via email at [email protected].