Effective July 1, 2020, Behavior Analysis groups who are currently participating or wish to participate in the Medicaid program will need to show proof of having a health care clinic license as required under Fla. Stat. 400.9905 and 400.991 or show proof of exemption from licensure as a health care clinic as stated at Fla. Stat. 400.9905 and 400.9935. Note that in Florida a variety of provider group types including for example audiologists, chiropractors, dentists, licensed midwifes, physicians, physical therapists among other therapists types will need to meet the requirement deadline for establishing proof of licensure or exemption from licensure. See Rule 59G-1.60, F.A.C.
Per Florida Medicaid’s Provider Enrollment Draft Policy all providers including Behavior Analysis groups will need to submit an application for licensure or exemption between 60-120 days prior to requirement date. For Behavior Analysis groups the completed application must be submitted no later than Friday, May 1, 2020. We strongly recommend as does the Agency for Health Care Adminstration (AHCA) that the application process for licensure or exemption be started sooner rather than later as processing times will likely be delayed the closer to the date the application is filed. AHCA states that “[w]aiting to apply may cause delays due to heavier workloads as Medicaid rule deadlines approach for all health care providers.” See https://ahca.myflorida.com/MCHQ/Health_Facility_Regulation/Hospital_Outpatient/HealthCareClinic/docs/FAQ_BAHCC_060419_final.docx at FAQ # 5.
As stated above, the question is whether to apply for a health care clinic license or apply for an exemption from licensure. The answer depends on the general makeup/ownership for each specific group but generally speaking most groups will likely need to apply for licensure as their current ownership structure will not meet the requirements for filing an exemption from licensure.
It is recommended that a provider work with an experienced health care attorney who has experience with the requirements for licensure or requirements for meeting the exemption from licensure for various provider types including but not limited behavior analysis groups. Moreover, an experienced health care lawyer should be able to assist, coordinate with and provide guidance to the provider’s CPA who will prepare the facilities financial projections. The health care lawyer should also act as the provider’s principle when communicating with AHCA as it pertains to the application submitted as well as communicating, assisting and coordinating with the health care consultant, if requested, who will be tasked with preparing the facility and staff for the onsite inspection survey.
Mr. Rafael (Ralph) Gaitan, Esq., is experienced in these matters and can assist all different types of health care providers, including behavior analysis companies with filing for licensure or exemption as well as preparing and advising on whether to retain a medical doctor or osteopathic physician as medical director or to retain a health care practitioner who is also a Board Certified Behavior Analyst to act as the clinical director for the group. Mr. Gaitan can be reached at (786) 440-8115 or via email at [email protected] should you require additional information or assistance with this topic or any other health care related matter.