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AHCA Secretary Recognizes National Nursing Home Week

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Agency for Health Care Administration (Agency) Secretary Justin M. Senior released the following statement today recognizing the beginning of National Nursing Home Week (May 14-20):

“This week, nursing homes across Florida will host events in honor of National Nursing Home Week. Nursing homes care for many of our state’s most vulnerable residents, and I am thankful for their commitment to improving the quality of life for Floridians. When our staff visit facilities around the state, we are often amazed at the level of care and service that nursing home staff and administrators provide for their residents. Please join me in recognizing the hard work and dedication shown by these facilities.”

To find more information about National Nursing Home Week, click here.

To utilize our nursing home comparison tool, view inspection reports and learn more about nursing homes in your community please visit our Nursing Home Guide.

AHCA Secretary Recognizes National Nurses Week

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Agency for Health Care Administration (Agency) Secretary Justin M. Senior released the following statement today recognizing National Nurses Week (May 6th– 12th):
“As we recognize National Nurses Week, I would like to thank all nurses who work throughout our state to provide passionate care for Floridians. The American Nurses Association has designated 2017 as the ‘Year of the Healthy Nurse,’ and this year’s National Nursing Week celebrates those nurses who are leading advocates for health and wellness. I also want to recognize all of the nurses who work for AHCA and help our Agency achieve its goal of Better Health Care for All Floridians. Nurses are on the frontline of caring for our vulnerable citizens, and I ask that you will please join me in celebrating all that they do for our state.”
To learn more about National Nurses Week please visit: http://www.nursingworld.org/nationalnursesweek.

March Monthly Actions from AHCA

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March Monthly Actions: Agency Took Licensure Action against Five Providers,
Eight Additional Providers Suspended from the Medicaid Program

The Agency for Health Care Administration (Agency) issued final orders to four providers for failure to meet licensure requirements in March.
There were three final orders to deny a license renewal and one to revoke an existing license. Some of these providers were enrolled in the Medicaid program and the Agency has terminated or is in the process of terminating their participation in the program.
The Agency also issued an Immediate Moratorium on Admissions to Little Friends Learning Center, Inc. dba Alpine Adult Care Center, an assisted living facility in Escambia County.
In addition, the Agency suspended eight providers from participation in the Medicaid program, prohibiting the providers from being paid for claims to the Medicaid program for furnishing, supervising a person who is furnishing, or causing a person to furnish goods or services.
Agency Medicaid terminations and suspensions typically result from failure to return funds due to the Agency within required timeframes; a charge, indictment, or guilty plea to a health care related crime; suspension, termination, or exclusion from Medicare or Medicaid in another state; or a license denial, revocation, suspension or termination by the licensing agency.
The chart below displays the Agency’s March licensure actions:

The chart below displays the Agency’s March Medicaid final order actions:

Further information about the actions and final orders can be found on the public records search page. Emergency orders, including moratoriums on admissions and suspensions, can also be found on the public records search page by searching the name of the facility.
The Agency encourages anyone who may have a concern or observes a problem in any health care facility or with any provider regulated by the Agency, to file a complaint by calling our consumer complaint line at 1-888-419-3456 or by reporting online at http://ahca.myflorida.com/Contact/call_center.shtml.
Tips about suspected fraud can be reported by calling the Attorney General’s Fraud Hotline at 1-866-966-7226 or the Agency’s Consumer Call Center at 1-888-419-3456. Anyone can report fraud online by visiting the Agency’s website at https://apps.ahca.myflorida.com/InspectorGeneral/fraud_complaintform.aspx.

Gov. Scott announces resignation of Melinda Miguel

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Eric Miller to join as Chief Inspector General

Governor Rick Scott today announced Chief Inspector General Melinda Miguel’s resignation, which will be effective today. Melinda Miguel will be pursuing opportunities in the private sector. Click HERE to see her resignation letter. Eric Miller, who currently serves as Inspector General at the Agency for Health Care Administration, will serve as the Governor’s Chief Inspector General beginning Friday, April 21, 2017.
Governor Scott said, “Melinda has done a great job serving our state as Inspector General, and I’m extremely grateful for her commitment to ensuring government remains accountable to Florida taxpayers. She has been a valuable part of my team for over six years and I wish her success in her new endeavor as a business owner.”
Melinda Miguel said, “I’d like to thank Governor Scott for his leadership during my time as his Chief Inspector General for the past six years. It has been an honor to serve Florida’s families and work to make Florida even better for our future generations.”
Governor Scott continues, “Eric has dedicated his career to serving our state for more than twenty years. As Inspector General at AHCA, Eric has firsthand experience in fighting fraud and ensuring tax dollars are used efficiently and effectively. I am confident he will continue his great work as Chief Inspector General in my office.”
Eric Miller has served in his current position as Inspector General at AHCA since September, 2011. Prior to this role, Eric served as Manager of Corporate Compliance at Citizens Property Insurance Corporation from 2008 to 2011. He has also served in various leadership roles in Florida state government since 1993. Eric received his Bachelor of Arts degree in Criminal Justice from the University of West Florida and his Master of Science in Public Administration from Troy University.

AHCA announces continued improvements in access to health care services for children

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The Agency for Health Care Administration (Agency) announced today that Florida’s Medicaid program showed significant improvement in a key national report on quality and access for children. The report showed continued improvement in children’s access to services for the second year in a row, with Florida once again showing gains in every single metric in the report. The 2016 Form 416 data reported to the Centers for Medicare & Medicaid Services (CMS) is a nationally recognized quality and access measure in the Medicaid program, and includes a yearly report that tracks the number of children who received preventive screening and dental services. The Agency saw improvements in children receiving blood lead screenings and the usage of dental and other oral health services, and Florida’s dental scores have improved every year since 2011.

Agency Secretary Justin M. Senior said, “The Agency has worked to improve quality and access simultaneously, and the increase in usage of Medicaid services by eligible children is a testament to the hard work that our Agency has done. Preventive services are vital for keeping Florida’s children healthy, and I am excited that we are delivering necessary health care to more eligible children than ever. Our managed care system is working as it was intended to, and we will continue to work to ensure that all Medicaid recipients have access to quality health care.”

During this reporting period, 36 percent of eligible children enrolled for 90 continuous days received a preventive dental service, such as dental cleanings and fluoride varnish, as calculated using the Child Core Set P-Dent measure. This is an increase of 3 percentage points from last year and 17 percentage points from the federal fiscal year 2012 report. In addition, this year 156,291 children received a sealant on a permanent molar, an increase of more than 16,550 children (12 percent) compared to last year. Over the reporting period, 38 percent of eligible enrollees accessed dental services provided by a dentist, an increase of 3 percentage points, and more than 41 percent of eligible enrollees accessed some form of oral health care through Medicaid. These dental scores are the highest in the history of the program. In addition, the ratio for eligible enrollees receiving an initial or periodic screening increased from 0.57 to 0.59. The Agency also achieved a 5.4 percent increase in children who were tested for lead in their blood.

States are required by CMS to inform all Medicaid-eligible individuals under the age of 21 of the availability of Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services, provide or arrange for the provision of screening services, arrange for necessary corrective treatment and annually report EPSDT performance information via Form CMS-416. For more information on the Agency’s Medicaid program, visit the Medicaid website at:  http://ahca.myflorida.com/Medicaid/index.shtml

AHCA Releases Statewide Medicaid Managed Care Re-Procurement Data Book

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The Agency for Health Care Administration (Agency) announced today the release of the Statewide Medicaid Managed Care (SMMC) data book in preparation for the program’s competitive re-procurement. The data book provides relevant background information that prospective plans will find useful in the development of their response to the Invitation to Negotiate (ITN), which the Agency will release in the summer of 2017. 

Agency Secretary Justin M. Senior said, “Releasing the data book is an important step in the re-procurement process of the SMMC program. We hope this will provide prospective plans with valuable information as they prepare their responses to the ITN. The Agency looks forward to working with the plans to provide the best possible health care for Medicaid recipients as we move through the first re-procurement of the program.”

The Agency is hosting a public meeting to address questions about the Statewide Medicaid Managed Care data book released on March 30, 2017. The public meeting will be held on Wednesday, April 12, 2017, 8:30am – 11:30am Eastern Time at the Agency for Health Care Administration, 2727 Mahan Drive, Bldg. 3, Conference Room A, Tallahassee, Fla.   32308. A conference number will be available for those unable to attend in person.

Dial In Number: 1-(877)-218-8845
Conference Code: 497-971-21# 

Anyone interested in the data book can download it from the SMMC re-procurement website. For additional information about the public meeting and the SMMC program, click here. 

Event Notification Service covers more than two million Floridians

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The Agency for Health Care Administration (Agency) announced today that the Florida Health Information Exchange’s (Florida HIE) Event Notification Service (ENS) has expanded to cover more than two million Florida residents. The ENS provides timely and secure notifications of patient hospital encounters to health care providers and health plans, who use these notifications to improve the delivery of patient care.
Agency Secretary Justin M. Senior said, “The ENS bridges a critical gap by notifying providers and health plans about their patients’ hospital visits. Reaching two million Floridians is an incredible milestone for this service, and the use of ENS and other health information technology platforms will be a key element in improving quality and reducing the cost of health care across the state.”
Together eight Florida health plans – Aetna, Florida Blue, Humana, Magellan Complete Care, Molina Healthcare, Prestige Health Choice, Sunshine Health, UnitedHealthcare and Wellcare of Florida – receive alerts on nearly half of all Florida Medicaid enrollees. This patient-authorized exchange provides information essential to improving care coordination, promoting primary care utilization and reducing health care costs.
Over 20 Accountable Care Organizations (ACOs) are also participating in ENS and together cover an additional 300,000 Florida residents. Each ACO is a group of doctors, hospitals, and other health care providers who voluntarily come together to provide high quality care to their Medicare patients. By keeping providers informed of patient hospital encounters, the ENS is making it easier to provide high quality care to Florida’s Medicare population.
The ENS was piloted in late 2013 and the dedicated service has delivered over 1.8 million notifications since its inception. For more information on this and other Florida HIE programs, please visit www.florida-hie.net.
The Agency for Health Care Administration is committed to better health care for all Floridians. The Agency administers Florida’s Medicaid program, licenses and regulates more than 49,000 health care facilities and 43 health plans, and publishes health care data and statistics at www.FloridaHealthFinder.gov.  Additional information about Agency initiatives is available via Facebook (AHCAFlorida), Twitter (@AHCA_FL) and YouTube (/AHCAFlorida).

Gov. Scott’s “Fighting for Florida’s Future” budget fights for patients and families

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The Agency for Health Care Administration (AHCA) today highlighted Governor Rick Scott’s “Fighting for Florida’s Future” Budget, which invests $27 billion in the agency. The Governor’s proposed budget includes important initiatives to improve transparency and protect patients at Florida hospitals, and invests funding to reduce administrative burdens in order to speed up the connection between health care providers and the Floridians they intend to serve.
Governor Scott said, “We have fought to make important reforms to fight price gouging at hospitals and help Floridians make informed decisions regarding the care offered to them and their families. This year, we are continuing our commitment to fighting for Florida patients and families by implementing initiatives that save millions of dollars in hospital costs and reduce burdensome regulations, helping to more easily connect Floridians to the care they need.”
Agency Secretary Justin M. Senior said, “With his ‘Fighting for Florida’s Future’ Budget, Governor Scott has continued to improve health care in Florida. By streamlining processes and removing burdensome regulations providers will be able to focus more on the quality of health care than the administrative burdens often associated with the health care field. This budget will allow our Agency to continue to ensure that Medicaid recipients are receiving the highest quality care, as we make investments in technology infrastructure that will help to support our goal of better health care for all Floridians.”
The “Fighting for Florida’s Future” Budget includes:
A savings of $298 million in hospital costs, which are responsible for the largest increases in Medicaid program expenditures. Governor Scott is committed to fighting for patients and families by working to prevent price gouging and unfair costs for medical care. Public hospitals, not-for-profit hospitals, and for-profit hospitals are all at an all-time low in how much charity care they are providing relative to their record profits. These proposed savings are accomplished by eliminating existing supplemental payments for hospitals who provide less charity care compared to the for-profit hospital industry.
A savings of $581 million by allowing Medicaid managed care plans to reimburse hospitals at more efficient rates compared to the traditional Medicaid program. Hospital services are the only services in Medicaid managed care where plans are forced to pay higher rates.
A savings of $50 million by slowing hospital inflation and eliminating an automatic increase in Medicaid hospital rates. 
$480,000 for improvements to the Online Licensing system and $610,000 for improvements to the Care Provider Background Screening Clearinghouse, which supports Governor Scott’s goal of reducing burdensome regulations on Florida businesses so they can invest more in serving families and communities. The Agency has already worked hard to eliminate duplication in the employee/operator background screening process and has reduced the burden and costs for those applying to work with children and vulnerable adults in Florida, and the “Fighting for Florida’s Future Budget” will build on this success. In addition to the Care Provider Background Screening Clearinghouse, the Agency has also worked to make investments in the online licensing system. The requested system modifications will allow providers to submit all licensure applications and changes online. These projects reduce undue burdens on businesses and state agencies by eliminating multiple duplicative screenings, reducing paperwork lowering costs, and ensuring the most effective methods are being used to connect those in need with potential healthcare providers. 
$750,000 for enhancements to the Provider Data Management System to streamline the application process for providers who wish to enroll in the Medicaid program, speeding up providers’ ability to begin serving Medicaid patients. These investments from the “Fighting for Florida’s Future” Budget will also allow Florida businesses to open sooner which in turns means generating revenue earlier in the business cycle and adding new jobs to the health care economy faster.
Emmett Reed, Executive Director, Florida Health Care Association, said, “Florida Health Care Association is grateful  to Governor Scott for his continued support of quality care and services for Florida’s frailest elders. We appreciate him fully funding Medicaid for nursing center services and for initiating the dialogue on the creation of a Prospective Payment System. In addition, his ‘Fighting for Florida’s Future’ Budget will help to further streamline the background screening process, allowing qualified employees applying at our centers to enter the long term care workforce faster so they can more quickly begin caring for nursing center residents.”
Bobby Lolley, Home Care Association of Florida said, “The investments in the Provider Data Management System in the ‘Fighting for Florida’s Future’ Budget will greatly streamline the application process for providers wishing to participate in the Medicaid program. Thanks to Governor Scott for streamlining the process, and allowing us to open our doors and serve Floridians in the most cost-effective, patient-preferred setting sooner.”