Agency for Health Care Administration (Agency) Secretary Mary Mayhew recognized Governor Ron DeSantis and President Donald Trump for their commitment to putting patients first. [Read more…] about AHCA Secretary Mayhew Applauds Gov. DeSantis & President Trump’s Unprecedented Efforts to Improve Health Care Pricing
The Florida Association for Behavior Analysis (FABA) today called on the state
Agency for Health Care Administration (AHCA) to immediately address significant issues in how behavior analysis providers throughout Florida are approved and authorized to provide treatment for children. The association said many children with autism or other developmental disorders are being denied medically necessary behavior analysis services as a result of harmful delays, routinely lasting a month or longer, by a state contractor hired by AHCA.
The Agency for Health Care Administration (AHCA) today launched a new, interactive website that allows families to find out which nursing homes and assisted living facilities (ALFs) in Florida are in compliance with the emergency power rules. This webpage updates daily and enables viewers to view data by county, facility type, and status of compliance. Recognizing the significant public interest in this issue, AHCA is prioritizing the transparency of this data availability.
AHCA also announced that currently, 99 percent of nursing homes and a majority of the assisted living facility (ALF) beds are in homes that have the emergency backup power that is required by the rules or have submitted a plan to have this power installed within the coming months. AHCA’s new website is important as it will be updated daily to reflect facilities coming into compliance with the rules and those installing emergency backup power. Data shows that 683 of 684 nursing homes are in compliance, and 1,620 ALFs are in compliance, representing 71,974 licensed beds out of 101,997.
Secretary Justin Senior said, “Ensuring the safety of the patients and residents in Florida’s nursing homes and assisted living facilities is our Agency’s top priority, and we’re proud that Florida is one of the first states in the country to require this critical safety measure. Families must have the assurance that the facilities responsible for caring for their loved ones have the resources needed to be fully prepared ahead of any potential storms. These life-saving rules put safeguards in place and now, more than ever, facilities are prepared for an event that could knock out power. We will continue to do everything in our power to hold these important facilities accountable and strictly enforce these rules which include fines for facilities refusing to comply.”
AHCA is working with state and local officials to inspect the facilities that have implemented their emergency plan to ensure compliance. If a facility has not documented compliance, AHCA will issue fines and other penalties. The Agency is also actively working to bring every facility in Florida into compliance and hold those accountable that are not.
Pursuant to Florida law, a private business may seek a variance from any rule, given the business meets stringent requirements specific to that variance. While extensions are allowable under the rule, before one is approved by AHCA, the facility must provide a detailed explanation of how they will ensure patient protection during the extension timeframe. There are a variety of reasons a facility could request an extension, for example if they are waiting on the local emergency management officials to approve their plan, or if they are waiting on permits for construction or zoning. Extension details include how patient temperatures will remain safe during loss of power, such as how the facility will be cooled and evacuation plans if needed.
Examples of plans during the extension period include:
- Bringing a temporary generator onsite during power outages;
- Contracting for priority fuel replenishment during a power outage;
- Moving residents to common areas that can be cooled with an existing generator; and
- Evacuation if needed.
AHCA is tasked with regulating the state’s nursing homes and ALFs, which ensure that Florida’s most vulnerable populations are safe. These licensed facilities must comply with all rules including patient care standards, medication assistance and administration, and other life safety measures; the same compliance is expected for emergency power requirements. Inspections are ongoing to monitor compliance.
To easily see the status of compliance for nursing homes and assisted living facilities click here. This easy to use site allows you to see the status of implementation by facility, facility type and county.
Florida Association for Behavior Analysis’ Response
The Florida Association for Behavior Analysis (FABA) today commended the state Agency for Health Care Administration (AHCA) for issuing a temporary moratorium on the enrollment of new behavior analysis providers in Miami-Dade and Broward counties. The issue of Medicaid fraud and abuse is something that board-certified behavior analysts take very seriously, and FABA is grateful that AHCA is aggressively investigating and prosecuting fraudulent providers. [Read more…] about Florida Association for Behavior Analysis Responds to Recent Moratorium on Enrollment of New Providers in Miami and Broward
TALLAHASSEE, Fla. – Today, the Agency for Health Care Administration (AHCA) released a timeline of actions regarding the state of Florida’s continued work urging the federal government to reauthorize and extend the federal Children’s Health Insurance Program (CHIP). For months AHCA and the Florida Healthy Kids Corporation have been working with federal partners and conducting weekly meetings with our Florida KidCare partners which includes the Florida Healthy Kids Corporation, Florida Department of Health and Department of Children and Families to plan and implement strategies related to CHIP reauthorization. AHCA has also participated in calls regarding CHIP arranged by the federal Centers for Medicare and Medicaid Services (CMS), the National Academy for State Health Policy, and the National Medicaid Directors Association.
Secretary Justin Senior said, “Governor Scott has made it clear that he supports reauthorizing CHIP and the state of Florida fully expects Congress to act immediately on CHIP reauthorization. Our Agency is closely monitoring Congressional activity regarding the extension of CHIP funding. We remain hopeful that Congress will act to ensure that the many children and families that rely on this federal program have continued and uninterrupted service. Our Agency has been involved in discussions on CHIP reauthorization since August with federal CMS. Additionally, representatives from Florida Healthy Kids have been in Washington, D.C. to pursue this reauthorization since the summer of 2016. AHCA will do everything to ensure that these children have health care, and Florida has funding to continue the CHIP program through January. We will continue to reevaluate funds as this process moves forward. Ultimately, the continuation of this important federal program requires federal action.”
CHIP Related Planning:
· Contingency calls to discuss how Florida would ensure seamless operations following CHIP reauthorization, including short term and long term plans were held on August 23, September 19, October 13, October 27, November 3, November 11, November 17, December 1, December 8, and December 15. These calls included AHCA, Florida Healthy Kids and the Department of Health.
· Calls with CMS to discuss Florida’s availability of CHIP funding were held on August 17, September 23, October 4, December 19, and December 21.
· Florida Healthy Kids continues to have internal discussions and partner calls scheduled on October 6, November 3, and December 1, where congressional action around CHIP reauthorization was discussed.
· Florida submitted the CHIP funding template to the Centers for Medicare and Medicaid Services (CMS) with estimated need for November and December of 2017 on October 4, 2017.
“FHCA is extremely disappointed with the Agency for Health Care Administration (AHCA), which today chose to use the media as a vehicle to release unfavorable information about nursing homes that are in fact working to comply with the Governor’s Emergency Power Plan Rule. Several facilities on the list not only submitted their documentation, but those variance requests have also been published on the AHCA website since October 16. The agency appears to have made no attempt to contact facilities in advance to verify the accuracy of this ill-conceived list before releasing it to the public.
FHCA has consistently stated its willingness to work with the agency to strengthen the emergency procedures in nursing centers and assisted living facilities in order to ensure that residents are safe during disasters. It appears AHCA is more interested in generating news stories than in gathering facts and arriving at a place of consensus to will ensure that nursing homes meet the Governor’s mandate, despite its unrealistic timeline. Despite this disappointment, we remain committed to working with the Governor and his administration to adopt workable procedures to protect the well-being of those entrusted to our care.”
Agency for Health Care Administration (AHCA) Secretary Justin Senior today announced that 23 nursing homes have not responded to requirements in Emergency Rule 59AER17-1. By October 31, all nursing homes were required to submit a detailed plan to AHCA or apply for a waiver. These facilities will be subjected to the fine of $1,000 per day or license revocation starting November 15 if they fail to come into compliance by the deadline.
Secretary Senior said, “It is of the utmost importance that the nursing homes who have not responded do so immediately. These rules were implemented with the safety of patients and residents in nursing homes in mind. Our Agency will continue to work to aggressively implement this life-saving rule. Our goal is compliance with the emergency rule, and we will continue working to bring facilities into compliance.”
A list of facilities that have not responded to AHCA regarding the Emergency Rule is below:
The Agency for Health Care Administration Secretary Justin Senior today released the following statement on the upcoming Florida Healthy Kids Board meeting.
Secretary Senior said, “Our Agency remains steadfastly committed to ensuring that no children lose their insurance coverage due to Hurricane Irma. During tomorrow’s Board meeting, the Board will hear and discuss the facts and the options Florida may have. We look forward to learning the facts, and discussing strategies that ensure that no child loses insurance as a result of Hurricane Irma.”
Ensuring that children have access to health care has always been a priority of our Agency. Under Governor Scott’s leadership, Florida has had much success in lowering the rate of uninsured children. According to a Georgetown University study, in 2009 Florida’s uninsured rate among children was 14.8 percent, and by 2016 had dropped to 6.2 percent. This is the second best improvement of any state in the U.S. this decade.
To qualify for CHIP, families can have incomes between 133 percent and 200 percent of the poverty level. This means the children in a family of four would qualify with an annual income between $33,000 and $49,000. Children included in the full-pay population are families living over 200 percent of the federal poverty line.
The Agency for Health Care Administration (Agency) is now accepting nominations for the 2017 Fraud Fighter Achievement Award. This award recognizes an individual, team or entity whose efforts to reduce or deter fraud increased integrity in health care while supporting the Agency’s mission of providing better health care for all Floridians.
A nominee of this award may be a Medicaid recipient or provider, government official or entity, or a private citizen who demonstrates the Agency’s values of accountability, fairness, responsiveness, and teamwork in efforts that helped to detect, prosecute, or prevent fraudulent activity in health care.
Nominations will be accepted through November 3, 2017 and award winners will be recognized during Fraud Awareness Week (November 12-18, 2017). The nomination form and a list of past winners are available on the Agency’s website.
The Agency uses many techniques to deter fraud or abuse in the Medicaid program including, but not limited to:
- Field initiatives that incorporate teams of investigators focusing on a single provider type making unannounced visits and specific checks regarding Medicaid billing, necessary medical services rendered, proper licenses, and certifications;
- Third-party billing verification to ensure that Medicaid is the payer of last resort;
- In-house data-mining and analytical efforts that allow the Agency to perform random audits of providers’ billing activities and run targeted audits of providers that bill outside the average for their provider type; and
- Educational programs for providers to help them understand the Medicaid billing process, the laws, rules and regulations that apply to them as providers.
In addition, the Agency, in collaboration with the Office of the Attorney General, annually releases a comprehensive report highlighting efforts to reduce and deter fraud and abuse. Click here to view the 2015-16 Florida Medicaid Fraud and Abuse Annual Report.
Please see the below statement from the Agency for Health Care Administration (AHCA):
“The Agency for Health Care Administration (AHCA) provided additional information about the Emergency Power Plan Rule. This does not repeal or modify the requirements of the Emergency Power Plan Rule. Nursing homes and assisted living facilities are still required within 60 days of the rule being published to have working generators and 96 hours of fuel to keep patients safe and comfortable.
“This information outlines the rule variance process where under extreme circumstances beyond a facility’s control, a facility can request more time to comply with this life-saving rule per Florida law. Each variance request must contain: steps the nursing home has taken to implement the rule, specific circumstances beyond the facilities control that have prevented full implementation, what arrangements have been made to fully implement the rule, a plan to inform residents and their families of the variance request, and an estimated time of full compliance with the rule. Each request will be thoroughly reviewed for consideration by AHCA.
“Yesterday, Governor Rick Scott directed AHCA and the Department of Elder Affairs (DOEA) to begin the full rulemaking process to make the emergency power plan rule permanent. Again this variance process is already defined in Florida law and does not change the emergency rule that was issued on September 16th in any way. AHCA will continue to aggressively enforce this emergency rule to keep patients safe.”