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Medicaid Providers Required to Obtain Clinic Licensure or Clinic Exemption Certificate

The firm’s health care department offers knowledge about how Florida Medicaid is in the process of updating the Provider General Handbook (“Handbook”) and will soon begin requiring a copy of either a health care clinic license, or a certificate of exemption from licensure as a health care clinic, from newly enrolling providers.  Once the handbook changes are adopted, the Agency for Health Care Administration (“AHCA”) will announce a roll-out schedule for existing providers to submit either the license or certificate of exemption.   Existing providers who require a license and presently do not hold one are encouraged to immediately obtain their health care clinic license.  Providers who are required to be licensed and who are not presently licensed are engaged in unlicensed activity, which is subject to sanctions.  Furthermore, Medicaid reimbursements to unlicensed entities are subject to recoupment.

Providers who are exempt from licensure under Florida’s Health Care Clinic law, Florida Statutes §400.990- §400.995, should consider seeking the exemption certificate sooner rather than later as ACHA’s Health Care Clinic Unit reports higher numbers of exemption applications already.  Once the Handbook is amended, Medicaid will begin rejecting claims unless a health care clinic license or exemption certificate is on file. This could result in significant reimbursement delays.

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