agency for health care administration health care clinic licensure unit n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Agency for Health Care Administration Health Care Clinic Licensure Unit PowerPoint Presentation
Download Presentation
Agency for Health Care Administration Health Care Clinic Licensure Unit

Loading in 2 Seconds...

play fullscreen
1 / 12

Agency for Health Care Administration Health Care Clinic Licensure Unit - PowerPoint PPT Presentation


  • 146 Views
  • Uploaded on

Agency for Health Care Administration Health Care Clinic Licensure Unit. Health Quality Assurance Gov. Rick Scott Liz Dudek Secretary. Public Records. Chapter 119, Florida Statutes Call direct On time and under budget Agency for Health Care Administration

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Agency for Health Care Administration Health Care Clinic Licensure Unit' - talasi


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
agency for health care administration health care clinic licensure unit

Agency for Health Care AdministrationHealth Care Clinic Licensure Unit

Health Quality Assurance

Gov. Rick Scott Liz Dudek

Secretary

public records
Public Records

Chapter 119, Florida Statutes

Call direct

On time and under budget

Agency for Health Care Administration

2727 Mahan Drive, Mail Stop #53

Tallahassee, FL 32308

(850) 412-4404

Tom.Jones@ahca.myflorida.com Manager

Dennis.LaRosa@ahca.myflorida.com OMC Mgr.

health care clinic act
Health Care Clinic Act

Agency for Health Care Administration, Division of Health Quality Assurance, Bureau of Health Facility Regulation, Health Care Clinic Unit

One of the most consequential penalties of the law is that all charges made by unlicensed clinics will be unlawful and uncollectible after March 1, 2004

legislative intent
Legislative Intent

The purpose of the Health Care Clinic Act is:

To provide for the licensure

Establishment and enforcement of basic standards for health care clinics

To provide administrative oversight by the Agency for Health Care Administration

what is a clinic
What is a “Clinic?”

"Clinic" means an entity where health care services are provided to individuals and which tenders charges for reimbursement for such services

exemption for wholly owned clinics
Exemption for “wholly owned” Clinics

Wholly owned by practitioner, and the spouse, parent, child or sibling

One of the owners is supervising business activities services performed

Legally responsible for compliance with state and federal laws

May not supervise services beyond the scope of the practitioner's license

need a license to bill pip in 2013
Need a License to bill PIP in 2013?

Notwithstanding this subsection, an entity shall be deemed a clinic and must be licensed under this part in order to receive reimbursement under the Florida Motor Vehicle No-Fault Law, ss. 627.730-627.7405, unless exempted under s. 627.736(5)(h)

s. 400.9905(4), Florida Statutes

pip 5 h licensing exemptions
PIP (5)(h) Licensing Exemptions

(5)(h) …However, this licensing requirement does not apply to:

1. wholly owned by an MD or DO and spouse, parent, child, or sibling of the physician

2. Dentist

3. Chiropractic physician

4. Hospital or ambulatory surgical center

6. Medical school

wholly owned
Wholly Owned

(17) "Entity wholly owned" means a [company] that provides health care services …by licensed health care practitioners and in which licensed health care practitioners are the business owners of:

All aspects of the business entity

Business owners on the title or lease of the physical facility

Filing taxes as the business owners

Account holders on the entity's bank account

Listed as the principals on incorporation documents

having ultimate authority over all personnel and compensation decisions relating to the [company]

false or misleading ahca application
False or Misleading AHCA Application

Knowingly presents, causes to be presented, or prepares or makes with knowledge or belief that [license or certificate of exemption]

Will be presented to any insurer a claim for personal injury protection insurance

false or misleading ahca application1
False or Misleading AHCA Application

If the person knows that the payee knowingly submitted a false, misleading, or fraudulent application or other document

for licensureas a health care clinic, or

seeking an exemption from licensure as a health care clinic, or demonstrating compliance with part X of chapter 400. = “Fraudulent Insurance Act”

challenges
Challenges

New law may not be investigated til late 2013, so there is time to prepare

Sharing information and with stakeholders

Knock on doors! “I am with the Division of Insurance Fraud and you’re not.”

--Col. Dan Anderson