Are You the Target of a Medicaid Audit? Tips Health Professionals Should Be Following
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The Agency for Health Care Administration (AHCA), Office of Inspector General (OIG), and Bureau of Medicaid Program Integrity is the Florida agency responsible for routine Medicaid audits The agency ensures that the Medicaid program was billed correctly for […]
Assisted Living Facilities (ALFs) Allowed to Terminate a Resident For Almost Any Reason
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Currently, Florida law and regulations allow an assisted living facility (ALF) to relocate or terminate a resident for almost any reason. However, the administrator must provide a 45-day notice and document the reason for termination or relocation. Section 429.28(k), […]
Orlando-based Assisted Living Facilities Appeal ALJ Decision, Win Case Against AHCA
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Two related assisted living facilities (ALFs) based in Orlando won a case against the Agency for Health Care Administration (AHCA) on appeal. The First District Court of Appeal heard the case and filed an opinion in favor of […]
Appeal Court Rules AHCA Was Justified in Withdrawing Home Health Agency’s License Application
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law The First District Court of Appeal has ruled that the Agency for Health Care Administration (AHCA) had substantial justification to withdraw a home health agency’s application for licensure in a recent case. To view the opinion, click here. […]
Invoking Fifth Amendment by Applicant’s Personnel May Result in Denial of Their Application for a License
The foregoing case summary was prepared by and appeared in the DOAH case notes of the Administrative Law Section newsletter FACTS: The Agency for Health Care Administration (“AHCA”) denied Avalon Assisted Living III’s (“Avalon III”) application for licensure of an assisted living facility in Orlando. Avalon III challenged the denial, and the case was referred […]
AHCA Expert Not Allowed to “Use His Discretion” in Deciding Claims Were Improper in Medicaid Appeal Hearing
FACTS: The Agency for Health Care Administration’s (“AHCA”) Office of Medicaid Program Integrity audited Dr. Rao, an authorized provider of Medicaid services, for claims between July 1, 2007, and June 30, 2009, and found him to be in violation of certain Medicaid provider policies. AHCA prepared a Final Audit Letter on June 1, 2011, notifying […]
Governor Requests the Agency for Health Care Administration to Inspect Florida’s VA Hospitals
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law In response to recent deaths at Veterans Affairs (VA) hospitals throughout Florida and the rest of the nation, on April 1, 2014, Governor Rick Scott wrote a letter to the Florida Agency for Health Care Administration (AHCA) requesting […]
A New Year Means New Audits and Site Visits for Assisted Living Facilities – Protect Yourself Now
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law For Assisted Living Facilities (ALFs) in Florida, it’s time to do a little brushing up on your compliance material. Beginning in January 2015, the Agency for Health Care Administration (AHCA), Office of Inspector General (OIG), Bureau of Medicaid […]
Florida Medicaid Audits Dental Claims
By Michael L. Smith, R.R.T., J.D., Board Certified by The Florida Bar in Health Law The Agency for Health Care Administration (AHCA) is auditing Medicaid claims submitted by dental providers in Florida. AHCA is auditing dental practices looking for claims that were not billed in compliance with the Florida Medicaid Dental Services Coverage and Limitations […]
ALFs Are Able to Terminate a Patient for Almost Any Reason in Florida
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Florida law and regulations currently allow an assisted living facility (ALF) to relocate or terminate a resident for almost any reason. However, the administrator must provide a 45-day notice and document the reason for termination or relocation. Section […]