The Agency for Health Care Administration – AHCA, is responsible for the administration of the Florida Medicaid program, as well as for the licensure and regulation of Florida’s health facilities.
The Florida Legislature created the Agency for Health Care Administration as part of the Health Care Reform Act of 1992 (Ch. 92-33, Laws of Florida).
AHCA’s motto is “Better Health Care for All Floridians”. AHCA also works to reduce the number of uninsured across the State of Florida as well as targets fraudulent and unlicensed activities in the State.
Florida Statutes under section 400.9905(4), F.S. defines that a Health Care Clinic is an entity that provides health care services to individuals and tenders charges for reimbursement for these services to payors such as Medicare, Medicaid or other insurance. If an entity meets this complete definition, then it is a health care clinic.
Obtaining a Health Care Clinic license from AHCA is a multi-step process.
For new applicant licensees, the process entails the completion and submission of AHCA non-financial and financial forms along with supporting documentation including, but not limited to, Medical/Clinic Director agreement and demonstrate proof of funds, among others. In addition, level 2 background screening is required for some individuals listed on the application such as Owner(s), Administrator, Financial Officer, among others.
For Health Care Clinics who are undergoing a change of ownership – CHOW, the licensing application process is similar to that of the initial application.
Once the application package is submitted, the Agency will generate an application file number and the file is assigned to a lead specialist who will review the non- financial information and supporting documentation. The lead specialist will also send the Proof of Financial Ability to Operate form (Financial Schedules) to a financial analyst for review.
After both reviews are completed and deemed satisfactory, the lead specialist will notify the applicant that the file has been conditionally approved pending a non-deficient site survey.
At the inspection, the AHCA surveyor will request that the applicant licensee produce supporting Policies and Procedures that are in compliance with Florida Statutes and Administrative Codes.
It is important to highlight that some applicant licensees may qualify for an Exemption from Licensure as a Health Care Clinic provided that they qualify for an the exemption under F.S. 400.9905(4)(a-q).
The applicant licensee should carefully review the licensing requirements prior to filing the documentation and should consider seeking the assistance of a qualified health care consultant to be designated as the contact person to prepare, review, and coordinate the entire application process.