The Centers for Medicare & Medicaid Services (CMS) has extended the temporary moratorium on new home health agency enrollments into the Florida Medicaid program through July 29, 2021. However, there currently are other opportunities to become a Florida Medicaid service provider through various Medicaid Waiver programs.
These programs waive many of the rules which providers and recipients of Medicaid must meet in order to participate. The purpose of the Waiver programs is to expand services to meet the needs of specific groups of people who have certain health and social needs and are unable to pay for services.
In Florida, the Medicaid Waiver program is administered by the Agency for Health Care Administration and the Agency for Persons with Disabilities, (APD). Each agency provides services to specific types of recipients through the Home and Community-Based Services (HCBS) waiver program. HCBS programs generally fall into two categories: health services and human services. HCBS programs may offer a combination of both types of services and do not necessarily offer all services from either category.
Aside from the traditional medical or medically oriented services, waiver programs also reimburse for services as varied as architects, carpenters, electricians, dietitian services, transportation and plumbers, among many others. However, Medicaid only reimburses for services that are determined to be medically necessary. A medical necessity determination must be made by a qualified professional (such as a registered nurse, board-certified behavior analyst, qualified developmental disabilities professional, or physician) and must be obtained at least annually and periodically upon request to determine that the level of service requested continues to meet the level of the recipient’s need.
General long-term care-oriented business opportunities exist in addition to those currently reimbursed by Medicaid in spite of the moratorium on enrollment of new home health agencies. Whether or not the Medicaid extends the moratorium for home health agency enrollment in 6-month increments, you have many options available to leverage the unique growth on the horizon for the long-term care industry. Here are some recent blogs on some of your options: general info, nurse registry, APD, and group homes.