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Minimal Wage Enhance for Workers of Florida Medicaid Suppliers – JD Supra

On June 2, 2022, Governor DeSantis signed the “Freedom First Funds” for Fiscal Yr 2022-2023 for the only real function of accelerating the minimal wage for workers and unbiased contractors of Medicaid suppliers to no less than $15.00 an hour. The Florida Legislature allotted over $600 million in funding to the Florida Company for Well being Care Administration (“AHCA”) to help Medicaid suppliers with this new minimal wage requirement. These funds might be utilized to sure Medicaid fee-for-service (FFS) reimbursement price schedules and managed care charges.

What’s Required?

The brand new invoice (HB 5001 – Normal Appropriations Act) requires that AHCA enter right into a Supplemental Minimal Wage Settlement (the “Settlement”) with every affected Medicaid supplier no later than October 1, 2022. Beneath the Settlement, the supplier will attest below penalty of perjury that each worker of the Medicaid supplier, as of October 1, 2022, might be paid no less than fifteen {dollars} ($15) per hour. Whereas the Settlement makes reference to “each worker of the Medical supplier,” AHCA has clarified that for all suppliers aside from nursing house suppliers, this new wage requirement will solely apply to direct care workers. As well as, observe that the brand new wage requirement will apply to each workers and unbiased contractors.

What’s a Direct Care Worker?

AHCA has outlined a Direct Care Employee as a person that has direct contact with a Medicaid recipient for functions of offering a Medicaid reimbursable service. Direct care employees don’t embrace people who don’t present a Medicaid reimbursable service, whose main responsibility is sustaining the bodily atmosphere of the office, or whose duties are primarily administrative. AHCA offered an illustrative record of direct care employees on its website.

Are Managed Care Plans Lined?

Medicaid managed care plans might be required to enter into an settlement with AHCA to make sure the funds allotted to the plans are used to lift the wages of direct care workers of Medicaid suppliers. The managed care plan shall additionally present an attestation to AHCA that they’ve amended every supplier’s contract reimbursement fee to adjust to this provision by January 1, 2023. Consequently, managed care plans receiving monies from Medicaid might want to revise their contracts with Medicaid suppliers to extend the suppliers’ contracted charges to permit the suppliers to lift their direct care workers’ wages.

Are There Any Exceptions?

The Medicaid Payment-For-Service Payment Schedules listed under is not going to obtain a rise associated to the minimal wage requirement. Florida Medicaid suppliers who invoice solely below these price schedules should not required to signal the Settlement and to pay their direct care workers $15.00 per hour.

  • Habits Evaluation Payment Schedule
  • Neighborhood-Primarily based Substance Abuse County Match Payment Schedule
  • County Well being Division Licensed Match Program Payment Schedule
  • Sturdy Medical Tools and Medical Provide Companies Supplier Payment Schedule for All Medicaid Recipients
  • Early Intervention Companies Payment Schedule
  • Medicaid Licensed Faculty Match Program Payment Schedule
  • Doctor Pediatric Surgical procedure Payment Schedule
  • Prescribed Medication Immunization Payment Schedule
  • Prescribed Medication Doctor Administered Billing Codes
  • Regional Perinatal Intensive Care Middle (RPICC) Neonatal Companies Payment Schedule
  • Regional Perinatal Intensive Care Middle (RPICC) Obstetrical Companies Payment Schedule
  • Focused Case Administration for Kids at Danger of Abuse and Neglect

What are the Dangers for Non-Compliant Medicaid Suppliers?

Starting January 1, 2023, a direct care worker of a Medicaid supplier that’s not receiving a wage of no less than fifteen {dollars} ($15) per hour might convey a civil motion in courtroom towards the Medicaid supplier and, upon prevailing, is entitled to get well the complete quantity of any again wages unlawfully withheld plus the identical quantity as liquidated damages and shall be awarded cheap lawyer’s charges and prices.

As well as, primarily based on info offered by AHCA, suppliers who fail to signal the Settlement might be topic to recoupment of funds related to the minimal wage requirement.

Will AHCA Present Extra Steering?

AHCA arrange a Regularly Requested Questions (“FAQ”) web page on its website. Suppliers might submit inquiries to AHCA in reference to this new wage requirement. Questions submitted might be used to replace the FAQ web page. Suppliers ought to evaluate this web page usually for updates and clarifications.

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