The State of Florida Agency for Health Care Administration (AHCA) has the duty to regulate provider enrollment which includes managed care, facility and home and community based services, applicant eligibility for practitioners and suppliers, and provider outreach and compliance.
Florida Statutes Title XXX Chapter 409, Social Welfare provides details for the Medicaid Provider license eligibility and bond requirements. Physician groups, transportation providers, independent laboratories, durable medical equipment (DME), home and community based services (HCBS) and home health agency provider's bond requirements are as follows:
1. A $50,000 surety bond may be required for the application process and maintained for the first 12 months unless otherwise noted.
2. A surety bond is required for each provider location up to a maximum of five locations.
3. Surety bond renewals are due to AHCA within 30 days prior to the expiration date.
4. Physician groups with 50% or more ownership by non-physicians requires a surety bond. The exception is if the physician group is owned by a non-profit entity, then a bond is not required.
5. Transportation providers are required to have a bond unless they enroll with a zero dollar ($0.00) rate.
6. Durable medical equipment (DME) providers require a surety bond. Pharmacy providers enrolled in Medicaid may not need a surety bond if they only need a DME locater number. Medicaid requires DME providers to provide a surety bond annually.
7. Home and community based services (HCBS) waiver providers (when ownership or control is by a DME or home health agency that is not Medicaid enrolled).
8. Home health agency providers are required to have a surety bond if within the past five years there were or currently have had sanctions or terminations (voluntary or involuntary). A surety bond is not required enrolling for the first time in the Medicaid program and there have been no license sanctions or terminations. This exception extends to satellite locations, under the same tax identification number as well.
The premium that you pay for a Florida Medicaid Provider Bond is dependent on credit and experience.
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