The Medicaid Providers Surety Bond guarantees that healthcare providers will conduct business honestly while complying with state statutes. There are several requirements to meet within a minimal amount of time to avoid deactivation from the Medicaid program.
Health care providers who accept Medicaid can include physician groups, ambulance transportation providers, physican groups, durable medical equipment (DME) providers, home health agencies and personal care assistance providers.
Medicaid is a joint federal and state government program, and the government wants to make sure the program is not abused by the providers. Depending on the state, Minnesota, Texas and Florida providers and suppliers may need a Medicaid Provider Bond.
The State of Florida Agency for Health Care Administration (AHCA) may require physician groups, transportation providers, independent laboratories, durable medical equipment (DME), home and community based services (HCBS) and home health agency’s providers to obtain a bond based on the following:
1. A $50,000 surety bond may be required for the application process and maintained for the first twelve 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 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 all satellite locations having the same tax identification number.
The State of Minnesota Department of Human Services requires personal care assistance (PCA's) that are Medicare-certified Class A licensed home health agencies, personal care provider organizations, and PCA Choice agencies to obtain a surety bond based on the following:
1. An initial start-up agency provider is required to have a $50,000 bond.
2. For subsequent years, if annual PCA payments from Medicaid in the previous calendar year were less than $300,000, the $50,000 surety bond requirement continues.
3. If the annual PCA payments from Medicaid were more than $300,000 in the previous calendar year, a $100,000 surety bond is required.
4. The bond requirement remains in effect each year as long as Medicaid payments are received.
5. In addition to the bond requirement, the state also requires a $20,000 fidelity bond.
The State of Texas Health and Human Services Commission & Healthcare Partnership (TMHP) requires durable medical equipment (DME) suppliers and ambulance and air ambulance providers to obtain a surety bond based on the following:
1. DME providers are required to submit a $50,000 surety bond for an initial enrollment, enrollment for a new practice location, or for re-enrollment.
2. Ambulance (non-government) providers are required to have a $50,000surety bond for each license they are re-enrolling.
3. If the business has multiple locations the total bond amount increases by $50,000 for each location (example: three locations will have one bond form with a $150,000 bond amount).
How Much Will This Bond Cost?
The premium that you pay for a Medicaid Provider Bond varies and is dependent on the state requiring the bond, the bond amount and personal credit. For bond amounts exceeding $50,000, personal and business financial statements are required.
Our Surety Bond Specialists are ready to assist you with your bonding needs.
Hours: 8:00-5:00 CST, Monday through Friday
For more information, read our Blog on Medicaid Provider Bonds.