Resources

Client Alerts, News Articles, Blog Posts, & Multimedia

Everything you need to know about BMD and the industry.

CLIENT ALERT UPDATE: AHCA License Alert

Client Alert

IMPORTANT UPDATE:  AHCA updated its website to clarify that all Behavior Analysis (“BA”) Groups have either (1) a health care clinic license or (2) an exemption from licensure as a health care clinic under Fla. Stat. 400.9905(4)(g) by December 1, 2020.  Florida Medicaid has also updated Section 9.5, Appendix E of the Florida Medicaid Enrollment Policy, which confirms the December 1, 2020 date.  This date extends the previously published date from July 1, 2020 to December 1, 2020. 

BA Groups will only qualify for an exemption if (1) all of its owners are Florida-licensed health care practitioners (i.e. Licensed Mental Health Counselor), or (2) the BA Group is owned by a combination of Florida-licensed health care practitioner and the spouse, parent, child, or sibling of the Florida-licensed health care practitioner owner. 

BA Groups that do not qualify for the exemption must file an Application for Licensure as a Health Care Clinic with AHCA. As part of the application process, BA Groups will need to complete a Proof of Financial Ability to Operate. Additionally, BA Groups will need to complete Level 2 Background screenings for all employees and owners who will have contact with patients and/or access to patient information. 

BA Groups that qualify for the exemption must still file an Application for Certificate of Exemption as a Health Care Clinic with AHCA.

Health Care Clinic Licensure applications need to be filed at least 60 – 120 days prior to the effective date; therefore, for a license to be effective by December 1, 2020 the application will need to be submitted no later than September 30, 2020.

For additional information regarding updates to AHCA’s Behavior Analysis Policy, please refer to the Frequently Asked Questions Specific to Providers of Behavior Analysis Services.  

If you would like copies of the regulations, need legal assistance with filing your AHCA Health Care License application or Exemption application, or have any questions concerning these matters, please contact:

Member, Executive Committee
Licensed in Ohio & Florida
P: 330.253.9185
C: 330.351.1945
F: 330.253.9187

 

 


Employee or Independent Contractor? New Guidance Issued by the Department of Labor

On January 9, 2024, the U.S. Department of Labor (DOL) issued its long-awaited final rule — effective March 11, 2024 — revising its prior interpretation of worker classifications under the federal Fair Labor Standards Act (FLSA). The new final rule rescinds the standard previously established in 2021, in turn, shifting the analysis of whether a worker is an employee (versus an independent contractor) of a business from a more streamlined “economic reality” test to a more complex “totality of the circumstances” standard.

Increased Medicaid Rates to Take Effect This Month for Ohio Providers

As required by House Bill 33, Ohio’s 2024-2025 operating budget bill, reimbursement rates paid by the Ohio Department of Medicaid will increase for a wide range of providers starting on January 1, 2024.

Corporate Transparency Act Update

The Corporate Transparency Act (“CTA”), with an effective date of January 1, 2024, is set to impose strict reporting guidelines on business owners throughout the country. The following provides a brief update on two aspects of the CTA ahead of its effectiveness next week.

The Second Wave of UnitedHealthcare's Prior Authorization Cuts Started in November

In August 2023, UnitedHealthcare released its plan to eliminate roughly one-fifth of its then-current prior authorization requirements. The first round of prior authorization cuts took effect on September 1, 2023. In that round, UnitedHealthcare eliminated the necessity for some prior authorizations for UnitedHealthcare Medicare Advantage, UnitedHealthcare commercial, UnitedHealthcare Oxford and UnitedHealthcare Individual Exchange plan members. The second and final round of prior authorization cuts began on November 1, 2023. The November 2023 Prior Authorization Cuts apply to the same plans as well as community plans (i.e., Medicaid managed care plans).

Legal Uncertainties Remain Following Passage of Issue 1 in Ohio

In the November 2023 General Election, Ohio voters passed Issue 1 which, among other things, “[e]stablish[es] in the Constitution of the State of Ohio an individual right to one’s own reproductive medical treatment, including but not limited to abortion”. Despite passage of Issue 1, questions persist about how its codification on December 7 affects previously passed legislation restricting abortion and related pending court cases.