The Agency for Health Care Administration (AHCA), Florida’s chief health policy and planning entity, issued a moratorium for enrollment of new durable medical equipment (DME) providers in the Florida Medicaid program effective March 20.
Under the initial six-month moratorium, which AHCA can extend, the agency will not accept any new applications for DME providers for Florida Medicaid enrollment, but will continue processing DMEPOS provider applications submitted on or before March 20. Existing DME providers can continue to provide and bill for authorized services.
On February 27, the Centers for Medicare & Medicaid Services announced a six-month nationwide enrollment moratorium prohibiting initial Medicare enrollment for seven types of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers. Florida is the first state to implement a similar Medicaid moratorium.
The moratorium does not apply to DMEPOS suppliers that operate as part of a pharmacy, hospital, or other medical provider or apply to businesses that provide DMEPOS as a secondary function.
According to a post by legal firm McDermott Will & Schulte, “Both moratoria exempt providers for which DME is not the ‘principal function,’ and Florida explicitly carves out pharmacies, hospitals, and other medical providers furnishing DME as a ‘secondary function.’ However, neither moratorium specifies how ‘principal function’ is determined (e.g., revenue percentage, personnel devoted to the different operations, location) and if investigated, what documentation would be required to support principal function.”
