Florida’s Agency for Health Care Administration Reviews Proposed Changes to Crossover-Only Provider Enrollment Requirements

Dec 21, 2012


Florida’s Agency for Health Care Administration (“AHCA”) held a hearing on December 19, 2012 for the purpose of discussing changes to the “Crossover-Only” policy in an amendment to Rule 59G-5.020, “Provider Requirements,” which revises the Florida Medicaid Provider General Handbook. 

AHCA is proposing changes to Crossover-Only Provider Enrollment Requirements, which would include Crossover-Only Durable Medical Equipment Providers. These providers will now be required to submit a Medicare Approval Letter, an Explanation of Benefits showing a claim paid with a date of service within 30 days prior to the application submission, a letter on company letterhead signed by a company officer attesting that the provider meets all Florida Medicaid provider enrollment criteria, and completed fingerprint cards.

AHCA is also proposing additional exclusions to Crossover-Only Providers including home health agencies, physician groups with majority ownership composed of non-physicians, entities that have been sanctioned by Florida Medicaid and providers that have been involuntarily terminated. 

During the hearing, the Florida Association of Nurse Practitioners expressed concern that nurse practitioner-owned providers would be excluded from being Crossover-Only Providers under the exclusion of non-physician-owned providers.  Several other current independent Crossover-Only Providers echoed similar concerns.

A complete copy of the proposed Rule changes is attached for review.


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