Florida
LLC
Website link to register:
https://dos.myflorida.com/sunbiz
Naming conventions
Name cannot include terms like “Bank” without additional approvals.
Must include “Limited Liability Company,” “LLC,” or “L.L.C.” PLLC required for licensed professionals.
Licensing Requirements
Professional licenses must be validated by the Florida Board of Medicine.
Proof of malpractice insurance required. Additional licensing for controlled substance dispensing may apply.
Required documentation for medical practices
Articles of Organization, Malpractice Insurance, Professional Licenses, Controlled Substances Certificate
Filing Fee: $125
Annual/Biennial Fee: $138.75
Additional Notes: Annual report due May 1.
Medicaid
Program Name: Florida Medicaid
Official Website: https://ahca.myflorida.com/medicaid
Legislation: Florida passed SB 80 and HB 37 in 2018, defining Direct Primary Care (DPC) agreements as not being insurance, thereby exempting them from insurance regulations.
Private Contracting
Permitted; DPC agreements are explicitly allowed and are not subject to state insurance laws.
Restrictions
No explicit restrictions for DPC providers; compliance with federal and state regulations is necessary.
Medicaid Program
Florida Medicaid provides health coverage to eligible low-income residents, including children.
Notification Requirements
Notification required if declining Medicaid coverage for services.
Provider Enrollment Requirements
Providers must enroll with Florida Medicaid to serve beneficiaries directly or offer reimbursable services.
Enrollment Options
No "Ordering and Referring Only" status available.
Ordering, Referrals, and Testing
Non-enrolled providers may face challenges with Medicaid recognition for orders and referrals.
Designated PCP Restrictions
DPC physicians cannot act as PCPs without Medicaid enrollment.
Billing and Reimbursement
DPC practices typically do not bill Medicaid for services covered under private agreements.
Managed Care Plan Exemptions
Not specified.
Billing Clarity
Cannot bill Medicaid patients for covered services without clear agreements.
CMS Guidance
CMS supports state-specific innovations for Medicaid delivery frameworks.
Opportunities for Collaboration
Potential collaboration with Medicaid Managed Care Organizations (MCOs) or participation in state healthcare initiatives.
State-Specific Notes
Collaboration possible with Florida's Medicaid Managed Care plans to integrate DPC models.
Dispensing Medication
Board of Pharmacy Official Link: https://floridaspharmacy.gov/
State Licensing
Physicians must register with the Florida Department of Health for dispensing medications.
Scope of Practice
Dispensing medications is allowed for physicians; additional rules apply for controlled substances.
Inventory Management
Inventory records must be meticulously maintained, and storage must meet state security requirements.
Record-Keeping
Records must meet Florida Department of Health standards and HIPAA compliance.
Dispensing Standards
Medication labels must meet state standards, including details such as patient name, dosage, and instructions.
Controlled Substances
Controlled substances require DEA registration and reporting to the E-FORCSE PDMP.
Billing and Reimbursement
Billing practices must align with federal Stark Law and state-specific requirements.
Federal Compliance
Adherence to federal and Florida Department of Health regulations is mandatory.
State Pharmacy Laws
Physicians dispensing medications must comply with the Florida Board of Pharmacy requirements.
Patient Consent
Informed consent is required for all dispensed medications.
Insurance and Liability
Physicians must ensure their malpractice insurance includes coverage for in-office dispensing.
Training Requirements
Continuing education specific to Florida’s controlled substances regulations is required.
Audits and Inspections
Florida Department of Health conducts regular inspections; non-compliance can result in penalties or suspension of privileges.