An entity seeking a certificate of exemption must publish and maintain a schedule of charges for medical services charged to an uninsured person paying for such services by cash, check, credit card, or debit card as described in s. 400.9935 (6), Florida Statutes.
The Certificate of Exemption issued to the current exempted entity is valid only for the owner(s) and location for which it was originally issued. To report a transfer of ownership you must apply for a new initial certificate by completing the exemption application and providing all of the required documents, including a copy of the transfer documents.
Facilities which hold a Certificate of Exemption are required to request a change of address by submitting a completed Application for Certificate of Exemption as a Health Care Clinic. The application must be received by the Agency 21 to 120 days in advance of the effective date of the change of location. Refer to Rule 59A-35.040 (2)(b)(9), F.A.C.
The applicant must also meet the requirement as indicated in Rule 59A-35.060 (4), F.A.C.
Applications received prior to the change of address but less than 21 days in advance will be subject to a $500 fine. Refer to Rule 59A-35.040 (3), F.A.C.
Any information required to be reported to the agency must be submitted within 21 calendar days from the effective date of the change, as required by s. 408.810 (3), Florida Statutes.
Changes must be reported by completing the exemption application form.