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FAQs: Medicaid Provider Minimum Wage Requirements, Fee-for-Service Fee Schedules, and Supplemental Wage Agreement

The funds appropriated to support the $15.00 minimum wage will be applied to certain Medicaid fee-for-service (FFS) reimbursement fee schedules and managed care rates as directed in the 22/23 General Appropriations Act (GAA). The impacted FFS Medicaid reimbursement fee schedules will be posted to the Provider Reimbursement Schedules and Billing Codes page on the Agency’s website once the increases are final. Please continue to check this page in the coming weeks for updates on fee schedule increases.

Medicaid Fee-For-Service Fee Schedules Receiving an Increase:

  • Assistive Care Services Fee Schedule
  • Behavioral Health Overlay Services
  • Birthing Center Fee Schedule
  • Child Health Targeted Case Management Services Fee Schedule
  • Community Behavioral Health Services
  • Dental Fee Schedule
  • Hearing Services Fee Schedule
  • Home Health Visit Services Fee Schedule
  • Licensed Midwives Fee Schedule
  • Medical Foster Care Services Fee Schedule
  • Mental Health Targeted Case Management Services Fee Schedule
  • Occupational Therapy Services Fee Schedule
  • Personal Care Services Fee Schedule
  • Physical Therapy Fee Schedule
  • Practitioner Fee Schedule
  • Prescribed Pediatric Extended Care Services Fee Schedule
  • Private Duty Nursing Services Fee Schedule
  • Radiology Fee Schedule
  • Respiratory Therapy Services Fee Schedule
  • Specialized Therapeutic Services
  • Speech-Language Pathology Services Fee Schedule
  • Transportation Services Fee Schedule
  • Visual Services Fee Schedule
  • FQHC/RHC Rates
  • Hospice Room & Board Rates and Level of Care
  • Hospital and ASC Inpatient and Outpatient Services Fee-for-Service Rates
  • ICF/IID Fee-for-Service Rates
  • Nursing Home Fee-for-Service Rates

 

The Agency is finalizing the fee-for-service fee schedule increases related to the minimum wage. The Agency anticipates completion of all fee schedule increases by October 1, 2022. The increases for Nursing Homes, Federally Qualified Health Centers and Rural Health Clinic rates will be effective October 1, 2022. All other Fee Schedule increases related to the minimum wage will be complete by October 1, 2022, and retroactively effective to July 1, 2022. Please continue to check this page in the coming weeks for updates on the remaining impacted fee schedule increases.

At this time, the following fee schedules have been updated with the increase related to the minimum wage:

Completed Medicaid Fee-For-Service Fee Schedule Increases

The Medicaid Fee-for service fee schedules listed on the “Fee Schedules,” tab of this webpage will receive an increase. Florida Medicaid Providers who bill for services under the impacted fee schedules will be reimbursed at the increased rates.

The Agency will publish the Supplemental Wage Agreement on August 4, 2022, to the Medicaid Provider Secure Web Portal at http://mymedicaid-florida.com. A provider who logs in to their Secure Web Portal account on or after August 4, 2022, will be able to review and sign the supplemental wage agreement.

Providers must complete the supplemental wage agreement by October 1, 2022.

Please Note: Providers who enroll after October 1, 2022, will complete the provider supplemental wage agreement during the Medicaid provider enrollment process. For providers who enroll after October 1, 2022, the supplemental wage agreement will have the same effective date as the provider’s Medicaid Provider Agreement.

No. All providers who bill for services under the impacted fee schedules must sign the Medicaid Provider Supplemental Wage Agreement and will be reimbursed under at the increased rates. Providers who fail to sign the agreement will be subject to recoupment of funds associated with the minimum wage requirement.

Providers must sign the Medicaid Provider Supplemental Wage Agreement and will be reimbursed under the increased fee schedules. Providers who fail to sign the agreement will be subject to recoupment of funds associated with the minimum wage requirement.

Yes. All providers who bill for services under the impacted fee schedules must sign the Medicaid Provider Supplemental Wage Agreement and will be reimbursed under at the increased rates.

Providers who fail to sign the agreement will be subject to recoupment of funds associated with the minimum wage requirement.

Yes. Capitated rates paid to the plans for the contract year beginning on October 1, 2022, will include funds that were appropriated in the 22/23 General Appropriations Act to increase Medicaid managed care rates for Florida Medicaid Managed Medical Assistance (MMA) and Long-Term Care (LTC) Plans for the sole purpose of raising wages of employees of Medicaid providers including 1099 employees who provide services under the Florida Medicaid Program to at least $15.00 per hour.

A Direct Care Worker is defined as an individual that has direct contact with a Medicaid recipient for purposes of providing a Medicaid reimbursable service. Direct care workers do not include individuals who do not provide a Medicaid reimbursable service, whose primary duty is maintaining the physical environment of the workplace, or whose duties are primarily administrative.

The list below has examples of healthcare industry professionals that are considered direct care workers. This list is illustrative only and is not all-inclusive.

Examples of Direct Care Workers

  • Social and Human Service Assistants
  • Community Health Workers
  • Community and Social Service Specialists
  • Acupuncturists
  • Cardiovascular Technologists and Technicians
  • Diagnostic Medical Sonographers
  • Nuclear Medicine Technologists
  • Radiologic Technologists and Technicians
  • Magnetic Resonance Imaging Technologists
  • Emergency Medical Technicians and Paramedics
  • Dietetic Technicians
  • Psychiatric Technicians
  • Surgical Technologists
  • Ophthalmic Medical Technicians
  • Licensed Practical/ Licensed Vocational Nurses
  • Hearing Aid Specialists
  • Surgical Assistants, and other Technical Healthcare Workers
  • Home Health and Personal Care Aides
  • Nursing Assistants
  • Orderlies
  • Psychiatric Aides
  • Occupational Therapy Assistants
  • Occupational Therapy Aides
  • Physical Therapist Assistants
  • Physical Therapist Aides
  • Massage Therapists
  • Dental Assistants
  • Medical Assistants
  • Healthcare Support Workers
  • Ambulance Drivers and Attendants

During the enrollment process Full and Limited providers receive a welcome letter containing a Florida Medicaid ID. Following receipt of the welcome letter, providers also receive a PIN letter. Providers must visit https://public.flmmis.com/public/pinletter, and use their Medicaid ID and PIN to create an account on the Secure Web Portal.

Secure Web Portal account users can use the self-service Reset Password tool to unlock the account if the account’s password has expired, or if the user has forgotten the password. To view detailed instructions on how to reset a password, please visit the Medicaid public Web Portal at http://mymedicaid-florida.com and navigate to Provider Services > Training > Quick Reference Guides and select Reset an Account Password Quick Reference Guide (QRG).

Note: Providers that need help creating a Secure Web Portal account and require a PIN, should visit the Medicaid public Web Portal at http://mymedicaid-florida.com and navigate to Provider Services > Support > Contact Us. 

All providers, including local governments, who are enrolled with the Florida Medicaid program and who bill using the included fee-schedules found here are included in the minimum wage requirement. With the exception of nursing homes, this requirement is limited to employees providing direct care services within the service category(ies) for which the provider/employer is enrolled.

Example: If a provider is enrolled as an ambulance/transportation provider, the entity would only be required to pay $15 an hour for those employees providing direct care within the enrollment category, meaning only direct care employees for the ambulance/transportation category would need to be increased.

The Agency is finalizing the fee-for-service fee schedule increases related to the minimum wage requirement and is expecting these to be completed well before the October 1, 2022, deadline. As each fee schedule is updated, the Agency will notify providers impacted by the specified fee schedule.

Increases for Nursing Homes, Federally Qualified Health Centers and Rural Health Clinic rates will be effective October 1, 2022. All other fee schedule increases related to the minimum wage will be complete by October 1, 2022 and will be made retroactive for claims processed on and after July 1, 2022.

For all providers other than nursing home providers, the requirement applies only to direct care workers employed by the enrolled Medicaid Provider.

A Direct Care Worker is defined as an individual that has direct contact with a Medicaid recipient for purposes of providing a Medicaid reimbursable service. Direct care workers do not include individuals who do not provide a Medicaid reimbursable service, whose primary duty is maintaining the physical environment of the workplace, or whose duties are primarily administrative.

Medicaid providers, including local governments, who are reimbursed for services under the following Medicaid fee-for-service fee schedules must sign the supplemental wage agreement related to direct care employees (or all employees if the provider is a nursing home provider):

  • Assistive Care Services Fee Schedule
  • Behavioral Health Overlay Services
  • Birthing Center Fee Schedule
  • Child Health Targeted Case Management Services Fee Schedule
  • Community Behavioral Health Services
  • Dental Fee Schedule
  • Hearing Services Fee Schedule
  • Home Health Visit Services Fee Schedule
  • Licensed Midwives Fee Schedule
  • Medical Foster Care Services Fee Schedule
  • Mental Health Targeted Case Management Services Fee Schedule
  • Occupational Therapy Services Fee Schedule
  • Personal Care Services Fee Schedule
  • Physical Therapy Fee Schedule
  • Practitioner Fee Schedule
  • Prescribed Pediatric Extended Care Services Fee Schedule
  • Private Duty Nursing Services Fee Schedule
  • Radiology Fee Schedule
  • Respiratory Therapy Services Fee Schedule
  • Specialized Therapeutic Services
  • Speech-Language Pathology Services Fee Schedule
  • Transportation Services Fee Schedule
  • Visual Services Fee Schedule
  • FQHC/RHC Rates
  • Hospice Room & Board Rates and Level of Care
  • Hospital and ASC Inpatient and Outpatient Services Fee-for-Service Rates
  • ICF/IID Fee-for-Service Rates
  • Nursing Home Fee-for-Service Rates

Medicaid Fee-for-Service Fee Schedules that did not receive an increase to support the minimum wage can be found HERE. Medicaid providers who are reimbursed exclusively under these fee schedules do not have to sign the supplemental wage agreement.

Only Nursing Home providers will be obligated to pay all employees a minimum wage of $15 per hour.

The language in the supplemental wage agreement mirrors that found in proviso throughout the GAA, which states:

The agency shall enter into a supplemental wage agreement with each provider to include this minimum wage requirement to ensure compliance. The agreement must require the provider to agree to pay each of its employees at least $15.00 per hour. The agreement shall include an attestation under penalty of perjury under section 837.012, Florida Statutes, stating that every employee of the provider, as of October 1, 2022, will be paid at least $15.00 per hour.

However, the GAA provides additional proviso to clarify this requirement for providers who are not enrolled as nursing homes which states the requirement applies to only direct care employees. An example is below:

From the funds in Specific Appropriation 208, $333,481 from the General Revenue Fund and $506,521 from the Medical Care Trust Fund are provided to the Agency for Health Care Administration to adjust fee for service rates at the annual rate setting date for the sole purpose of raising wages of direct care employees of Medicaid providers including 1099 employees who provide services under the Florida Medicaid Program to at least $15.00 per hour. The funds are contingent upon House Bill 539 or similar legislation becoming law.

The initial supplemental wage agreement included an introductory wherefore clause to account for this as noted below:

WHEREFORE, The Agency and the Provider (the “Parties”) are required to enter into this Agreement to ensure that as of October 1, 2022, all employees, including 1099 employees of the Provider are paid at least $15.00 per hour pursuant to the State of Florida General Appropriations Act (“GAA”) for State Fiscal Year 2022-2023.

However, in an effort to provide additional clarity for providers, the Agency will insert the following language into the supplemental wage agreement as underlined below:

“On behalf of the Provider, I attest under the penalty of perjury pursuant to section 837.012, Florida Statutes, that as of October 1, 2022, all employees impacted by the requirements of the 2022-2023 General Appropriations Act, including employees defined as 1099 workers, will be paid at least $15.00 per hour.

The requirement is limited to employees providing direct care services for the service category in which the local government is enrolled as a Florida Medicaid provider.

Example: If the public entity is enrolled as an ambulance/transportation provider, the entity would only be required to pay $15 an hour for those employees providing direct care within the enrollment category, meaning only direct care employees for the ambulance/transportation category would need to be increased.

The Agency is finalizing the fee-for-service fee schedule increases related to the minimum wage requirement and is expecting these to be completed well before the October 1, 2022, deadline. As each fee schedule is updated, the Agency will notify providers impacted by the specified fee schedule.

Increases for Nursing Homes, Federally Qualified Health Centers and Rural Health Clinic rates will be effective October 1, 2022. All other Fee Schedule increases related to the minimum wage will be complete by October 1, 2022 and will be made retroactive for claims processed on and after July 1, 2022.

For all providers other than Nursing Facility providers, the requirement applies only to direct care workers employed by the enrolled Medicaid Provider.

A Direct Care Worker is defined as an individual that has direct contact with a Medicaid recipient for purposes of providing a Medicaid reimbursable service. Direct care workers do not include individuals who do not provide a Medicaid reimbursable service, whose primary duty is maintaining the physical environment of the workplace, or whose duties are primarily administrative.

The GAA includes these funds through the standard Florida Medicaid rate setting process, meaning the increase is paid on a per claim basis based on a calculated rate adjustment, rather than a one-time lump sum payment. The Legislature DID NOT allocate this funding based specifically on whether a provider is a public or private entity, nor specifically to local governments. This is how the Legislature funds the Florida Medicaid program and is no different than how providers are reimbursed today.

Medicaid providers, including local governments, who are reimbursed for services under the following Medicaid fee-for-service fee schedules must sign the supplemental wage agreement related to direct care employees (or all employees if the provider is a nursing home provider):

  • Assistive Care Services Fee Schedule
  • Behavioral Health Overlay Services
  • Birthing Center Fee Schedule
  • Child Health Targeted Case Management Services Fee Schedule
  • Community Behavioral Health Services
  • Dental Fee Schedule
  • Hearing Services Fee Schedule
  • Home Health Visit Services Fee Schedule
  • Licensed Midwives Fee Schedule
  • Medical Foster Care Services Fee Schedule
  • Mental Health Targeted Case Management Services Fee Schedule
  • Occupational Therapy Services Fee Schedule
  • Personal Care Services Fee Schedule
  • Physical Therapy Fee Schedule
  • Practitioner Fee Schedule
  • Prescribed Pediatric Extended Care Services Fee Schedule
  • Private Duty Nursing Services Fee Schedule
  • Radiology Fee Schedule
  • Respiratory Therapy Services Fee Schedule
  • Specialized Therapeutic Services
  • Speech-Language Pathology Services Fee Schedule
  • Transportation Services Fee Schedule
  • Visual Services Fee Schedule
  • FQHC/RHC Rates
  • Hospice Room & Board Rates and Level of Care
  • Hospital and ASC Inpatient and Outpatient Services Fee-for-Service Rates
  • ICF/IID Fee-for-Service Rates
  • Nursing Home Fee-for-Service Rates

Medicaid Fee-for-Service Fee Schedules that did not receive an increase to support the minimum wage can be found HERE. Medicaid providers who are reimbursed exclusively under these fee schedules do not have to sign the supplemental wage agreement.

Only Nursing Home providers will be obligated to pay all employees a minimum wage of $15 per hour.

The language in the supplemental wage agreement mirrors that found in proviso throughout the GAA, which states:

The agency shall enter into a supplemental wage agreement with each provider to include this minimum wage requirement to ensure compliance. The agreement must require the provider to agree to pay each of its employees at least $15.00 per hour. The agreement shall include an attestation under penalty of perjury under section 837.012, Florida Statutes, stating that every employee of the provider, as of October 1, 2022, will be paid at least $15.00 per hour.

However, the GAA provides additional proviso to clarify this requirement for providers who are not enrolled as nursing homes which states the requirement applies to only direct care employees. An example is below:

From the funds in Specific Appropriation 208, $333,481 from the General Revenue Fund and $506,521 from the Medical Care Trust Fund are provided to the Agency for Health Care Administration to adjust fee for service rates at the annual rate setting date for the sole purpose of raising wages of direct care employees of Medicaid providers including 1099 employees who provide services under the Florida Medicaid Program to at least $15.00 per hour. The funds are contingent upon House Bill 539 or similar legislation becoming law.

The initial supplemental wage agreement included an introductory wherefore clause to account for this as noted below:

WHEREFORE, The Agency and the Provider (the “Parties”) are required to enter into this Agreement to ensure that as of October 1, 2022, all employees, including 1099 employees of the Provider are paid at least $15.00 per hour pursuant to the State of Florida General Appropriations Act (“GAA”) for State Fiscal Year 2022-2023.

However, in an effort to provide additional clarity for providers, the Agency will insert the following language into the supplemental wage agreement as underlined below:

“On behalf of the Provider, I attest under the penalty of perjury pursuant to section 837.012, Florida Statutes, that as of October 1, 2022, all employees impacted by the requirements of the 2022-2023 General Appropriations Act, including employees defined as 1099 workers, will be paid at least $15.00 per hour.

Capitation rates that become effective on October 1, 2022, will include the necessary funding for plans to begin reimbursement their network providers beginning on October 1, 2022.