Medicaid Provider Bond - Statewide in Florida

Brief Summary

The Florida Medicaid provider bond is not one flat number. DME suppliers post $50,000 per location, while other fee for service providers can be asked for an amount tied to what they bill Medicaid. Knowing which rule applies before you apply keeps the enrollment from stalling, and the bond is written on AHCA Form 5000-1064, the form the agency incorporates into its enrollment rule.

Florida's Agency for Health Care Administration requires a surety bond from durable medical equipment and medical supply providers under s. 409.912(8)(b), set at $50,000 for each provider location. Under s. 409.907(7), AHCA may also require a bond from other Medicaid providers paid on a fee for service or non cost based fee schedule basis, in an amount up to $50,000 or the provider's total Medicaid billing for the current or most recent calendar year, whichever is greater. Bonds are filed on AHCA Form 5000-1064.

We can help with all Florida bonds!

How to Apply for a Medicaid Provider Bond:

• Identify which rule applies: s. 409.912(8)(b) for DME and medical supply providers, or s. 409.907(7) for other fee for service providers.
• DME suppliers: list every provider location and its FEIN, since the bond is $50,000 per location up to 5 bonds or a $250,000 aggregate bond.
• Other providers: get the amount AHCA sets, based on billing for the current or most recent calendar year or, for new providers, the estimate of first year billing.
• Have the surety issue the bond on AHCA Form 5000-1064.
• Submit the bond with the Florida Medicaid enrollment or revalidation application.
• Renew each year and submit proof of renewal, even when the bond is continuous.

Detailed Information About the Florida Medicaid Provider Bond:

Two different amount rules

A flat $50,000 figure is only certain for DME suppliers.

Durable medical equipment and medical supply providers fall under s. 409.912(8)(b), Florida Statutes. They must provide a surety bond of $50,000 for each provider location, up to a maximum of 5 bonds statewide or an aggregate bond of $250,000 statewide, as identified by Federal Employer Identification Number. A provider posting a statewide or aggregate bond must list all of its locations on its DME enrollment application or bond renewal.

Other providers fall under s. 409.907(7). Before entering into the provider agreement, AHCA may require providers reimbursed on a fee for service basis, or on a fee schedule basis that is not cost based, to post a bond not to exceed $50,000 or the total amount billed to the program during the current or most recent calendar year, whichever is greater. For new providers, AHCA sets the amount from the provider's estimate of its first year's billing, and if actual first year billing exceeds the bond, AHCA may require an additional bond equal to the actual billing level. The bond need not exceed $50,000 if physicians licensed under chapter 458, 459 or 460 hold a 50 percent or greater ownership interest in the provider, or if the provider is an assisted living facility licensed under chapter 429.

Which providers are asked for a bond

AHCA's Provider Enrollment Policy, incorporated in Rule 59G-1.060, F.A.C., says providers in a moderate or high risk category may be required to post a surety bond. Newly enrolling home health agencies and newly enrolling DMEPOS suppliers are designated high risk, and revalidating home health agencies and DMEPOS suppliers are designated moderate risk. The policy's provider specific requirements list the surety bond for DME and medical supply providers, behavior analysis groups, independent laboratories during their first year of enrollment, and physician groups with majority ownership by non physicians.

DME suppliers that are exempt

Under s. 409.912(8)(b), three groups are exempt from both the accreditation requirement and the bond: DME providers owned and operated by a government entity, DME providers operating within a pharmacy currently enrolled as a Florida Medicaid pharmacy provider, and active Medicaid enrolled orthopedic physician groups, primarily owned by physicians, that provide only orthotic and prosthetic devices.

Form and renewal

The bond is written on the State of Florida Agency for Health Care Administration Florida Medicaid Provider Surety Bond, AHCA Form 5000-1064, incorporated by reference in Rule 59G-1.060. Each DME location's bond must be renewed annually, and the provider must submit proof of renewal even if the original bond is a continuous bond. The enrollment policy also says providers may be required to replace an expired bond within 30 days of the expiration date. Under s. 409.907(7), these bonds are in addition to the bonds referenced in s. 400.179(2)(d). Confirm the amount AHCA assigns to your provider type before the bond is issued.

Eligibility and Requirements for a Florida Medicaid Provider Bond:

• AHCA Form 5000-1064, the Florida Medicaid Provider Surety Bond.
• DME and medical supply providers: $50,000 for each location, capped at 5 bonds or $250,000 aggregate statewide per FEIN.
• Other required providers: up to $50,000 or Medicaid billing for the current or most recent calendar year, whichever is greater.
• A $50,000 ceiling for providers at least 50 percent owned by licensed physicians and for licensed assisted living facilities.
• Annual renewal with proof of renewal submitted.

Florida Medicaid Provider Bond FAQs:

Official and Additional Resources for the Florida Medicaid Provider Bond: