Providers Can Resubmit Claims from Oct. 1 Forward for Reprocessing

FLORIDA—Last week, the Florida American Health Care Association (AHCA) released its updated durable medical equipment (DME) Medicaid fee schedule based on state budget legislation that provided the first broad-scope DME reimbursement increase in 23 years, the American Association for Homecare (AAHC) said. The increase works out to 7.3%, based on funds allocated by legislators to the Florida budget.

Providers will have to resubmit claims from Oct. 1, 2023, to get the earlier claims reprocessed at the higher rate. Funds were also provided to the managed care organization (MCO) plans to provide rate increases to DME providers. If a provider’s fee schedule is not based on the updated Florida Medicaid FFS fee schedule or it is not at 100% of the fee schedule rates, contact the MCO plan to negotiate its contracts to ensure receiving the full 7.3% increase.  

As AAHC shared when first announced in May, the historic increase follows a persistent four-year advocacy effort by AAHC’s payer relations team and Florida Alliance of Home Care Services (FAHCS). While the rate change was originally described as a 7.5% increase by Florida officials, the 7.3% number reflects the dollars ultimately allotted by the legislature.

See the new Florida Medicaid DME fee schedule here.