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June 30, 2004 Dear LMT: Please read this notice in its entirety so that you have all the facts before making your personal decision. You will soon be receiving a notice from the Department of Health entitled “Frequently Asked Questions” addressing questions about electronic tracking of your CE hours through the CE Broker system. The Department is once again encouraging you to subscribe to the CE Broker system. The CE Broker system is an electronic, internet-based tracking system. The Department of Health is mandated by Florida Statute to electronically track CE hours completed by health care providers. The Department entered into a contract with Information Systems of Florida, Inc., to develop and operate the electronic tracking system called “CE Broker.” Information Systems of Florida, Inc. derives income from subscriptions to the CE Broker system by health care providers. A subscription now costs $35.00 for the licensure biennium. A subscription allows you to view the hours which have been reported on your behalf by CE providers to CE Brokers and to view CE courses which are offered (all of which is a public record available to you on request to the Department, for less than $1). You must make the individual decision as whether it is worth paying $35.00 for the subscription. There is no statute or rule REQUIRING you to subscribe and pay $35.00 to this private company. YOU DO NOT HAVE TO SUBSCRIBE. The CE provider from whom you take courses is required to report your hours to CE Broker. However, you should keep copies of your certificates of attendance should you be questioned by the Department whether you completed the required number of hours during the last licensure biennium. Subscription to CE Brokers WILL NOT offer you protection from audit of your CE hours by the Department of Health. Subscription to CE Brokers is a private business relationship between you and Information Systems of Florida, Inc. The Department does not know or keep track of who subscribes. You must decide for yourself if it is beneficial to spend $35.00 for a two-year subscription to see what hours have been credited to you and to view course offerings. We hope this information may be of help in your individual decision-making process.
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TO ALL, CLINIC REGISTRATION & LICENSURE: DOES THAT APPLY TO ALL LMT’s? The Governor signed SB 1062 into law on June 15, 2004 which amends the clinic licensure law. SB 1062 took effect as law on June 15. Under the clinic licensure law as amended by SB 1062, LMT practices or massage establishments which are owned in whole or in part by non-health care providers AND WHICH FILE CLAIMS FOR REIMBURSEMENT WITH HEALTH OR PIP INSURERS are required to be licensed by the Agency for Health Care Administration (AHCA) as a “clinic.” SB 1062 repeals the exemptions from clinic licensure previously granted to massage establishments. However, the FSMTA lobby team lobbied the 2004 legislature to include LMTs in the exemption from clinic licensure that applies to other health care providers.
Now, LMTs who wholly own a massage practice, called “clinic” in the clinic licensing statute, or own the massage practice (clinic) in conjunction with another LMT or in conjunction with a spouse, parent, child or sibling are exempt from licensure. That exemption applies to the clinic (massage practice) which file health or PIP insurance claims, even if it is licensed as a massage establishment. However, the massage practice is not eligible for an exemption if a non-health care provider (other than a spouse, parent, child or sibling) owns any part of the practice and which files health or PIP insurance claims and must apply for clinic licensure with the Agency for Health Care Administration (AHCA). A massage practice which does not file any claims for reimbursement with a health or PIP insurer does not have to be licensed, regardless of whether a non-health care provider own all or part of the practice, because the clinic licensure law ONLY APPLIES TO MASSAGE PRACTICES OR CLINICS WHICH FILE CLAIMS FOR REIMBURSEMENT WITH HEALTH OR PIP INSURERS. Health or PIP insurers do not have to pay claims for reimbursement form clinics which are required to be licensed but are not so licensed. It is a felony to operate a clinic that is required to be licensed and which is not licensed. An exempt clinic may apply to the AHCA for a voluntary certificate of exemption showing that the massage practice or clinic is exempt from licensure in the event a health or PIP insurer questions the exemption.
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CONTACT: Jackie DiPietre 850-245-4111 September 2, 2004 DOH ASSISTS IN UNLICENSED ACTIVITY ARREST TALLAHASSEE--The Florida Department of Health’s (DOH) unlicensed activity unit today announced that their investigation with the Hillsborough County Sheriff’s Office has led to the arrest of Gary Steven Mezo for practicing medicine without a license and obtaining a medicinal drug by fraud. Practicing any type of healthcare without a valid Florida license is a crime that puts the health of our citizens and visitors at risk,” said DOH Secretary John O. Agwunobi M.D., M.B.A., M.P.H. “These perpetrators--who perform unlicensed, unregulated health care services--are criminals and need to be stopped.” Mezo, who was licensed as an Advanced Registered Nurse Practitioner (ARNP) in the State of Florida from 1979 until 2002, was charged with using his expired license number to call in prescriptions to a Publix Pharmacy in Tampa. The investigation found that Mezo had obtained medicinal drugs for his wife, daughter, mother and himself from September 13, 2002 through May 7, 2004. DOH has several resources to combat unlicensed activity:
The Florida Department of Health’s (DOH) unlicensed activity program protects Florida residents and visitors from the potentially serious and dangerous consequences of receiving medical and health care services from an unlicensed person. DOH’s Division of Medical Quality Assurance (MQA) investigates and refers for prosecution all unlicensed health care activity complaints and allegations. The unlicensed activity unit works in conjunction with law enforcement and the state attorney’s offices to prosecute individuals practicing without a license. Unlicensed activity is a felony level criminal offense. More importantly, receiving health care from unlicensed people is dangerous and could result in further injury, disease or even death. The mission of MQA is to protect and promote the health of all persons in Florida by diligently regulating health care practitioners and facilities. MQA regulates more than 750,000 health care practitioners and facilities. MQA, in conjunction with 22 boards and six councils, regulates 37 health care professions and six types of facilities. MQA evaluates the credentials of all applicants for licensure, issues licenses, analyzes and investigates complaints, inspects facilities, assists in prosecuting practice act violations, combats unlicensed activity and provides credential and discipline history about licensees to the public. Visit www.doh-mqaservices.com for more information about MQA.
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NOTICE TO FSMTA Board and all of those you come in contact with that work with physician referrals and insurance cases. Please pass this on to anyone who can benefit by this information. To help one is to help all at this point with insurance reimbursement problems. Help us to take this insurance acceptance to a higher level than we have been on since Oct. 1992 Law was passed to require insurance companies to reimburse massage therapists under certain circumstances! RE: ATTORNEY who is willing to help us to receive reimbursement from insurance companies. Attorney: Jim Farson, Jacksonville, Florida We now have an attorney who is more than willing to work on insurance related cases where a massage therapist has had problems collecting from the insurer. You do NOT have to wait for the patient to obtain an attorney when you are not being paid (As long as you have that Assignment of Benefits Form signed by the patient). We can also go back as far as FIVE years to try to collect. Over the years, in my courses, manuals and other instructions to massage therapists I have stressed the importance of the legalities in working with insurance cases. The importance of having all documentation in place and having everything match. There would be no reason for an insurance company to delay or deny payment. However, I am not the only one teaching insurance courses, therefore we find many therapists, including some who have taken my classes, still trying to circumvent the requirements or who still try to accept cases that we most likely would not be paid for. However, in spite of all you may do right, there are still many times an insurance company will NOT reimburse us for a variety of reasons, some even for no reason. These are the cases we want to help you with!! NOW WE HAVE HELP!! I am glad to say Mr. Farson is excited about working with us not only on an individual basis for a small percentage of collected amounts, but on cases such as some of the employer group plans who may NOT fall under the Federal ERISA guidelines. I will be willing to assist in checking out the information for you prior to sending to the attorney to be sure you have followed the proper normal billing procedures. I am asking you to fax the following information to me, to my toll free fax line: 1-888-822-5006. PLEASE, if you try to fax and it does NOT go through, phone me at once on my home line to ask me to get off the computer to free up fax line: HOME LINE: 1-865-436-3573 or send e-mail to cvivianm@aol.com or vivianmadison@aol.com in subject line say, "sending fax" PER MR. FARSON, THE FOLLOWING IS WHAT WE NEED Copies of the following: 1. Prescription for date (s) in question 2. EOB (Explanation of Benefits) from insurance company stating denial, reductions or other excuses for non payment. 3. Patient's insurance card, front and back 4. Authorization of Benefit Form, signed by patient 5. CMS (formerly known as HCFA) 1500 Claim Form for date(s) in question 6. Documentation for dates of service in question ---------------------------------------------------------------------------------------------- |
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Who trusts a "free offer" that requires a credit card? We strongly recommend that you advise our members not to subscribe. Some new developments are happening...let's wait and see. Maureen Gilbert As a Florida healthcare professional, you are now able to register for a free, 7-day trial of CE Broker's Full Access subscription!
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The CE Broker system is an electronic, internet-based tracking system. The Department of Health is mandated by Florida Statute to electronically track CE hours completed by health care providers. The Department entered into a contract with Information Systems of Florida, Inc., to develop and operate the electronic tracking system called “CE Broker.”
