On September 27, 2022, the Agency for Health Care Administration (AHCA) published the adjusted Medicaid fee-for-service (FFS) fee schedules in accordance with the 2022-23 state budget. Rate adjustments were made solely to increase wages for direct care workers of Medicaid providers, including 1099 workers, to at least $15 per hour. The mandate will become effective this Saturday, October 1.

According to the announcement, Milliman, AHCA's actuarial services vendor, provided the estimated impact that a $15 per hour minimum wage for direct care workers would have on costs for health care providers. The legislature utilized this study as the basis for appropriating funds in the budget.

The Milliman analysis provided AHCA with an estimated percent impact of an increased minimum wage for direct care employees broken down by NAICS (North American Industry Classification System) codes. AHCA then created a crosswalk that mapped the corresponding NAICS code and percent increase to the provider fee schedule and appropriation category.

The legislature appropriated more than $181 million for the Statewide Medicaid Managed Care (SMMC) health plans to pass through to providers the minimum wage increase for services provided under the program. Health plans will increase payments to providers by the same increment as was applied in the updated fee schedules for those providers whose reimbursement by health plans is equal to the FFS reimbursement. For providers whose reimbursement by plans differs from the FFS reimbursement or for whom reimbursement is not based on a fee schedule, plans will increase payments in a manner to ensure providers are able to pay impacted workers at least $15 per hour.

Home health agencies are subject to the following fee schedule increases:

• Home Health Visit Services Fee Schedule: +3.33%
• Personal Care Services Fee Schedule: +15.45%
• Private Duty Nursing Services Fee Schedule: +3.33%

HCAF welcomes feedback from providers regarding their experience in securing rate increases from the health plans now that the fee schedules have been published. Click here to complete the online survey, which we will share confidentially with AHCA so that the implementation of the mandate will go as smoothly as possible.

HCAF has joined a lawsuit with stakeholder groups to protect providers against minimum wage-related lawsuits if the appropriated funds in the budget are not sufficient to increase wages to $15 an hour. To read the Florida Politics news article on this development, click here.