06/20/2012 Agreement DANNY L. KOLHAGE
CLERK OF THE CIRCUIT COURT
DATE: June 28, 2012
TO: Kim Wilkes Wean, Sr. Grants
Coordinator - Social Services
FROM: Pamela G. Hanco k, . C.
At the June 20, 2012, Board of County Commissioner's meeting the Board granted
approval and authorized execution of the following:
Item C7 Standard Memorandum of Agreement for Limited County Access to Florida
System Data between the Florida Department of Children and Families (the Department) and
Monroe County Board of County Commissioners.This required MOU is part of the Agency for
Health Care Administration (AHCA) plan for successful implementation of the provisions in
House Bill 5301, which references County Medicaid Billing.
Item C38 Modification #006 to the Weatherization Assistance Program, American Recovery
and Reinvestment Act sub -grant Agreement (ARRA WAP), Contract # 10 WX- 7X- 11 -54 -01 -719
between Monroe County Board of County Commissioners (Community Services /Social
Services) and the State of Florida, Department of Economic Opportunity.
Item C39 Modification #002 to Weatherization Assistance -Low Income Home Energy
Assistance Program, Sub -grant Agreement (WAP- LIHEAP), Contract #12LH- 9Z- 11 -54 -01 -039
between Monroe County Board of County Commissioners (Community Services /Social
Services) and the State of Florida, Department of Economic Opportunity.
Enclosed are five duplicate originals of each of the above - mentioned, executed on behalf
of Monroe County, for your handling. Please be sure to return two fully executed duplicate
originals as soon as possible. Should you have any questions, please feel free to contact my
office.
cc: County Attorney w/o documents
Finance
File/
eT �S � `:. FbrMa oepnnmem of
Chlldrm & Families
State of Florida Rick Scott
Governor
Department of Children and Families
David E. Wilkins
Secretary
STANDARD MEMORANDUM OF AGREEMENT FOR
LIMITED COUNTY ACCESS TO FLORIDA SYSTEM DATA
This Memorandum of Agreement for Limited County Access to FLORIDA System data (MOU) is
entered into between the Florida Department of Children and Families (the Department) and
M otAD+ County (the County).
WHEREAS, the Department maintains certain information in its Florida Online Recipient
Integrated Data Access system (FLORIDA) System regarding applicants seeking to qualify for
Medicaid Services;
WHEREAS, the County needs to access limited data on the FLORIDA System to confirm limited
information regarding recipients of Medicaid Services within the County for payment purposes;
and
WHEREAS, the Department is willing to provide the County with limited access to the data in
the FLORIDA System for such purposes, provided that the County complies with certain
security requirements.
NOW THEREFORE, IT IS AGREED AS FOLLOWS:
1. The foregoing recitations are true and incorporated into the terms of this MOU by reference.
2. Conditioned on the County's compliance with the terms of "Exhibit A° to this MOU and the
terms below, the Department will grant authorized County personnel limited access to the
FLORIDA System to verify Medicaid recipient addresses. Authorized County personnel will
be provided view only" access to the screens shown in "Exhibit B° to this MOU (the limited
FLORIDA data). The Department will have sole discretion to determine the means of
access and the manner of display of the limited FLORIDA data.
3. The County hereby agrees to comply with the terms of "Exhibit A° and will access the limited
FLORIDA data exclusively for purposes of verifying Medicaid recipient addresses and will
not utilize nor permit any person to utilize the limited FLORIDA data for any other purpose.
Any County record of the limited FLORIDA data shall be maintained and used only in
accordance with the terms of this MOU.
4. The Department will provide appropriate and timely training and support to the county with
regard to FLORIDA system access.
1317 Winewood Boulevard, Tallahassee, Florida 32399 -0700
Mission: Protect the Vulnerable, Promote Strong and Economically Self- Sufficient Families, and
Advance Personal and Family Recovery and Resiliency
.1 , . is
5. Prior to granting access to the FLORIDA System to individual users at the County level, the
following must be accomplished:
a. The Department must be in receipt of a signed MOU with the appropriate County
entity(ies).
b. The Department must be in receipt of a FLORIDA Individual Security Information Form
("Exhibit C ") for each user requesting access to the FLORIDA System.
c. The Department must be in receipt of a signed DCF CF 114 form "Security Agreement
Form" (Exhibit D). This form should accompany Exhibit C.
d. Individual users must have received confirmation from the FLORIDA Application Data
Security Administrator that access has been granted and received a user ID and an
initial password.
e. Individual users have completed FLORIDA access training.
f. Individuals have completed the required initial Department online security training, and
have printed out their completion certificate for their local personnel file. A copy of the
security - training certificate should accompany Exhibit C. This training is required
annually after completion of the initial training.
6. Term and termination. This MOU shall commence the last day executed by all parties and
shall continue for a period of five years, provided, however, that the confidentiality
requirements regarding the limited FLORIDA data shall survive the expiration or termination
of this MOU. This MOU may be terminated by either party without cause upon 30 days
written notice. This MOU may be terminated by either party for cause upon no less than 24
hours written notice. The Department may administratively suspend access to the FLORIDA
System at any time the Department has reason to believe that the County is not in full
compliance with the provisions of this MOU.
7. To the extent permitted by law, including Section 768.28, Florida Statutes, and without
waiving the limits of sovereign immunity, the County shall indemnify the Department, its
officers, employees and agents from any suits, actions, damages, claims and costs of every
name and description, including attorneys' fees, relating to access to or use of the limited
FLORIDA data by the County, its officers, employees or agents.
8. This MOU executed and entered into in the State of Florida, shall be construed, performed
and enforced in all respects in accordance with Florida law and venue shall be in Leon
County, Florida.
9. There are no provisions, terms, conditions, or obligations other than those contained herein,
and this MOU shall supersede all previous communications, representations, or
agreements, either verbal or written between the parties.
10. If any term or provision of this MOU is legally determined unlawful or unenforceable, the
remainder of the MOU shall remain in full force and effect and such term or provision shall
be stricken.
11. Modifications of provisions of this MOU shall be valid only when they have been reduced to
writing and duly executed by the duly authorized officials of both parties.
12. The parties contact coordinators for the administration of this MOU are:
County contact/coordinator:
Name - 5VNen t Gna -hay^"
Title - Soua..t tYfukc , e-g D Re-c- a-,
Organization Movnfoe_ ��'�j a o a.r-d oP C` , UA C o &"M- �SSilo1'�e -Rs
Mailin Address (city, state ZIP kl pp 5 ��, 2 - Z57
Phone - 30 2-12- 451 p 1 �i (�t}e,y } F I. 330�
Email - Gnos r _
Department contact/coordinator: J
Bruce R. Belrose
Chief, Operations and Research
Florida Department of Children and Families
Economic Self - Sufficiency Program Office
1317 Winewood Boulevard, 3 -426
Tallahassee, FL 32399 -0700
850 - 717 -4083
Bruce belroseCcadcf.stateftus
IN WITNESS THEREOF, the parties hereto have caused this Memorandum of Agreement to be
executed by their undersigned officials as duly authorized.
MONROE COUNTY BOARD FLORIDA DEPARTMENT OF CHILDREN
OF COUNTY COMMISSIONERS AND AM IES
/22�' 06/20/2012 �h �'
ignature Date Signature Date
Mayor David P. Rica =' Ann M. Berner
Director, Economic Self- Sufficiency
(name and title) Program r
a
,_ - n
DEP! CLER!� U�
Attachments:
Exhibit A — Use and Security Requirements
Exhibit B — FLORIDA system screen shots o
Exhibit C — FLORIDA Individual Security Information form r =; o :;0
Exhibit D — DCF CF114 Security Agreement Form --i °
I . i l
EXHIBIT A — COUNTY USE AND SECURITY REQUIREMENTS
The County agrees to comply with the following use and security requirements:
1. That the information obtained from the Department's system pursuant to the MOA
(hereinafter "the limited FLORIDA data ") is confidential in nature and protected from
disclosure by State and Federal Law.
2. To restrict the transmission of the limited FLORIDA data using secure file transfer
protocols to County personnel who have a verifiable need to know in the performance of
their official duties for the purposes stated in Section 3 of the MOA.
3. To maintain a listing of County personnel granted on -line access privileges to the
Department's system pursuant to this MOA and, upon request, make such information
available to the Department. At a minimum, the list will include the user's first and last
name, User Identification (USERID), date access was granted /changed /deleted, dates of
initial security training and annual awareness training. This information will be
maintained for a period of 5 years after access has been terminated or until
administrative purposes have been served, whichever is longer.
4. To abide by IT Security Awareness training provided by the Department at
http: / /www.dcf. state .fl.us /admin /training.shtml or an equivalent security training provided
to court IT security officers. Initial and annual refresher IT Security Awareness training
shall be documented.
5. To comply with State of Florida network security requirements specified in Florida
Administrative Code 60DD- 2.006, Network Security.
6. That the limited FLORIDA data may not be re- disclosed by the County or its personnel
verbally, electronically or in any other forms except as specifically authorized by law or
regulation and in compliance with 42 C.F.R., Subpart F.
7. That any the limited FLORIDA data will be used only for the purposes stated in Section 3
of the MOA and may be disclosed only for such purposes.
8. That the limited FLORIDA data shall be stored in a place physically secure from access
by unauthorized persons.
9. To safeguard access to the limited FLORIDA data in such away that unauthorized
persons cannot view, print, copy or retrieve the information by any means.
10. To instruct all personnel granted on -line access privileges to the Department's system or
granted access to the limited FLORIDA data in the County's possession regarding the
confidential nature of the information, the safeguards and requirements of this MOA and
the provisions of Chapters 71A -1 and 71A -2, Florida Administrative Code as well as
Chapters 119, 812, 815, 817, 839 or 877, Florida Statutes, or similar state and federal
requirements.
11. To adhere to the confidentiality requirements stated herein, and to fully and promptly
report any infraction of these requirements to the respective contacts specified in
Section 10 of the MOA.
e'
12. To promptly notify the Department of any breach of security related to the limited
FLORIDA data in its possession and to be responsible for full compliance with section
817.5681, F.S., if applicable, in the event of a breach of security concerning confidential
personal information in its possession received from one another, including but not
limited to, providing notification to affected persons.
13. To provide any such breach notification, if applicable, to the Department for prior review
and approval of the contents of the notice.
7
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THE FLORIDA INDIVIDUAL SECURITY INFORMATION FORM
INSTRUCTIONS
The following information is needed for all personnel who request access to the
FLORIDA Application. Below is a description of the information necessary for the
FLORIDA Individual Security Information Form.
1. LAST NAME: The User's last name (max 15 characters).
2. FIRST NAME: The User's first name (max 15 characters).
3. MIDDLE INITIAL: The User's middle name - optional.
4. PREFIX: The User's prefix. Example MR, MRS, MS (max 4 characters) optional
5. SOCIAL SECURITY NUMBER: The User's social security numbers (max 9 characters).
6. POSITION TITLE: The User's position title (Clerk Typist, Receptionist, and Public Assistance Specialist).
7. UCB: Indicates if individual requires access to the Agency For Workforce Innovation
System.
8. AGENCY/BUSINESS: The agency or business the User is employed by.
9. CONTRACTED WTTII: List the Agency the User is contracted with (DCF, DOR, AHCA,
etc.).
10. ACCESS TO FEDERAL TAX INFORMATION: Indicates if individual requires access
to Federal Tax Information.
10a. ACCESS TO SAVE: Indicates if individual requires access to US Citizenship and
Immigration Services.
10b. ACCESS TO AMS: Indicates if individual requires access to AMS.
10c. AMS ROLE: The AMS Roles controls the user access. The roles listed below can be
assigned.
• Administrator
• Call Center Administrator
• Call Center Agent
• Case Maintenance ESSS
• Case Processor
• Change ESSS
• Child In Care ESSS
• Clerk / Receptionist
• Inquiry Only / Help Desk
• Intake Specialist
• Interview Clerk
3
• Program Office
• Regional Security Officer
• Statewide Security Officer
• Transfer Coordinator
• Unit Supervisor
• Unit Supervisor Inquiry Only access to RR
• Universal
11. ACTION REQUIRED: Indicate the action needed for each User ID.
A = ADD, C = CHANGE, D = Delete, S = Suspend, R = RESUME.
12. USER ID: This is the RACF User ID. The User ID will be assigned by ISCO.
13. WORKER TYPE: Indicates the types of access the worker will have in the system:
• PY for Confidential Caseload Personnel, i.e.: Child in Care and employee clients.
• P for Public Assistance
• PD for Public Assistance District Change Worker
• PS for Public Assistance Service Site Change Workers
• C for Child Support Enforcement
• PC for Confidential Caseload Personnel — can work on cases statewide
• PT for Statewide Worker
• PM for Public Assistance District Change Worker — allows access to
disability screens
NOTE: PC and PT can only be assigned by the Sate Security officer in Headquarters.
WHO SHOULD HAVE THE PS AND PD WORKER TYPES?
The PS a nd PD worker types have the ability to cross validation lines for either a service center or
an entire district. For this reason, these worker types must remain tightly restrictive and should
only be assigned on an extremely limited basis, in accordance with the following:
• Out posted staff (primarily hospital based
• Medicaid Eligibility File Coordinators and/or
• Change workers
SECURITY PROCEDURES FOR ASSIGNING THE PS AND PD WORKER TYPES
• PS (Service Site): The Individual Security Information form (CF FORM 113) must be
signed by the Operations Program Administrator (OPA) for the service site.
• PD (District): The Economic Services Program Administrator must sign the Individual
Security Information Form (CF FORM 113).
14. SECURITY PROFILE NAME: The PROFILE assignment controls, which screen what a
user can access. Please refer to Attachment A — User Profiles and Their Security Levels
15. SECURITY LEVEL: The Security Level is used in conjunction with the Administrative
Structure and the Security Profile to specify user access. Refer to Attachment A, USER
4
PROFILES AND THEIR SECURITY LEVELS, for the levels that can be assigned to Profile
Names. The security levels that are assigned to each Profile Name will be adhered to at all times.
• 10 for Clerical
• 50 for Workers
• 75 for Supervisors
• 80 for Coordinators
• 98 for Administrators and BR Staff
• 99 for State/District Personnel and Security Coordinators
16. PROFILE BEGIN DATE: Enter the date the profile should become active.
17. PROFILE END DATE: Enter the date the profile should be deactivated.
18. DISTRICT /CSE REGION: Enter your district/region number (01 - 15), Region 23
(Suncoast Region), 90 for Headquarters Personnel,.
19. SERVICE -SITE COUNTY No.: Enter the County where the user is physically located.
Valid entries are 01 - 67. (Max 2 characters)
20. SERVICE -SITE LOCATION NO.: Enter the Service -Site Number for the building the user
is physically located. (Max 3 characters) NOTE: The Service -site county and the
Service -site location must be a valid entry in the Service Site Table, TCTY.
21. SUNCOM #: The user's SUNCOM telephone number (max 3 characters)
22. AREA CODE and PHONE #: The user's area code (max 3 characters) and the local
telephone number, (max 7 characters). Include the telephone extension number when applicable,
(Maximum 5 characters).
23. User E -Mail address: Enter the users E -Mail address
24. ADMINISTRATIVE UNIT ASSIGNED: Enter the Administrative unit the user is assigned
to. (Max 5 characters)
25. SUPERVISORY UNIT ASSIGNED: Enter the supervisory unit the user is assigned to
(Max 5 characters).
26. PRIMARY UNIT SUPERVISOR'S ID: Enter the ID of the user's primary unit supervisor.
(Max 7 characters).
27. CASELOAD NUMBER: Enter the user's caseload number. (Max 6 characters)
28. SUPERVISOR'S NAME: Enter the NAME of the user's primary supervisor
29. PHONE #: Enter the PHONE # of the primary supervisor (Max 7 characters). Include the
telephone extension when applicable (Max 5 characters).
30. JUSTIFICATION /C01VIMENTS: Use this field to clarify changes, to explain why a
nontraditional (non- public assistance, PI, or CSR workers) user requires access to the FLORIDA
System.
5
31. SIGNATURE OF REQUESTER AND DATE: The signature and date of the
requester /supervisor is required.
32. SIGNATURE OF ADMINISTRATOR OR NEXT LEVEL SUPERVISOR DATE: The
Administrator or next level Supervisor must review this form prior to signing and dating.
33. SIGNATURE OF DISTRICT SECURITY OFFICER: The Security Officer will sign
when the user information has been entered into the FLORIDA Application.
34. SIGNATURE OF HQTR SECURITY OFFICER:
35. SIGNATURE OF OPA/PROGRAM ADMINISTRATOR: If the WORKER TYPE is
"PS: then OPA/POA's signature is required. If the WORKER TYPE is "PD" the Program
Administrator's signature is required.
c""
SECURITY AGREEMENT FORM
The Department of Children and Families has authorized you:
Employee's or Contractor's Name /Organization
to have access to sensitive data using computer - related media (e.g., printed reports, microfiche, system
inquiry, on -line update, or any magnetic media).
Computer crimes are a violation of the department's Standards of Conduct. In addition to departmental
discipline, committing computer crimes may result in Federal or State felony criminal charges.
I understand that a security violation may result in criminal prosecution according to the provisions of
Federal and State statutes and may also result in disciplinary action against me according to the
department's Standards of Conduct in the Employee Handbook.
By my signature below, I acknowledge that I have received, read, understand and agree to be bound by
the following:
• The Computer Related Crimes Act, Chapter 815, F.S.
• Sections 7213, 7213A, and 7431 of the Internal Revenue Code; which provide civil and criminal
penalties for unauthorized inspection or disclosure of Federal tax data.
• 6103(1)(7) of the Internal Revenue Code, which provides confidentiality and disclosure of returns
and return information.
• CFOP 50 -2.
• It is the policy of the Department of Children and Families that no contract employee shall have
access to IRS tax information or FDLE information, unless approved in writing, by name and
position to access specified information, as authorized by regulation and /or statute.
• It is the policy of the Department of Children and Families that I do not disclose personal passwords.
• It is the policy of the Department of Children and Families that I do not obtain information for my own
or another person's personal use.
• 1 will only access or view information or data for which I am authorized and have a legitimate
business reason to see when performing my duties. I shall maintain the integrity of all confidential
and sensitive information accessed.
• "Casual viewing" of employee or client data, even data that is not confidential or otherwise exempt
from disclosure as a public record, constitutes misuse of access and is not acceptable.
• The Department of Children and Families will perform regular database queries to identify misuse of
access.
• Chapter 119.0712, Florida Statutes, and the Driver Privacy Protection Act (DPPA
PRIVACY ACT STATEMENT: Disclosure of your social security number is voluntary, but must be provided
in order to gain access to department systems. It is requested, however, pursuant to Section 282.318,
Florida Statutes, the Security of Data and Information Technology Resources Act. The Department
requests social security numbers to ensure secure access to data systems, prevent unauthorized access to
confidential and sensitive information collected and stored by the Department, and provide a unique
identifier in our systems.
Print Employee /Contractor Name Signature of Employee /Contractor
Date
Print Supervisor Name
CF 114. PDF 06/2010
Signature of Supervisor Date
y I - wi uncracz rne; Copy — Employee /Contractor
t= Xl✓ll�'J1}'
CHAPTER 815: COMPUTER - RELATED CRIMES
815.01 Short title. The provisions of this act shall be known and may be cited as the "Florida Computer Crimes Act."
(History: s. 1, ch. 78 -92.)
815.02 Legislative Intent. The Legislature finds and declares that:
(1) Computer - related crime is a growing problem in government as well as in the private sector.
(2) Computer - related crime occurs at great cost to the public since losses for each incident of computer crime tend to be far greater than the
losses associated with each incident of other white collar crime.
(3) The opportunities for computer - related crimes In financial institutions, government programs, government records, and other business
enterprises through the introduction of fraudulent records into a computer system, the unauthorized use of computer facilities, the alteration or
destruction of computerized information or files, and the stealing of financial instruments, data, and other assets are great.
(4) While various forms of computer crime might possibly be the subject of criminal charges based on other provisions of law, it is
appropriate and desirable that a supplemental and additional statute be provided which proscribes various forms of computer abuse.
(History: s. 1, ch. 78 -92.)
815.03 Definitions. As used in this chapter, unless the context clearly indicates otherw
computer, computer system, or computer network. ise:
(1) "Access" means to approach, instruct, communicate wit h, store data in, retrieve data from, or otherwise make use of any resources of a
(2) "Computer" means an internally programmed, automatic device that performs data processing.
(3) "Computer contaminant" means any set of computer instructions designed to modify, damage, destroy, record, or transmit information
within a computer, computer system, or computer network without the intent or permission of the owner of the information. The term includes,
but is not limited to, a group of computer instructions commonly called viruses or worms which are self - replicating or self - propagating and which
are designed to contaminant other computer programs or computer data; consume computer resources; modify, destroy, record, or transmit
data; or in some other fashion usurp the normal operation of the computer, computer system, or computer network.
(4) "Computer network" means any system that provides communications between one or more computer systems and its input or output
devices, including, but not limited to, display terminals and printers that are connected by telecommunication facilities.
(5) "Computer program or computer software" means a set of instructions or statements and related data which, when executed in actual or
modified form, cause a computer, computer system, or computer network to perform specified functions.
(6) "Computer services" include, but are not limited to, computer time; data processing or storage functions; or other uses of a computer,
computer system, or computer network.
(7) "Computer system" means a device or collection of devices, including support devices, one or more of which contain computer programs,
electronic instructions, or input data and output data, and which perform functions, including, but not limited to, logic, arithmetic, data storage,
retrieval, communication, or control. The term does not include calculators that are not programmable and that are not capable of being used in
conjunction with external files.
(8) "Data" means a representation of information, knowledge, facts, concepts, computer software, computer programs, or instructions. Data
may be in any form, in storage media or stored in the memory of the computer, or in transit or presented on a display device.
(9) "Financial Instrument" means any check, draft, money order, certificate of deposit, letter of credit, bill of exchange, credit card, or
marketable security.
(10) "Intellectual property" means data, including programs.
(11) "Property" means anything of value as defined in [Footnote 11 s. 812.011 and includes, but is not limited to, financial instruments,
information, including electronically produced data and computer software and programs in either machine - readable or human- readable form,
and any other tangible or intangible item of value.
(History: s. 1, ch. 78 -92; s. 9, ch. 2001 -54.) ([Footnote 11 Note: Repealed by s. 16, ch. 77 -342.)
815.04 Offenses against intellectual property; public records exemption.
(1) Whoever willfully, knowingly, and without authorization modifies data, programs, or supporting documentation residing or existing internal
or external to a computer, computer system, or computer network commits an offense against intellectual property.
(2) Whoever willfully, knowingly, and without authorization destroys data, programs, or supporting documentation residing or existing internal
or external to a computer, computer system, or computer network commits an offense against intellectual property.
(3) (a) Data, programs, or supporting documentation which is a trade secret as defined in s. 812.081 which resides or exists internal or
external to a computer, computer system, or computer network which is held by an agency as defined in chapter 119 is confidential and exempt
from the provisions of s. 119.07(1) and s. 24(a), Art. I of the State Constitution. (b) Whoever willfully, knowingly, and without authorization
discloses or takes data, programs, or supporting documentation which is a trade secret as defined in S. 812.081 or is confidential as provided by
law residing or existing internal or external to a computer, computer system, or computer network commits an offense against intellectual
property.
(4) (a) Except as otherwise provided in this subsection, an offense against intellectual property is a felony of the third degree, punishable as
provided in s. 775.082, s. 775.083, or s. 775.084. (b) If the offense is committed for the purpose of devising or executing any scheme or artifice
to defraud or to obtain any property, then the offender is guilty of a felony of the second degree, punishable as provided in s. 775.082, s.
775.083, or s. 775.084.
(History: s. 1, ch. 78 -92; s. 1, ch. 94 -100; s. 431, ch. 96 -406.)
815.045 Trade secret information. The Legislature finds that it is a public necessity that trade secret information as defined in s. 812.081, and
as provided for in s. 815.04(3), be expressly made confidential and exempt from the public records law because it is a felony to disclose such
records. Due to the legal uncertainty as to whether a public employee would be protected from a felony conviction if otherwise compl ying with
chapter 119, and with s. 24(a), Art. I of the State Constitution, it is imperative that a public records exemption be created. The Legislature in
making disclosure of trade secrets a crime has clearly established the importance attached to trade secret protection. Disclosing trade secrets in
an agency's possession would negatively impact the business interests of those providing an agency such trade secrets by damaging them in
the marketplace, and those entities and individuals disclosing such trade secrets would hesitate to cooperate with that agency, which would
impair the effective and efficient administration of governmental functions. Thus, the public and private harm in disclosing trade secrets
significantly outweighs any public benefit derived from disclosure, and the public's ability to scrutinize and monitor agency action is not
diminished by nondisclosure of trade secrets. (History: s. 2, ch. 94 -100.) (Note. Former s. 119.165)
815.06 Offenses against computer users.
(1) Whoever willfully, knowingly, and without authorization: (a) Accesses or causes to be accessed any computer, computer system, or
computer network; (b) Disrupts or denies or causes the denial of computer system services to an authorized user of such computer system
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services, which, in whole or part, is owned by, under contract to, or operated for, on behalf of, or in conjunction with another; (c) Destroys,
takes, injures, or damages equipment or supplies used or intended to be used in a computer, computer system, or computer network;
(d) Destroys, injures, or damages any computer, computer system, or computer network; or (e) Introduces any computer contaminant into any
computer, computer system, or computer network, commits an offense against computer users.
(2) (a) Except as provided in paragraphs (b) and (c), whoever violates subsection (1) commits a felony of the third degree, punishable as
provided in s. 775.082, s. 775.083, or s. 775.084. (b) Whoever violates subsection (1) and: 1. Damages a computer, computer equipment,
computer supplies, a computer system, or a computer network, and the monetary damage or loss incurred as a result of the violation is $5,000
or greater; 2. Commits the offense for the purpose of devising or executing any scheme or artifice to defraud or obtain property; or 3.
Interrupts or impairs a governmental operation or public communication, transportation, or supply of water, gas, or other public service,
commits a felony of the second degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (c) Whoever violates subsection (1)
and the violation endangers human life commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084.
(3) Whoever willingly, knowingly, and without authorization modifies equipment or supplies used or intended to be used in a computer,
computer system, or computer network commits a misdemeanor of the first degree, punishable as provided in s. 775.082 or s. 775.083.
(4) (a) In addition to any other civil remedy available, the owner or lessee of the computer, computer system, computer network, computer
program, computer equipment, computer supplies, or computer data may bring a civil action against any person convicted under this section for
compensatory damages. (b) In any action brought under this subsection, the court may award reasonable attorney fees to the prevailing party.
(5) Any computer, computer system, computer network, computer software, or computer data owned by a defendant which is used during the
data obtained in violation of this section is subject to forfeiture as provided under ss. 932.701
commission of any violation of this section or any computer owned by the defendant which is used as a repository for the storage of so data 932.704.
ftware or
(6) This section does not apply to any person who accesses his or her employer's compute
or computer data when acting within the scope of his or her lawful employment. r system, computer network, computer program,
(7) For purposes of bringing a civil or criminal action under this section, a person who causes, by any means, the access to a computer,
computer system, or computer network in one jurisdiction from another jurisdiction is deemed to have personally accessed the computer,
computer system, or computer network in both jurisdictions.
(History: s. 1, ch. 78 -92; s. 11, ch. 2001 -54.)
815.07 This chapter not exclusive. The provisions of this chapter shall not be construed to preclude the applicability of any other provision of
the criminal law of this state which presently applies or may in the future apply to any transaction which violates this chapter, unless such
provision is inconsistent with the terms of this chapter. (History: s. 1, ch. 78 -92.)
SECTION 7213 — UNAUTHORIZED DISCLOSURE OF INFORMATION
(a) RETURNS AND RETURN INFORMATION -
(1) FEDERAL EMPLOYEES AND OTHER PERSONS — It shall be unlawful for any officer or employee of the United States or any person
described in section 6103(n)(or an officer or employee of any such person),or any former officer or employee, willfully to disclose to any person,
except as authorized in this title, any return or return information [as defined in section 6103(b)]. Any violation of this paragraph shall be a
felony punishable upon conviction by a fine in any amount not exceeding $5,000, or imprisonment of not more than 5 years, or both, together
with the costs of prosecution, and if such offense is committed by any officer or employee of the United States, he shall, in addition to any other
punishment, be dismissed from office or discharged from employment upon conviction for such offense.
(2) STATE AND OTHER EMPLOYEES — It shall be unlawful for any person [not described in paragraph (1)] willfully to disclose to any
person, except as authorized in this title, any return or return information [as defined in section 6103(b)] acquired by him or another person
under subsection (d) )(6),(7),(8),(9),(10),(12),(15) or (16) or (m)(2),(4),(5),(6), or (7) of section 6103. Any violation of this paragraph
shall be a felony punishable by a fine in any amount not exceeding $5,000, or imprisonment of not more than 5 years, or both, together with the
cost of prosecution.
(3) OTHER PERSONS — It shall be unlawful for any person to whom any return or return information [as defined in section 6103(b)] is
disclosed in an manner unauthorized by this title thereafter willfully to print or publish in any manner not provided by law any such return or
return information. Any violation of this paragraph shall be a felony punishable by a fine in any amount not exceeding $5,000, or imprisonment
of not more than 5 years, or both, together with the cost of prosecution.
(4) SOLICITATION — It shall be unlawful for any person willfully to offer any item of material value in exchange for any return or return
information [as defined in 6103(b)] and to receive as a result of such solicitation any such return or return information. Any violation of this
paragraph shall be a felony punishable by a fine in any amount not exceeding $5,000, or imprisonment of not more than 5 years, or both,
together with the cost of prosecution.
(5) SHAREHOLDERS — It shall be unlawful for any person to whom return or return information [as defined in 6103(b)] is disclosed pursuant
to the provisions of 6103((e)(1)(D)(iii) willfully to disclose such return or return information in any manner not provided by law. Any violation of
this paragraph shall be a felony punishable by a fine in any amount not exceeding $5,000, or imprisonment of not more than 5 years, or both,
together with the cost of prosecution.
SECTION 7213A — UNAUTHORIZED INSPECTION OF RETURNS OR RETURN INFORMATION
(a) PROHIBITIONS —
(1) FEDERAL EMPLOYEES AND OTHER PERSONS — It shall be unlawful for -
(A) any officer or employee of the United States, or
(B) any person described in section 6103(n) or an officer willfully to inspect, except as authorized in this title, any return or return
information.
(2) STATE AND OTHER EMPLOYEES — It shall be unlawful for any person [not described in paragraph(I)] willfully to inspect, except as
authorized by this title, any return information acquired by such person or another person under a provision of section 6103 referred to in section
7213(a)(2).
(b) PENALTY —
(1) IN GENERAL —Any violation of subsection (a) shall be punishable upon conviction by a fine in any amount not exceeding $1000, or
imprisonment of not more than 1 year, or both, together with the costs of prosecution.
(2) FEDERAL OFFICERS OR EMPLOYEES — An officer or employee of the United States who is convicted of any violation of subsection (a)
shall, in addition to any other punishment, be dismissed from office or discharged from employment.
(c) DEFINITIONS — For purposes of this section, the terms "inspect', "return ", and "return information" have respective meanings given such
terms by section 6103(b).
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SECTION 7431 — CIVIL DAMAGES FOR UNAUTHORIZED DISCLOSURE OF RETURNS AND RETURN INFORMATION
(a) IN GENERAL —
(1) INSPECTION OR DISCLOSURE BY EMPLOYEE OF UNITED STATES — If any officer or employee of the United States knowingly, or by
reason of negligence, inspects or discloses any return or return information with respect to a taxpayer in violation of any provision of section
6103, such taxpayer may bring a civil action for damages against the United States in a district court of the United States.
(2) INSPECTION OR DISCLOSURE BY A PERSON WHO IS NOT AN EMPLOYEE OF THE UNITED STATES — If any person who is not an
officer or employee of the United States knowingly, or by reason of negligence, inspects or discloses any return or return information with
respect to a taxpayer in violation of any provision of section 6103, such taxpayer may bring a civil action for damages against such person in a
district court of the United States.
(b) EXCEPTIONS — No liability shall arise under this section with respect to any inspection or disclosure -
(1) which results from good faith, but erroneous, interpretation of section 6103, or
(2) which is requested by the taxpayer.
(c) DAMAGES — In any action brought under subsection (a), upon a finding of liability on the part of the defendant, the defendant shall be liable
to the plaintiff in an amount equal to the sum of-
(1) the greater of—
(A) $1,000 for each act of unauthorized inspection or disclosure of a return or return information with respect to which such defendant is
found liable, or
(B) the sum of:
(i) the actual damages sustained by the plaintiff as a result of such unauthorized inspection or disclosure, plus
(ii) in the case of a willful inspection or disclosure or an inspection or disclosure which is the result of gross negligence, punitive
damages, plus
(2) the cost of the action.
(d) PERIOD FOR BRINGING ACTION — Notwithstanding any other provision of law, an action to enforce any liability created under this section
may be brought, without regard to the amount in controversy, at any time within 2 years after the date of discovery by the plaintiff of the
unauthorized inspection or disclosure.
SECTION 6103 — CONFIDENTIALITY AND DISCLOSURE OF RETURNS AND RETURN INFORMATION
(1) DISCLOSURE OF RETURNS AND RETURN INFORMATION FOR PURPOSES OTHER THAN TAX ADMINISTRATION
(7) Disclosure of return information to Federal, State, and local agencies administering certain programs under the Social Security Act, the
Food Stamp Act of 1977, or title 38, United States Code, or certain housing assistance programs
) return information from returns with respect to net earnings from self-employment (as defined in section 1402)! wages (as defined in
3121 (a) or 3401 (a)), and payments of retirement income, which have been disclosed to the Social Security Administration as provided by
paragraph (1) or (5) of this subsection, to any Federal, State, or local agency administering a program listed in subparagraph (D).
(B) Return information from Internal Revenue Service — The Secretary shall, upon written request, disclose current return information
from returns with respect to unearned income from the Internal Revenue Service files to any Federal, State, or local agency administering a
program listed in subparagraph (D).
(C) Restriction on disclosure — The Commissioner of Social Security and the Secretary shall disclose return information under
subparagraphs (A) and (B) only for purposes of, and to the extent necessary in, determining eligibility for, or the correct amount of, benefits
under a program listed in subparagraph (D).
(D) Programs to which rule applies — The programs to which this paragraph applies are:
(i) a State program funded under part A of title IV of the Social Security Act;
(ii) medical assistance provided under a State plan approved under title XIX of the Social Security Act or subsidies provided under
section 1860D -14 of such Act;
(iii) supplemental security income benefits provided under title XVI of the Social Security Act, and federally administered
supplementary payments of the type described in section 1616(a) of such Act (including payments pursuant to an agreement entered into under
section 212(a) of Public Law 93 -66);
(iv) any benefits provided under a State plan approved under title I, X, XIV, or XVI of the Social Security Act (as those titles apply to
Puerto Rico, Guam, and the Virgin islands);
(v) unemployment compensation provided under a State law described in section 3304 of this title;
(vi) assistance provided under the Food Stamp Act of 1977;
(vii) State - administered supplementary payments of the type described in section 1616(a) of the Social Security Act (including
payments pursuant to an agreement entered into under section 212(a) of Public Law 93 -66);
(viii)
(1) any needs -based pension provided under chapter 15 of title 38, United States Code, or under any other law administered by
the Secretary of Veterans Affairs;
(11) parents' dependency and indemnity compensation provided under section 1315 of title 38, United States Code;
(111) health -care services furnished under section 1710(a)(1)(1), 1710(a)(2), 1710(b), and 1712(a)(2)(B) of such title; and
(IV) compensation paid under chapter 11 of title 38, United States Code, at the 100 percent rate based solely on unemployability
and without regard to the fact that the disability or disabilities are not rated as 100 percent disabling under the rating schedule; and
(ix) any housing assistance program administered by the Department of Housing and Urban Development that involves initial and
periodic review of an applicant's or participant's income, except that return information may be disclosed under this clause only on written
request by the Secretary of Housing and Urban Development and only for use by officers and employees of the Department of Housing and
Urban Development with respect to applicants for and participants in such programs.
Only return information from returns with respect to net earnings from self - employment and wages may be disclosed under this paragraph for
use with respect to any program described in clause (viii)(IV). Clause (viii) shall not apply after September 30, 2008.
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DRIVER PRIVACY PROTECTION ACT (DPPA)
Under state law, motor vehicle, driver license, and vehicular crash records are subject to public disclosure. The Driver Privacy Protection Act
(DPPA) keeps your personal information private by limiting who has access to the information. ( http:// www .flhsmv.gov /ddl /DPPAinfo.html)
119.0712 Executive branch agency - specific exemptions from inspection or copying of public records.
(2) DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES.
(a) Personal information contained in a motor vehicle record that identifies an individual is confidential and exempt from s. 119.07(1) and
s. 24(a), Art. I of the State Constitution except as provided in this subsection. Personal information includes, but is not limited to, an individual's
social security number, driver identification number or identification card number, name, address, telephone number, medical or disability
information, and emergency contact information. For purposes of this subsection, personal information does not include information relating to
vehicular crashes, driving violations, and driver's status. For purposes of this subsection, the term "motor vehicle record" means any record that
pertains to a motor vehicle operator's permit, motor vehicle title, motor vehicle registration, or identification card issued by the Department of
Highway Safety and Motor Vehicles.
(b) Personal information contained in motor vehicle records made confidential and exempt by this subsection may be released by the
department for any of the following uses:
1. For use in connection with matters of motor vehicle or driver safety and theft; motor vehicle emissions, motor vehicle product
alterations, recalls, or advisories; performance monitoring of motor vehicles and dealers by motor vehicle manufacturers; and removal of
nonowner records from the original owner records of motor vehicle manufacturers, to carry out the purposes of Titles I and IV of the Anti Car
Theft Act of 1992, the Automobile Information Disclosure Act (15 U.S.C. ss. 1231 et seq.), the Clean Air Act (42 U.S.C. ss. 7401 et seq.), and
chapters 301, 305, and 321 -331 of Title 49, United States Code.
2. For use by any government agency, including any court or law enforcement agency, in carrying out its functions, or any private person
or entity acting on behalf of a federal, state, or local agency in carrying out its functions.
3. For use in connection with matters of motor vehicle or driver safety and theft; motor vehicle emissions; motor vehicle product
alterations, recalls, or advisories; performance monitoring of motor vehicles, motor vehicle parts, and dealers; motor vehicle market research
activities, including survey research; and removal of nonowner records from the original owner records of motor vehicle manufacturers.
4. For use in the normal course of business by a legitimate business or its agents, employees, or contractors, but only:
and a. To verify the accuracy of personal information submitted by the individual to the business or its agents, employees, or contractors;
b. If such information as so submitted is not correct or is no longer correct, to obtain the correct information, but only for the
purposes of preventing fraud by, pursuing legal remedies against, or recovering on a debt or security interest against, the individual.
5. For use in connection with any civil, criminal, administrative, or arbitral proceeding in any court or agency or before any self - regulatory
body for:
state. a. Service of process by any certified process server, special process server, or other person authorized to serve process in this
b. Investigation in anticipation of litigation by an attorney licensed to practice law in this state or the agent of the attorney; however,
the information may not be used for mass commercial solicitation of clients for litigation against motor vehicle dealers.
c. Investigation by any person in connection with any filed proceeding; however, the information may not be used for mass
commercial solicitation of clients for litigation against motor vehicle dealers.
d. Execution or enforcement of judgments and orders.
e. Compliance with an order of any court.
6. For use in research activities and for use in producing statistical reports, so long as the personal information is not published,
redisclosed, or used to contact individuals.
7. For use by any insurer or insurance support organization, or by a self- insured entity, or its agents, employees, or contractors, in
connection with claims investigation activities, anti -fraud activities, rating, or underwriting.
8. For use in providing notice to the owners of towed or impounded vehicles.
9. For use by any licensed private investigative agency or licensed security service for any purpose permitted under this subsection.
Personal information obtained based on an exempt driver's record may not be provided to a client who cannot demonstrate a need based on a
police report, court order, or business or personal relationship with the subject of the investigation.
10. For use by an employer or its agent or insurer to obtain or verify information relating to a holder of a commercial driver's license that
is required under 49 U.S.C. ss. 31301 et seq.
11. For use in connection with the operation of private toll transportation facilities.
12. For bulk distribution for surveys, marketing, or solicitations when the department has obtained the express consent of the person to
whom such personal information pertains.
13. For any use if the requesting person demonstrates that he or she has obtained the written consent of the person who is the subject
of the motor vehicle record.
14. For any other use specifically authorized by state law, if such use is related to the operation of a motor vehicle or public safety.
15. For any other use if the person to whom the information pertains has given express consent in a format prescribed by the
department. Such consent shall remain in effect until it is revoked by the person on a form prescribed by the department.
(c) Notwithstanding paragraph (b), without the express consent of the person to whom such information applies, the following information
contained in motor vehicle records may only be released as specified in this paragraph:
1. Social security numbers may be released only as provided in subparagraphs (b)2., 5., 7., and 10.
2. An individual's photograph or image may be released only as provided in s. 322.142.
3. Medical disability information may be released only as provided in ss. 322.125 and 322.126.
4. Emergency contact information may be released only to law enforcement agencies for purposes of contacting those listed in the event
of an emergency.
(d) The restrictions on disclosure of personal information provided by this subsection shall not in any way affect the use of organ donation
information on individual driver licenses or affect the administration of organ donation initiatives in this state.
(e)1. Personal information made confidential and exempt may be disclosed by the Department of Highway Safety and Motor Vehicles to an
individual, firm, corporation, or similar business entity whose primary business interest is to resell or redisclose the personal information to
persons who are authorized to receive such information. Prior to the department's disclosure of personal information, such individual, firm,
corporation, or similar business entity must first enter into a contract with the department regarding the care, custody, and control of the
personal information to ensure compliance with the federal Driver's Privacy Protection Act of 1994 and applicable state laws.
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2. An authorized recipient of personal information contained in a motor vehicle record, except a recipient under subparagraph (b)12.,
may contract with the Department of Highway Safety and Motor Vehicles to resell or redisclose the information for any use permitted under this
section. However, only authorized recipients of personal information under subparagraph (b)12. may resell or redisclose personal information
pursuant to subparagraph (b)12.
3. Any authorized recipient who resells or rediscloses personal information shall maintain, for a period of 5 years, records identifying
each person or entity that receives the personal information and the permitted purpose for which it will be used. Such records shall be made
available for inspection upon request by the department.
(f) The department may adopt rules to carry out the purposes of this subsection and the federal Driver's Privacy Protection Act of 1994,
18 U.S.C. ss. 2721 et seq. Rules adopted by the department may provide for the payment of applicable fees and, prior to the disclosure of
personal information pursuant to this subsection, may require the meeting of conditions by the requesting person for the purposes of obtaining
reasonable assurance concerning the identity of such requesting person, and, to the extent required, assurance that the use will be only as
authorized or that the consent of the person who is the subject of the personal information has been obtained. Such conditions may include, but
need not be limited to, the making and filing of a written application in such form and containing such information and certification requirements
as the department requires.
(g) This subsection is subject to the Open Government Sunset Review Act in accordance with s. 119.15 and shall stand repealed
October 2, 2012, unless reviewed and saved from repeal through reenactment by the Legislature
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AGENCY FOR
HEALTH CARE ADMINISTRATION
COUNTY BILLING
GUIDELINES
UPDATED 5/17/2012
Table of Contents
PREFACE....................................................................................................................................... ..............................
LEGISLATIVEREQUIREMENTS ................................................................................................ ..............................
BILLINGWORKFLOW ................................................................................................................ ..............................
ESTABLISHING COUNTY OF RESIDENCY ............................................................................. ..............................4
HOSPITALCHARGES ................................................................................................................. ...............................
5
1. Overview of Inpatient Hospital Charges ........................................................................... ...............................
5
2. Number of Days (of County Responsibility) ...................................................................... ..............................5
3 Calculation of County Share ............................................................................................. ...............................
5
4 Billing for Medicaid HMO Patients .................................................................................. ...............................
5
NURSINGHOME CHARGES ....................................................................................................... ..............................6
1. Overview of Nursing Home Charges ................................................................................ ...............................
6
2 Calculation of County Share ............................................................................................... ..............................6
3 Out of State Residents ......................................................................................................... ..............................6
MONTHLYBILLINGS .................................................................................................................. ..............................
1 Billing Cycle ...................................................................................................................... ..............................
2 Processing Charges ............................................................................................................ ..............................
3 Certification of Charges .................................................................................................... ...............................
7
SCREENSHOTSOF UPDATED PORTAL ................................................................................... ..............................8
REQUESTINGAN ADVANCE REFUND .................................................................................... ..............................9
I Due Date ............................................................................................................................. ..............................
2. Determining an Advanced Refund Request ...................................................................... ...............................
9
2. Marking an Advanced Refund Request in the Web Portal ................................................. ..............................9
REQUESTINGA BACK -END REFUND ..................................................................................... .............................10
1 Overview ........................................................................................................................... .............................
2 Due Date ............................................................................................................................ .............................10
3 Submission of the Request ................................................................................................ .............................10
4 Review of the Request ....................................................................................................... .............................10
BACK -END REFUND TEMPLATE ............................................................................................. .............................11
DEFINITIONS............................................................................................................................... .............................12
GLOSSARYOF TERMS .............................................................................................................. .............................13
PA
PREFACE
This supersedes any previous publications and is not intended to set policy or rules. Any changes in statute or rule
implemented will take precedence over this publication.
LEGISLATIVE REQUIREMENTS
Florida Law requires that each county pay a portion of the Medicaid costs associated with certain items
of care and services rendered to their county's eligible Medicaid recipients. Eligibility of Medicaid
services is determined by either the Department of Children and Family (DCF) or the Social Security
Administration (SSA), and is based on financial and categorical requirements.
Pursuant to Section 409.915, Florida Statues, each county is required to participate in the cost of
providing medical assistance for inpatient hospitalization and nursing home care. Each county is to set
aside sufficient funds to pay for the above items of care and service, regardless of where in the state the
care or service is rendered
BILLING WORKFLOW
Under the current billing system, all hospitals and nursing homes participating in the Florida Medicaid
Program submit claims to the Medicaid fiscal agent for the cost of providing care to eligible Medicaid
recipients. Claims submitted by providers are paid by the fiscal agent. At the end of each month, certain
data components for all claims processed during the month are extracted and compiled by the Florida
Medicaid Management Information System (FMMIS) County Billing Subsystem and sorted by county.
Personal profile and eligibility data for each recipient is obtained from the FLORIDA system, which is
administered by DCF. The profile and eligibility data is combined with the monthly payment data to
generate the monthly county billing invoice.
The billings from 11/01/2001 through 04/30/2012 (retrospective), which includes provider claims
processed through March 2012, will be handled pursuant to Section 409.915(7), Florida Statutes. The
billings beginning 05/01/2012 (prospective), which includes provider claims processed in April 2012,
will be handled pursuant to Section 409.915(9), Florida Statutes.
ESTABLISHING COUNTY OF RESIDENCY
According to Rule 59G- 1.020, Florida Administrative Code, individuals establish their county of
residence when they maintain a physical living arrangement, outside a medical facility, which they or
someone responsible for them consider to be home. The county in which this living arrangement is
maintained is the county of residence. A visit to another county or a planned temporary living
arrangement, prior to admission to a medical facility, does not constitute establishment of residency. In
all instances, the person's intent to reside in a county is the determining factor, regardless of the length of
time involved.
When an applicant has been admitted to a nursing home directly from a place of residence outside the
State of Florida, so that no Florida residency has been established, the certified county of residence is the
county where the nursing home is located.
Each county's eligible Medicaid recipients shall be determined by the recipient's address information
contained in the federally approved Medicaid eligibility system.
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HOSPITAL CHARGES
1. Overview of Inpatient Hospital Charges
Pursuant to Section 409.915 (2), Florida Statutes, all counties are responsible for 35% of the total cost of
providing inpatient hospital services to eligible Medicaid recipients. The exceptions are pregnant women and
children whose income is in excess of the poverty level and who do not participate in the Medicaid medically
needy program, and for lung transplant services.
2. Number of Days (of County Responsibility)
The counties are responsible for the payment of inpatient hospitalization for days in excess of 10 but not in
excess of 45 per State fiscal year.
The invoice shows the number of days hospitalized for prior claims under the column header "Prior YTD
Days ". The number of days hospitalized for the current coverage period are shown under the column header
"Nbr Days ". A county is only responsible for the number of days in the current coverage period that are in
excess of 10 days, but not in excess of 45 days of the YTD total, which is found under the header "Bill Days ".
3. Calculation of County Share
The "Amount Paid" is the amount paid to the hospital, and is calculated by multiplying the per diem rate for
the hospital by the number of days for the current coverage period. The "County Share" is calculated by
multiplying the per diem rate by 35% then multiplying by the number of days that the county is responsible
(Nbr Days).
4. Billing for Medicaid HMO Patients
The 1996 legislature mandated that as of July 1, 1996 the county billing process is to include hospital
inpatient days for eligible Medicaid recipients in Health Maintenance Organizations (HMO). Since this
inpatient care is charged directly to the HMO, a claim is not filed with the Medicaid fiscal agent. Each HMO
is required to file a report with the Agency quarterly which is used as the basis for the HMO portion of the
invoice. The HMO is provided its own per diem rate. The "County Share" is calculated by multiplying the
per diem rate by 35% then multiplying by the number of days that the county is responsible (Nbr Days).
NURSING HOME CHARGES
1. Overview of Nursing Home Charges
Pursuant to Section 409.915 (2), Florida Statutes, all counties are responsible for 35% of the total cost of
providing nursing home or intermediate facility services to eligible Medicaid recipients. The exception is
skilled nursing care for children under age 21.
2. Calculation of County Share
Counties are responsible for 35% of payments in excess of $170 per month, but not to exceed $55 per month
per person.
3. Out of State Residents
When an individual is admitted to a nursing home directly from a place of residence outside the State of
Florida, the county of residence is the county where the facility is located.
MONTHLY BILLINGS
1. Billing Cycle
Provider claims submitted during a calendar month are included in the monthly County Billing cycle.
Additionally, HMO charges are processed on a quarterly basis and will be included as part of a monthly
billing. The invoice will be posted on the County Billing portal on the second day of the following month.
Below are screen shots of the portal. The county staff will have until the end of the invoice month to
review the charges prior to the Agency certification. For example, claims submitted during May will be
included in the county billing invoice posted the second day of June. The county staff will have until the
end of June to review the charges.
2. Processing Charges
The charges in the monthly invoice will be indentified by an Accounts Receivable (AR) number. When the
invoice is posted to the portal, the status of the ARs will be "BILLED ". The county staff will have an
option to change the status to "ADV REFUND REQUEST" until the end of the invoice month. The "ADV
REFUND REQUEST" option will be available for May through October billings.
Counties will have an option to request a back -end refund request through the end of the month following
the invoice month (April claims billed in May, back -end request available through June).
Both of the refund request processes are described in more detail below.
3. Certification of Charges
The monthly ARs that are in the "BILLED" status after the end of the invoice month will be reclassified to
"CERTIFIED" status. The items that are assigned to a certified status will be removed from the County
Billing portal. The total amount of the certified ARs is the amount the county will owe for the monthly
billing.
Screenshots of updated portal
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REQUESTING AN ADVANCE REFUND
1. Due Date
The advance refund requests can be made up to the last day of the month in which the invoice was posted
to the County Billing portal. After the end of the month the option to change the status on an AR will not
be available.
a. Determining an Advanced Refund Request
Counties are responsible for participating in the cost of care and service provided to an eligible Medicaid
recipient. Counties may request an advance refund request for charges that they believe are not their
responsibility. The advance refund request will be reviewed by Agency staff within a 60 day period.
In order for the AHCA county billing unit to research and provide the required information to substantiate a
refund request, it is essential that each county indicate the reason for requesting the refund request. Please
indicate the reason on the invoice with appropriate comment, or provide a separate list that includes the AR
number, invoice number, amount and reason for the refund request.
The advance refund requests that are approved by Agency staff will be transferred out of the county's billing.
The charges may be transferred into another county's billing. The requests that are not approved will be
marked certified and included with the certified charges in the subsequent month.
3. Marking an Advanced Refund Request in the Web Portal
A county requests an advance refund request by checking the box to the left of the AR number (see screen
shot above). Use the drop -down box to change the status code from "BILLED" to "ADV REFUND
REQUEST ". Include the reason, which is also a drop -down box. Any additional information may be typed
in the comment field. Click the SAVE button when done. If a charge is accidentally marked "ADV
REFUND REQUEST" the county will have the ability to return it to a "BILLED" status.
01
County Billing Back -end Refund Request
County:
County Contact Name:
County Contact Phone Number:
Invoice # AR # County Share Amount Reason for Refund Request
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DEFINITIONS
AR Number — An identifying number assigned to a charge in the County Billing Subsystem
Invoice Number — The four -digit year + two -digit month during which the claim was processed
Provider ID — The Medicaid number of the provider who received payment for services rendered to the
recipient
Provider Name — The name of the provider who rendered care or service, and received payment
Recipient ID — This is the Medicaid identification number specifically assigned to the recipient
Recipient Name — Name of the recipient as it appears in the FLORIDA system
Prior YTD Days:
Hospital — The total number of days the recipient has been hospitalized for the current state fiscal year
prior to the current charge
Nursing Home — Not applicable
Nbr Days:
Hospital Invoice — The number of days hospitalized for the current charge
Nursing Home Invoice — The number of days in the service month
Bill Days — Number of days the county is responsible for on the current charge
Service Month — The month in which the care was rendered
Total Amount — The total paid to the provider for the designated recipient and service month
County Share — The county portion of the total amount due
Address History:
Hospital Invoice — Current address - The address of the Medicaid recipient
Nursing Home Invoice — Current address - The address of the nursing home
Prior address - The address of the recipient prior to entering the nursing home
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GLOSSARY OF TERMS
AHCA — Agency for Health Care Administration
Bill Days - The number of days that are to be billed to the county
Date Of Service — The day service was obtained
DCF — Department of Children and Family
Fiscal Agent — The contractor responsible for administering FMMIS, processing payments to Medicaid
providers, and generating the monthly county billing reports
FLORIDA System — The DCF computer system which has the personal profile and eligibility information
for a Medicaid recipient
FMMIS System — The Florida Medicaid Management Information System, which is the system that
processes Medicaid payments, and produces the monthly county billing invoice.
Intermediate Facility — (ICF/DD) Intermediate Care Facility for the Developmentally Disabled; a State
owned facility that provides care for mentally retarded or developmentally disabled individuals
Per Diem — The daily rate paid to providers for rendering services to a Medicaid recipient
Recipient — A person who has been determined eligible to receive Medicaid benefits
Third Party — Any other insurance that pays on a claim for a Medicaid recipient; Medicaid is the payer of
last resort
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