Item C07BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: 06/20/2012 Division: _Community Services
Bulk Item: Yes x No — Department: Social Services
Staff Contact Person/Phone #: Sheryl Graham 305-292-4510
AGENDA ITEM WORDING: Approval of a 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 BACKGROUND:
Attached please find the MOU that will need to be executed by each appropriate county office that
wishes access to the Department's FLORIDA system to verify client addresses for Medicaid billing
purposes.
Florida Law required 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 Families (DCF) or the
Social Security Administration (SSA). 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 above items of care and
service.
PREVIOUS RELEVANT BOCC ACTION: N/A
CONTRACT/AGREEMENT CHANGES: N/A
STAFF RECOMMENDATIONS: Approval
BUDGETED:TOTAL COST: n/a
DIFFERENTIAL OF LOCAL PREFERENCE: N/A
COST TO COUNTY: n/a SOURCE OF FUNDS: n/a
REVENUE PRODUCING: Yes No X AMOUNT PER MONTH Year
APPROVED BY: County Atty �OMB/Pnrchasing Risk Management
DOCUTMENTATION: Included X Not Required
114SPOSITION: AGENDA ITEM #
Revised 7/09
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: MOU with the Department of Contract:
Children And Effective Date:
Families
(DCF)
Expiration Date: n/a
Contract Purpose/Description: Approval of a 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.
Contract Manager: Sheryl Graham 4510 Social Services/Stop 1
(Name) (Ext.) (Department/Stop #)
For BOCC meeting on 6/19/2012 Agenda Deadline: 6/5/2012
CONTRACT COSTS
Total Dollar Value of Contract: N/A
Budgeted? Yes X No Account Codes:
County Match: NA
Additional Match: 0
Total Match $0
Estimated Ongoing Costs: $ /yr For:
(Not included in dollar value above) (e.g. i
Current Year Portion: $_
_N/A -
ADDITIONAL COSTS
janitorial, sa
CONTRACT REVIEW
Changes
—'
Date Out
Division Director
Date In
Needy _�
Yes N
W viewers
�.
Risk Management
Yes No
O.M.B./Puasing
l
Yes N
.
County Attorney
Yes
Comments:
v:vin r orm Kevrsea rdcttut ivit-jr ffL
s
ChJdren&Famines
State of Florida Rick Scott
Department of Children and Families Governor
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
MU4(Z.4.l�_ 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
0
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.
11711odifications 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.
M
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Department contact/coordinator:
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 belrose(cD-dcf.state.fl.us
IN WITNESS THEREOF, the parties hereto have caused this Memorandum of Agreement to be
executed by their undersigned officials as duly authorized.
COUNTY BOARD FLORIDA DEPARTMENT OF CHILDREN
OF COUNTY COMMISSIONERS AND FAMILIES
Signature
(name and title)
Date
Signature
Date
Ann M. Berner
Director, Economic Self -Sufficiency
Program
Attachments:
Exhibit Aand Security Requirements
Exhibit 6 — FLORIDA system screen shots
Exhibit C — FLORIDA Individual Security Information form
Exhibit D — DCF CF1 14 Security Agreement Form
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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.shtmi 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 a way 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.
report11 - To adhere to the confidentiality requirements stated herein, and to fully and promptly
any infractionof •• to the respectivecontacts i` `i in
Sectionof a
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.
N
"EXHIBIT B"
Limited FLORIDA Data
"EXHIBIT B"
Limited FLORIDA Data
"EXHIBIT B"
Limited FLORIDA Data
"EXHIBIT B"
Limited FLORIDA Data
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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 WITH: 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.
I Oa. 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
19
• 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 and 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
In
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. DISTRICTICSE 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. JCTSTIFICATIONICOMMENTS: 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.
0
3 1. 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.
SECURITY AGREEMENT FORM
The Department of Children and Families has authorized you:
Employee's
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.
al 6103(t)(7) of the Internal Revenue Code, which provides confidentiality and disclosure of returns
and return information.
0 CFOP 50-2.
0 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.
0 It is the policy of the Department of Children and Families that I do not disclose personal passwords.
0 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.
0 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.
0 "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 Department
Resources Act. The Technology
requests social security numbers to ensure secure access to data I
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
Print Super -visor Name
CF 114, POF 0612010
Signature of Employee/Contractor
Signature of Supervisor
M_
I— ..1, 1 — I rllej,,oruract tiie; COPY — Employee!Contractor
E X �A,11 6 i -� 1)
CHAPTER 816: COMPbTEG4RELATEmcRIKHES
816.01Sho title. The provisions of this act shall baknown and may oecited as the "Fln�a�o���C����
(n,mon,v. 1, no. ro-92l ' �^
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
lo I sses associated with each incident of other white collar crime.
(3) The opportunities for compute r-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.
816.03 Definitions. Amused inthis chapter, unless the context clearly indicates otherwise:
computer,U)7\ooeao^means uouppmaoh.inotm�.communicate w�x.amnadata in nmriovmu��'hnm or x
opmputeruye�m.ormomputa,n*�n,k. ' " ' oamaausmorenyn000uomoofo
(o)^Compumrmeans aninternally programmed, automatic device that performs ua� i
(a)^Compmernvnuarninant^means any set ofcomputer inotm�ionodooi u»o ��Pmc*«u»��
w1thinau«mpu»ar.00mpvtmruyo»am.nroompuu*rna�om"wthoutthein»sntQne imou|�/�maQe'da�mY.nau^'«.nr�xnnomi�in(bnnabon
but /unot |imhadto, ogmupo[computer instmct/onacommonly caoedvimozvp�/m»o/»nmmo«w«erv'�hmi��nna��n� Theuunnin�udee
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du«�es.including, but not limited to, display terminals and p,intasmmao»nouom«�m«»o»rm«nec«mpuuor ondi�inpvto,nu�pu�
(5) "Computer program or computer software" means a set of instructions or statements and related data which, when executed in actual or
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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 compu r
computer system, or computer network. te ,
(7) "Computer system" means a device or collection of devices, including support devices, one or more of which contain computer
electronic instructions, or input data and
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(4)(a)Except osotherwise provided inthis subsection, anoffense against intellectual property i na/
pmw«�ume�77s�Uoo.w�7r5����.nrn�77n�u84� (b)|y�honM�nseiacomnniueu*n,me �o «ny»'memimuaQ'ee.Pu»/ohab|eum
o`ue�au««'�n«mamonYPmpeny.theothou#ende,ingui|h/vfafehnyufthemeconu'»unp»ae»'«e«/aing»'«maummoanYscn�menra�mce
7rs�uVo.mre�Tr��V84� degree, punishable psprovided ioe.rrs.oau's.
(History:o. 1.oh. 78'92;a, 1.ch. g4'1VO/s�4u1.ch. 96'408,)
n1aO4sTrade secret information. The Legislature finds that it is a public necessity that trade secret information as defined in s. ~��=812V8"
'
a
n u__,_,.,~~.~..=".^"~�/.vvexp�ss�maueomnndent�|anuexemcuhnmmepvWipnacnpgs|awueoeuoe�|aowamnytod/»ubse su«n--_~�~.~~".�|=u=.="v/u/mvau,o�nemarapub/�emp�yoowou�bepmemeunnme8amnynonvictm nnthenwim*c«mp|�ngwm»umv�'1`�and w/�os.z^(a).A�|nfmmS��Cnn�bu�n.b�impaud"em�uapwm��cn�sexempt �noo«amu�r:�eg|o'eimakingu/o�usu"oo/tnooemeoetaaor/mahouc/eadymetaboahedtheimpo�anoeomaohoduutnaueseu�t�wm
anuoenc»ap»se»am/onwm«mneoauve|yimpocume»vamena/nu,mvtsnrmowepmvigmgaoagenqysuoon�e�/o«.Disclosing trade ne�etain
trade senno�u»damaging memm
the marketplace, and mnoeenUt/eaand /nu/v�ua|wmuu|ommgsuch trade aecno�wnuWhesitate tuvvupem�wh»maage»oY.which wwummpa��ee���eand »ffidentadminint,abunofgovemmon*a|fun�inns.Thus, the pubUoand v^"="�'""i"ommvs/»go�ue»e«��s�n'«�»n|vo^om»�msany P«$|�bene�dedvedhomdi*uoouna.and mapom~eeboUym=ut""nand monitor agency action isnot
diminished uynondisclosure of trade secrets, (History: s.z.ch. o4-1on.) pmmera.
u16.noOffenses agaimucomputer usan� '
computer (o)Accesses orcauses |oUeao�computer, n»
�vmpme'»emmum; (u)o�m�smden�sv,causes the denial ofcomputer sys�mservmeomwnaumo�zeuuser ". such computer system
services, which, /nwhole orpart, is owned by, under contract to, moperated for, onbehalf of, ^~cn~
i »c»»�n�m»wuhan�hac (�
Destroys,
ukem h�ue«.»rdamages equ�mon o/supp�sused m��od*dbobeused �a«nmpms�computer sYm�m.o'u»mpmernetwork;
(d) Deu�»yo'i�upas.nrdamages any uump--�comp�e/oys�m`o,computer n*mv«m;or (*)/ntmduma»any computer contaminant into
a
n
yconp«Uy�u»mP»ta'ayxtem.prcnmu»ern--'rh^ commits anoffense ogain�uamvmaruoem'(2)(o) Except axpmvided/npa�0, pou0�,odV�.wmv:vnr"io|a�o�uouonuon(1)commi-ofe/onyonmethi»ddeg�e'punishableasprov�edma rr5V8o_n� r75O80.o,n.//5.004, (u) 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,o's.//5.«m4. (c) Whoever violates subsection (1)
and the violation endangers human life commits a felony of the first degree, punishable aaprovided /n».r75.OV2.o.7r5.O83.ora.r7o.OV4,(3)Whoever willingly, knowingly, and without authorization modifies ^equipment o' supplies used »/ intended 0«baused inacomputer,
computer system, prcomputer network commits amisdemeanor ofthe first degree, punishable eoprovided ioo.7r5.002ors.r75O8» (4)(a)maddiUonmany other '�i|remedy available, the owner vna»eu*»'the c«mp�er'oomP«�rsystem, uomp�o/ne�mr�`computer
program, computer equipment, computer supplies, or computer data may bring a civil action against any person convicted
under this section foronmPensot»ryuomagms. (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 thecommisinnofanyvi~|a8onnfmisaam"ono/ooyu»mP«to«mw««ubyuhodefendontwhiuhis««edasonapositoryforthestonogoof'~~oa ~'datnuNa{nmd/nvio|-./onofthiemaoUo.isovbjoct=/vnmi`mn,aopmv/dodundo,uo�932-701-832'704 �)Th�smodondoes not epp�Nany o�on who accesses his orher emp/oye,ocomputer system, computer network, computer program,
urcomputer data when acting within the scope u*his orher lawful employment.
computer �mau��mu�m ~p"e' "x"='''.mcpmPmernetwork monejuhnu/c�on�omanmhor]uhod�8on�deomedtohovapersona| 'e000no d�h puoe''
mpu�'sY�em.o'computer network /nhmh]unod/ouono /v � euompuus,.
no
(Hiomry:e. 1.ch. 78'S2;o. 11'ch. 2OO1'54.) �
81507Thua chapter
the criminal law vfthis state which p provisions of this chapter " �'�""tve«ono�m «ooPe«m«euUeaPpUoabi|dyofanymharpm«�ionof
pnvv��n�moone��mvwmmhe»ap�°=. may mmmmmroopp�¢`any �anoe��nwh�hv���mm�uha�orun�mssuch
noamthis chapter. (Mimnry:n.1.ch. r8-92.)
SECTION 721u-UNAUTHORIZED DISCLOSURE OFINFORMATION
(o) RETURNS AND RETURN INFORMATION -
(1) FEDERAL EMPLOYEES AND^�OTxERpER8OwG-|tahaUbeun|owfu/foranyofficer-nremployee mthe United States « any pers
on
deocnoeomseononu1o»(n)(oranonowrorempmymeofanyouoopemnn).uranyfonnnroffineruromployne' willfully ¢disclose toany person,
exc=p^a="""""^cummisnne.aoymmmo,emrn/monnation[asdefiooumoen|on61O3(b)]Any violation ofthis paragraph shall o«o
felony punishable upon conviction uyafine inany amount not exceeding *5'Oo0 v,imprisonment ornot more thanoye�m'o'both, together
with the costs ofprosecution, and ifsuch offense iscommitted byany officer oremployee ofthe United States, he shall, maddition tpany other
punishment, uedismissed from office ordischarged from employment upon conviction for such offense.
(o)STATE AND OTHER EMPLOYEES -/tshall bmunlawful for amypem»n[»«td«muribpd/nPamQmPh(1)]wi|KbU todisclose toany
person, except oeauthorized mthis title, any return ormtureturn
Any violation vfbhieparagraph
shall boafelony punishable by- fine ' any amount not exc�oing $5,«00,mimprisonment ofnot more than 5years, o,both, together with cost of prosecution,
the
(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 r21mu-UNAUTHORIZED INSPECTION opRETURNS oRRETURN INFORMATION
(a) PROHIBITIONS -
(1) FEDERAL EMPLOYEES AND OTHER PERSONS - It shall be unlawful for-
(A)enyofficsruremp/uy000ftheUoiUodGtatee.ur
(ufonna(a)anYPam«n«esonuedinaocti»us1«3(n)uranmffio*rwiUfv/ly toinspect, except eaauthorized inthis title, any return o,return
(2) STATE AND OTHER EMPLOYEES - It shall be unlawful for any person [not described in paragraph(l)] willfully to inspect, except au
authorized "' this title, any return information acquired bvsuch peomno,an��wrpa��nvnu:'apm,��nofse��n ��o3e�rmutu in msectionr2/»(a)(u).
(b)PENALTY -
imp�r
;UvGENER�L-�m�o(aUsubsection �
bopunimom�upnnconvimmnbyafina|nanyomountnmexoeedinQ$1O0O or
.."".".="^". not more mmwith an, vemr.o,uo.�n���herthmeoomsorprosecution.'
(2) FEDERAL OFnCEnSOREMPLOYEES -»mo�ce,n,emp�yeou/moUnited
States who isconvicted ufany violation ofsubsection (a)
shal
l, from office ordischarged from emp/o;me^t
(�DEFINITIONS - For purposes o,m�ae�mm.mevennm''inaoeuC.^m�u,n^.and ^reuummh,,mau'~ given c*
a'nnmoyse��no1oo(b). mv
SECTION 74m—CIVIL DAMAGES FOR UNAUTHORIZED DISCLOSURE opRETURNS AND RETURN INFORMATION
(1)INSPECTION URDISCLOSURE BYEMPLOYEE OFUNITED STATES —Ifany officer oremployee «mofUmU hedS��s
�oaono'neS/�enua�nape�anru�c�oonany *�umor��mi�onnohoowith �ape�»oa�xpoynrinvio�dnnnypmv���m�ng�«r�v
"'"^. such taxpayer may oncivil damages aiostthe Un�edStm�m/nadistrict mou�oof United ofm^o`oenoo»
(2)INSPECTION ORDISCLOSURE BYAPERSON
`—WHO /SNOT xNEk0pLOvEsOFTHE UNITED
nn'«'sG�to»os�
oe'uremployee nfthe UndedStates knmw/oq|�� oynsesunmfnegUgenoe inmpemonrdiscloses a —/ro»yp*oa»»�»»/s»otan
o�
neape�tuutaxpayer inv|oioUunm[any pmv�innufee'�iun6105 such texp�-'~rmoybringaoivi/a�ny�momor�mm�»»rmnU«»w|�h
di��munou�ofthe Und*uG«atea ' mnmroamogaaogo/notouoxporaonioa
(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 6103or -
(2)which io�que�adbythe taxpayer, '
(c)DAMAGES —|nany action brought under subsection (m).upon ofinding ofliability unthe part ofthe def�ndan� �hmdmhandon�oha||�m|i b|
tothe p��oim
n in swmn� ' liable
(1)txegmooa,of—
foundnV\Xt �00Vfor each act ufunauthorized innpamm
/nnnruiuu|qeunanfonomornuuminoonnaUonwbxnnspectmwhioosuohdn*andantis
le, or
(B)the sum of:
(i) the actual damages sustained by the plaintiff as a result of such unauthorized inspection or disclosure, p|vo
damages,
(ii) in the case of a willful inspection or disclosure or an inspection or disclosure which is the result of gross negligence, punitive
plus
(2)the cost ofthe action.
(d)PERIOD FOR BRINGING ACTION — Notwithstanding any other provision oflaw, onaction toenforce any liability created under this aent/ may oebmugm.mxmnuteOavdtuthe amount movnt,ovomy.�gany Umewxmn2yeamafter the date ofu�cuva�uymen|sinUnufthe
»n
unauthorized inspection ordisclosure,
SECTION 61ou—CONFIDENTIALITY AND DISCLOSURE OpRETURNS AND RETURN INFORMATION
(VDISCLOSURE 0FRETURNS AND RETURN INFORMATION FOR PURPOSES OTHER THAN TAX AoM|w/GTpV\TON
Fu �V]ec|osumo �mm��nna8nntuFadom|.Sm�.and local agen�euodmin��nngcenoinpmgmmounder the
^/�o|8eoo�y��.me
oomm ampacx1o//.u'uue3W.Uni�dGto&aoCodo.o,ms�a|nhousingaaaiatonoepmgmma ~"
,�umiVVn�um��matmnhnmGo�o/Souurdyadmioiobotiun—ThmCummioniunarof Sn�o/Gooudtyoha// upon whUen»nquem disclose
31�1 (mmrmanonf�mn�umowit»�ope�tonet*aminWo�nmse|�emp/oyment(oadehnodinoeuUno14O2).'woges(aade8nedin'-ot�n
a)".^°v/()/.anopavmen�nfn$|namentinonme.wxiuhhwvebmendiomouedtomoOonia|8euudtyAdminiatrsUnnaap provided e� y
from (B)Retum|�onnaUonhnm|noamu|Revenue Oamioe—The Seon�oryshall, upon wr�ennaquea*d��osocurrent nem,Y�m»o,moUvm
pnpgemrnswuomupe�munoamodincnme�nmtho|nn*mu|RevenunGemioefi/ea|oanyFadem| State,— ur|000/agencyod"in|stadnga
osm oamomovupamgrapo(D). ' "'
(C�
b �Re�obonundis�oaum—TheCommiss�ne,cfSnn�|Se,u�yond�uSemmtoryuheUd�upoo��nnin�m�umonunu»'
ounonognapx o\ d(8)only for pumouenu�and tuthe e�entneuamea�in.d�enniminge|igim|nyoo, v,mevnrec�ompvn�u�benefits
underopmgmmxuomuinoubpomgroph(o). '
(D) Programs to which rule applies — The programs to which this paragraph applies are:
(0aState program funded under part Amtitle /Vofthe Social Security Act;
section uu1 (��nedkm/assistance vmvidadunder aState plan appmvauunder nuem` ufthe Social Security *�u,subs�/esprovided under
uu-1*n,such Act;
oup |~..�.(oVsuPp�mento|senvruyincome benof�s mv�edunder oUmXV ofmeGn�o/Souo�yA�.and �dem/�admini�emd
,,~'"a.'p"x..e..s".mevneooscn000msmct/um1n1o(a)v,auchA�(inc/udiogpuymon�pusuantmenogeeman�en*�mdi t u nm�mn21z(a)ofpuWioLawn3—s*); into er
Puerton�the Act ct(anmosrUUaaonp�m °~".�"�".anuov/ngmm�nds);
,., unemployment compensation provided under autate law described msection 33U4ofthis t0w
�;oeu��npapmvmeuunder m�
eFnodampA#of1o77; '
pa��,�AaG�-�min��n�auP�mr���y�»���e����ih�in��on161���theGm�|8o�myA�(iomuding
pursuant to an agreement entered into under section 212(a) of Public Law 93-66);
(^m)
the Secretary Uh�yne=dn�maodpension pmvidedunder chapter 15oft�|o3O.unhedStommCode, nrunder any other law odmin|w0amdby
f Veterans Affairs;
(|Vparents' dependency and indemnity compensation provided under section 131eo,title 3a United States Code;
(UVbeaUo�mreeamicaa*um(ohedunder mac*�n/71O(a)(1)(V. 17|U(a)<2> 17/0(U)and 171`(o)(2)(8)ofsuch UU` and
and without 0v)nompenaaUonpa�under c*o�er1I of��38.Un�oUS��oCoue.at ^ the 1OQ'pen�nt~rate based so��nn title;
.�ammthe��m�mou�bm�md�a��samom�mdas1oun�o�tg�om|ngunderme�mga����� ~~^�
<�m�»«�/����ncep �m/��n�� , schedule; and
penodicrav�wufaneppUuant'sp,paui�"—' income,
"'""=p"'��*^m�"«mmganou«za»oe«r|opmeo�mat|nvn*eoindiv|an�
mqu��uxme�mo��ryorHou�nQa"~wumnm�vme.axoen mat�mm'monnauoumay bed�oWasuunder uh��avaoon�pnwnuen
urbanoove|upm�n���ommp*'�»ma�d"."u,rveveopmentomoon/yxxumabymffinemonuemp|nveesufmuoepa�monto,Hnoo/nganu
pp'.=°..mfor and participants msuch 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 many program described imclause (viii)(|v). Clause (,|iVshall not apply after September 30.2OO&
DRIVER PRIVACY PROTECTION ACT (DPPA>
Under state law, motor vehicle, driver license, and vehicular crash records are ovNecmpvu|�dinu�uum The Dhvm�nva
(DpPA) keeps your pemona/imonnaUonp�mksuy|in8inQwho has access |othe �^^nna8on, (hup:---nh»yugmn~vocypm��Wn4�
118.$718Exeouthebranch aganoy'speci�cexempMena�nminspwcbnnu,copying ofpublic reoords (http://www.flhsmv,gov/ddi/DPPAInfo,htmi)
'
(a)Personal information contained inomuturveh/nlemmondthotidentifiaaon�(ndiv�^iuua(iscmnfidenb"e|aodaxemptbnms 118'07(1)
and 2(").Art. .". the State Constitution except amprovided inthis subsection. Personal information includes, but isnot limited to, enindividua [s
social security number, driver identification number or identification card number, name, address, telephone number, medical nrdisabi �inynnnauinn.andemergenoycnntootinfonnabon.Forpuqpomeaofthiosubaect/*n^pemo'a|inh~~ationd"="nm«ino|udoinformation 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, oridentification card issued bv meDepartment or
Highway Safety and Motor Vehicles.
(b) Personal information onntomedinmumrvehicle records made coofidenbo/and exempt bythis subsection may bems�auedbythe
departmentfor snymv/neru/|mwmAuses:
1. For use in connection with matters of motor vehicle or driver safety and theft; motor vehicle emissions; motor vehicle product
altera
tions,
nvnmxnerrecords from the original owner records mmotor vehicle manufaotvnae moonyout the purposes nfTi0as/a`d|Vofth � UC
Theft /�tof1SS2.the Aummobi�|�onnaUonDisclosure Act (15USC sn 1281'tsmg) the n 74o1 * » Car
uhoPu»m3U1.3Ob.and 321'331nfTiUe49.Uni�d States Code.
~ �' U.S.C. e�»eq�>.a»d
z. For use by any governmentagency, including any court orlaw enforcement agency, incarrying out its functionsorany pr�o�person
oren ruvacxmgonoemaxmafederal, state, n,local agency incarrying out ds�n�ionn. '
alterations, 3. For use inconnection w�hmauemofmotor vehicle n,dhve,safety and m'o��mo«v,vexi�|o�m/as|ona�mmorveh|c�pmduct
mooxad
visories; �«research
�h
uuUviUes./no|uuingoumoyveaoomx;andeomva/ofnnnuwnerneonpdu�omthenr�iou|mwner----~ndnnfmum'motor vehicle munufamu
4. For use inthe nomno|coumeufbusiness uyalegitimate U
U�mmmmeuab�eioeaaor�ogon�.employees,�or contractors, but /r`o�
and �� rovo,�h�ucmuoynfp�na|infonnuuonmuumiuedbythe individual mthe
—business orits agents,
'��—`employees, or contraunm;
b� |fsuch information aoausubmitted ianot correct orisnolonger correct, mobtain the correct imonneVon but on�for the
purposes o*pe"enUng�audby, pursuing legal mmedieaagainst, urnaunvohngonodebt ursecurity interest against, the individual
body for:
s. For use moonnecunnwimany civil, onmioo|.oum/n/mmove.oro'bd,o/pmneodinginanyoow�u,agencyr�tna�nyo K'ngu|am,y
nto»a. a. Service of process by any certified process server, special process server, or other person authorized to serve process in this
t»ninfn b. Investigation inand�poUnnof/�|gotionbyanounmm�
oy/ioenno�tupiun|mwinthiactoumo,theagontofthoouomeyhowever,
nnoounmaynutueuxodonrmessopmmenxo/eo/ioitytionufoxen�ho/|kigaUonagomotmntnrvex/mdealers.' a
o. |nvocx�mbonbyany pn�with "eused for mass
commercial solicitation of clients for litigation against motor vehicle dealers.
d. Execution orenforcement ovjudgments and orders.
m. Compliance with enorder many court.
m. For use inresearch activities and for use inproducing statistical ,epoxa.ov|ongastxoponanno|moonnoboniao��pubU�hou
�|aumaed. urusadm��ntmotind�|duo|o. '
�
r.For use byany insurer nrinsurance support organization, u,byaself-insured anUtyurimogon|oomp|oyooso,oun�nacmmm
connection with claims mvoaigaUnna��iUeo. onU�audouUv��e. rating, or underwriting. ' ' ' '
o.For use mproviding notice mthe owners mtowed nrimpounded vehicles.
n. For use by any licensed private investigative agency or licensed security service for any purpose permitted under this subsection.
Personal information obtained based onanexempt dd r pd may notu demonstrate oneed based o n
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.^.obtain ". verify information relating tvaholder n/acommercial driver's license that
|srequired under 49U.8.C,mo. 31301 e*aeq.
/1. For use in connection with the operation of private toll transportation facilities.
tc 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.
n��ho 1l Fmany use ��honaquesUnQnemnnuemuno�oteemotoeorshe has o�a{oudthe wriMenconsent cfthe person who iuthe sv�eo|
otor 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.
/5. 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 (u).without the express consent mfthe person towhom such information eppoea�he '~ following information
contained inmotor vemc|e�cundamay onhbrreleased oospsc�euinthis ponauoph: '
1. Social security numbers may bereleased only amprovided msubparagraphs (b)2,.5..7 �nu/8
z.Anind��ua[mphwmQnnphurimage may bem|eamadonly aapmv�ed|nm.Jz2.142, ' �
3, Medical disability information may hereleased only asprovided mws.322.125and 32%.120
4. Emergency contact in/unnouonmay hereleased only tnlaw enfonamentagencies for purposes
mcontacting those listed inthe event
ofanemergency.
(o) The restrictions on disclosure of personal information provided by this subsection shall not in any way affect �the use morgan donation
information on individual driver licenses or affect the administration of organ donation initiatives in this state.
(e)1. Personal /n«snnauonmade ouondeoUa}and exempt may uedisclosed bymvOepa�nentnfH�h—'—` ySafety and Motor Vehicles toon
individual, firm, corporation, or similar business entity whose primary business interest is to resell or redisclose personal —naona|info,manuoto
pe�onswho are authorized mo�e*esuch information. Prior vothe department's disclosure nfpersonal information. -- individual, nnn
co,porauoo.o,s/moentitycare, custody,'u ~~ntm|uf`
e`he '
neewna/imnnna�oou/snsumoomp|�nm**�omw�oena|Dnvm�sPr�mcyPm�oUonA�of1gV*and laws.~
4ws
�y ��������u�|��o�i��o,�r����.��a���u��au���h�12
�-' -_---with the ~~p~^^"" of Highway �eom�ae/|ormd�doaathe in�,manon�na d�« `
section. However, o.ruwmonzeomcm�mmn,pormmo/�f maVonunderaubpem�rophu012 meysoeVo, ' �
pusvanrmavopa�gen»(W/o. � �ueomaepemono{im�nnabon
oh 3. Any outhnr�edmcip�ntwho ,enaUanrndio�uoeapersonal inh`rmoUunshall mointain for apehod f5 eepesonorant�ythat eueiveuthe personal /nformu8permitted itwU/bevaed«Gyeus'ecu»da�en«fy/»g
o«aUamemrmapa�!onupon mqwnstbythe uepa�nenL � »o»'oo»m»soaUbamoue
1n (� The dopo�moo may adopt m/eotocarry o�the purposes ufthis subsection and the �doro|Dr�a�mPh,auyPm�ut/nnAct vf1894
personal information
2'z/cxoeg�Rules auop�dbymedopmnmentmay prnv�efor �epayment ufapplicable fees oud phnrtothe disclosure of'
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AGENCY FOR
HEALTH CARE ADMINISTRATION
1%-
COUNTY BILLING
GUIDELINES
UPDATED 5/17/2012
Table of Contents
PREFACE.... —....................... ............... ..................................... .................. ..................... ...............................
3
LEGISLATIVEREQUIREMENTS ............................................ .......................................................... ...... .............
4
BILLINGWORKFLOW .................. ............................................... ....... .......................... ..................... ..................
4
ESTABLISHING COUNTY OFRESIDENCY .............. ................... ............................... —.... ...............................
4
HOSPITALCHARGES ........... —................................................... .............................................. _........................
5
l. Overview ofInpatient Hospital Charges ................................................. ................. ............. ................. ......
5
2. Number ofDays (of County Responsibility) ........................ —................... ................... .......................... .....
5
3. Calculation oICounty Share ............................................................................................................................
»
4. Billing for Medicaid HMO Patients .................................................................................................................
5
NURSINGHOME CHARGES ......... ....................................................... ...................................................................
o
LOverview oINursing Home Charges ...............................................................................................................
h
2. Calculation oICounty Share ............................................................................................... .............................
h
l OotoIStatReuideut---------------------------------------------
o
MONTHLYBILLINGS ................................................................................................................................................
7
LBilling Cycle ....................................................................................................................................................
/
2. Po*euu�gCharges ----------------------------------------------
7
ICertification ofCharges ...................................................................................................................................
7
SCkEBN8BOTSOPUPDATED PORTAL .................................................................................................................
u
REQUESTING ANADVANCE REFUND ................................................................... ..............................................
v
l. Due Dute—........................................................................................................................................................
v
]. Determining xuAdvanced Refund Request .................................... ................................................................
9
2. Marking unAdvanced Refund Request inthe Web Portal --------------------------.9
REQUESTINGABACK-END REFUND ............ ........................................................................ ............................
]U
LOverview ............................. ............................................ .................................................. ........... ..............
lU
2. Due Date .......... ..............................................................................................................................................
]U
lSubmission ofthe Request .................................................... ................................................ .......................
]0
4. Review of the Bequem --------------------------------------------l0
BACK -END REFUND TEMOPLATE—... —........... ___ ... ................... .............. ................. .... ........ .......... ..........
ll
DEFINITIONS................ ............... ..... ................. .............. ......... —...... ....... ...... —......................... —..... .........
l2
19
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 WORKF
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.
0
CHARGESHOSPITAL
i. 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.
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.
0
MONTHLYG
1. Billing Cycle
Prodder 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.
2. 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.
W
County Billing Back -end Refund Request
County:
County Contact Name:
County Contact Phone Number:
Invoice # AR # County Share Amount Reason for Refund Request
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
IN
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 — (ICFIDD) 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
13