My Florida Medical License Renewal Application Expired? Now What?

Not filing on time the AHCA License Application Renewal can put your organization in jeopardy.

We work with owners and operators who fail to file their application to renew their facility license with the Florida Agency for Health Care Administration (AHCA). But not filing your renewal application by the deadline means your license is “expired” under Florida law.

AHCA Medical License Renewal Application & Why it’s Important

In Florida, the Agency for Health Care Administration (AHCA) is the chief regulator of health care facilities responsible for, among other things, health care facilities licensure, inspection, and regulatory enforcement.

AHCA licenses certify and regulate 40 different types of health care providers including hospitals, nursing homes, assisted living facilities, home health agencies, nurse registries, home medical equipment providers, durable medical equipment companies, diagnostic imaging centers—just to name a few.

Not Your Fault? Often, we hear from clients who tell us they did not meet the filing deadline for their renewal application because of a “clerical error,” “natural disaster,” “employee incompetence” or other explanation.  Interestingly, this happens to big national companies that own facilities in Florida down to “mom and pop” health care providers, who for one reason or another do not timely file their application for renewal of the AHCA license.

Missed the Follow-up? Operators have 20 or 30 days to provide supplemental information to the AHCA if they are requesting additional information from your renewal application. We often hear that the renewal application was filed timely, but the management of the facility did not respond to the omission letter.  In which case, the renewal of the license is denied.

Fees Involved. Once expired, you MUST submit a new license application as if this were the first time you are opening for business. If you are renewing your license after the expiration date and your status still indicates ’Clear/Active’ or ‘Clear/Inactive’, you will be assessed a delinquency fee. The delinquency fee will be in addition to your renewal fees. Other fines may apply.

Expired & Unlicensed: Failure to File Florida Medical License Renewal Application

Your failure to meet the deadline for renewing your license means it has expired and you must CEASE OPERATIONS. Here’s why being considered “unlicensed” is a big deal. Unlicensed activity constitutes harm that materially affects the health, safety, and welfare of clients, and constitutes abuse and neglect, as defined in s. 415.102.

But the implications of operating unlicensed stretch much farther.

Consider this heart-breaking example of when a clerical error resulted in one operator’s medical license renewal expiration and the impact it had on patients. These actions affect patient care, those you employ, and your operation’s revenue.

If after receiving notification from the AHCA, such person or entity fails to cease operations and apply for a license, that person or entity shall be subject to penalties as prescribed by Florida law and applicable rules.

Section 408.812, Florida Statutes, enumerates important provisions of Florida law that apply to unlicensed activity.  Some relevant portions of the law are:

1. A license holder may not advertise or hold out to the public that he or she holds a license for other than that for which he or she holds the license;
2. The AHCA or State Attorney may bring an action for an injunction to restrain such violation;
3. A person or entity that fails to cease operations after an AHCA notification of unlicensed activity may be fined $1,000 per day for each day of continuing violation;
4. Any other licensee or controlling interest in an entity that is involved in the unlicensed activity can be subject to emergency suspension or revocation of any other existing licenses and a continuing $1,000 per day fine.
5. A charge or reimbursement claim made by or on behalf of a provider that is required to be licensed, regardless of whether a service is rendered or whether the charge or reimbursement claim is paid, is an unlawful, non-compensatory charge and is unenforceable. A person who knowingly makes or causes to be made an unlawful charge commits theft within the meaning of and punishable as provided under the criminal law.

Penalties for Operating Unlicensed

Operating unlicensed could result in a misdemeanor or criminal penalty.  There are instances where AHCA alerts local law enforcement and the news media during statewide enforcement actions aimed at making examples of various operations. Read this example of how law enforcement and AHCA can combine efforts, see https://www.wuft.org/news/2013/10/28/florida-authorities-aim-to-shut-down-unlicensed-assisted-living-facilities/

What Can Be Done if Your AHCA License Was Not Renewed and Has Expired?

In some cases, not all is lost. Strategies may be able to be employed if too much time has not passed.

Act Fast. We recommend acting promptly to seek the advice of an experienced health care attorney who knows this process. You might stand a chance of getting back in operation if you submit a new application. The AHCA requires you to submit an “Initial Application” even if your existing license expired meaning your application and the documentation required are submitted as if you are a “start-up” and often means you have to demonstrate sufficient capital.

Proof of Financial Viability. The Initial Application which as previously explained will have to be filed after the AHCA license has expired generally requires most applicants to prove that they have sufficient funds to operate. This may seem a no-brainer for a company that has previously operated, however, it is a necessary component of meeting AHCA’s requirements to get a new license issued. With your Proof of Financial Ability to operate, AHCA will require you to produce documentation for any of your new “start-up” costs.  This will essentially require you to produce any necessary receipts for service equipment, office equipment, leasing agreements, etc.

AHCA will also require you to provide evidence of available funding which will cover up to three months of expenses for your “new” company. Sources of funding can be, available funding in a company bank account, funding, and pledge from a parent company or other available sources.

AHCA will also look take a serious look at your Full-Time Employees (FTEs) and will even consider if your employees are paid above minimum wage, and/or even if you are paying your employees within the industry standard. Not meeting these requirements may result in the AHCA issuing an Omissions Notice or a Notice of Intent to Deny, or Notice of Intent to Deem Application Incomplete.

Under Florida law, the following providers must provide financial information:

1. (a) Nursing Home Facilities, as specified in Chapter 400, Part II, F.S.;
2. (b) Assisted Living Facilities, as specified in Chapter 429, Part I, F.S.;
3. (c) Home Health Agencies, as specified in Chapter 400, Part III, F.S.;
4. (d) Hospices, as specified in Chapter 400, Part IV, F.S.;
5. (e) Adult Day Care Centers, as specified in Chapter 429, Part III, F.S.;
6. (f) Prescribed Pediatric Extended Care Centers, as specified in Chapter 400, Part VI, F.S.;
7. (g) Home Medical Equipment Providers, as specified in Chapter 400, Part VII, F.S.;
8. (h) Intermediate Care Facilities for the Developmentally Disabled, as specified in Chapter 400, Part VIII, F.S.;
9. (i) Health Care Clinics, as specified in Chapter 400, Part X, F.S.

Proof of financial ability to operate must be demonstrated for initial licensure and change of ownership applications, by submitting AHCA Form 3100-0009, July 2009, Proof of Financial Ability to Operate. We have found that this part of the application process requires knowledge and experience to have the greatest chance of obtaining AHCA’s approval of your license application.

Seek Legal Advice. There are a variety of scenarios that can result in denial and expiration where you may benefit from the advice of experienced counsel to review the documents.

1. Renewal Application Submitted, But Failed to Respond to Omission Letter on Time: The AHCA denies the license but sends you a Notice of Intent to Deny (NOID)/Withdraw from Consideration/ or Deem Application Incomplete. The NOID usually states you have 21 days from the date of receipt to challenge the actions of AHCA. The Notice will be accompanied by an Election of Rights form. This legal document has specific requirements for filing a legally sufficient challenge to the Agency’s actions. In these situations, our Firm usually files a challenge, makes a document request of the Agency to determine the exact basis for the denial (their evidence), opens up lines of communication with AHCA lawyers, and attempts to resolve the issues and put the application back on track for approval.
2. Renewal Application NOT Submitted on Time Results in Expired License: It is generally pointless to directly challenge the Agency because the license has lapsed by operation of law and not any action of AHCA. On behalf of our clients, our firm assists in the preparation and submission of an Initial Application. We review every aspect of the application and attachments, particularly if there is a requirement for Proof of Financial Viability to Operate. Every effort is made to prepare and detail the required information as well as contemplate every angle to appeal a denial of the application if a rare occurrence happens. We even hand-deliver the application to AHCA’s Tallahassee headquarters.
3. AHCA District Office Hand Delivers A Notice of Unlicensed Activity Letter to Provider:  Once a provider fails to file a Renewal Application on time, the license has expired. Continuing operations unlicensed is against the law in Florida. Generally, what happens is that AHCA in Tallahassee notifies its District Office where the provider is located and a local AHCA Surveyor or Investigator will hand-deliver or tape to the front door of the establishment a Notice of Unlicensed Activity.  This Notice is also called a Cease and Desist letter. Howell, Buchan & Strong, Attorneys at Law is located in Tallahassee, the State Capital of Florida. Because Tallahassee is the seat of State Government, the AHCA is also headquartered here. We can represent clients with facilities and operations in Florida and out-of-state companies that own or manage facilities in Florida.
4. If you have received a Notice of Expiration, Notice of Intent to Deny/ Deem Application Incomplete or Withdrawn from Consideration, Application Omission Letter, or Notice of Unlicensed Activity: Our firm is available for a FREE initial consultation. Since time is of the essence, we highly recommend you contact us promptly once you receive official notification from AHCA. We also recommend you gather promptly the notices, letters, and other communications with AHCA together with any other documents you deem important for our review.

Have Questions? Let’s Talk

Contact the law offices of Howell, Buchan & Strong, Attorneys at Law for your free consultation at any one of our locations:

Orlando (407) 717-1773 |Tallahassee (850) 877-7776 | Tampa (813) 833-6726 | Sarasota (941) 779-4348