Regulatory Scheme and Licensure Requirements

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Table of Contents

Introduction
Licensing procedure
Governing authority and state survey agency
Criteria for certification
Conclusion
Reference List

Introduction

Health care regulation is an important aspect of the legal system in the US. For a health care organization wishing to operate in the state of Florida, several statutes/laws are applicable. Generally these are covered in the Public Health Act from chapters 381-408. These chapters are concerned with specific aspects of the health care provisions and requirements. The general healthcare administration including planning of services and facilities, licensing, insurance access and eligibility and access are covered in the Chapter 408 of the Florida Statutes. The regulations of professionals in this field are covered in Regulation of Professions and Occupations Act stipulated in chapters 454-493 (Online Sunshine.com, 2010, 2)

Licensing procedure

The license application process for a new organization is covered in the Health Care Administration chapter 408 part II section 806 of the Public Health Act. It starts with making an application to the agency in forms provided which are then submitted under oath. In this step an application appropriate fee is paid to the agency for it to be regarded as complete application. Specific information on the name, address and social security number of the applicant, administrator, financial officer and each controlling interest if an individual must be included in the form; the name, address and federal identification number or tax identification number of the applicant and each controlling interests if they are individuals; name of the organization; capacity the organization is requesting; name of the person (s) in the management; certificate of authority as provided in Chapter 651 and other necessary information the agency may require.

After an application is received, the agency notifies the organization or applicant within 30 days in writing of any errors in the application or information that is not provided and requests correction or submission of the same. This additional information should be submitted within 21 days otherwise application will be considered incomplete and withdrawn from consideration and fees withheld. After complete application, a license is issued within 60 days. The license issued for healthcare organizations are valid for two years, unless in the category which require a shorter license period, after which a renewal is applied (Online Sunshine.com, 2010, 1).

Governing authority and state survey agency

In the state of Florida, the overall authority that regulates and licenses the health care organizations is the Agency for Health Care Administration (AHCA). Any organization seeking licensure applies for a license from the AHCA. This is authority is provided in the Health Care Administration Chapter 408 of the State of Florida Statutes. It has the authority to issue a license to a new health care organization after a certificate of need is provided (Agency for Health Care Administration, 2009).

The state survey and certification agency recognized by many states including Florida is the Joint Commission on Accreditation of Healthcare Organization (JCAHO). This is a private non-profit organization that operates accreditation programs for health care organizations and programs. JAHCO accreditation has been recognized in Florida as a condition of licensure and allocation of Medicaid reimbursement. Accreditation cycle of healthcare organizations is carried out on a triennial basis and the findings remain confidential. If the organization meets all or most of the required standards, a certification is awarded. Surveys are carried out unannounced since January 1, 2006. They are done 18 to 39 months after the previous one and results made public through its web site (Joint Commission on Accreditation of health Care Organizations, 2009)

Criteria for certification

For an organization to be certified, Full understanding of the current standards, processes, policies and procedures applicable to the particular health care organizations are needed. Secondly, compliance with federal regulations in regard to type of healthcare organization is a must. Thirdly, the organization must be in compliance to these regulations and standards for at least four months before the first survey. Finally, it must comply with the applicable standards and regulations during the three year accreditation period (National Committee for Quality Assurance, 2009).

Conclusion

For a health care organization wishing to operate in the state of Florida, several statutes/laws are applicable the main one being the Public Health Act. The licensing procedure is covered in the same Act and is given by the Agency for Health Care Administration (AHCA) which is the governing authority on healthcare provision in the state. Joint Commission on Accreditation of Healthcare Organization (JCAHO) is the state survey agency providing accreditation and licensure to health care organizations in the state.

Reference List

Agency for health care administration (AHCA). (2009). Attorney general McCollum, secretary arnold release annual medicaid fraud report. Web.

Joint Commission on Accreditation of health Care Organizations (JAHCO). (2009). The Joint Commission’s Hospital Accreditation Recognized by CMS. Web.

National Committee for Quality Assurance (NCQA). (2009). Accreditation. Web.

Online Sunshine (2010) 1. The 2009 Florida Statutes. Web.

Online Sunshine (2010) 2. The 2009 Florida Statutes. Web.

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Regulatory Scheme and Licensure Requirements

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