Guest commentary on Florida case - interrelationship of criminal case and licensure

Court Cases,

Jon Pellett, CLEAR member and attorney with Pennington Law in Florida, offers this summary and commentary on a recent case in Florida:

Client was arrested and charged with domestic violence. In less than 30 days from the arrest, the State Attorney’s Office, looking at the circumstances that led to his arrest, declined to pursue it and the charge was dropped.

More than 60 days from his arrest, AHCA – Medicaid removed him from the program due to a law that allows them to do so on the basis of the arrest for domestic violence. It is an automatic disqualification under the law without a right to challenge it. The law at issue applies to AHCA licensed facilities and Medicaid. Once Background Screening flags the arrest, AHCA removes the individual from Medicaid and notifies facilities that the individual is not eligible to be employed or practice at the licensed facilities.

Upon notice of the flag by Background Screening, AHCA made the Medicaid removal retroactive to the date of his arrest. AHCA was unaware at the time of termination that the criminal case had been dropped. Fortunately, once AHCA was shown the decision was based on incomplete information, within days of the decision to terminate him, they reversed course and placed him back in the system as eligible and the reinstatement was done in a way to render the earlier termination null.  

At the time they decided to remove him, over 80% of his practice was Medicaid. Had the termination been allowed to stand, he could have lost 80% of his practice. He would have been required to return money paid by Medicaid for services from the date of his arrest to the termination date, and he would have not been allowed to renew his medical license in Florida when it comes-up for renewal in January 2023. The interrelationship of the various statutory provisions between Department of Health and AHCA – Medicaid can cause substantial unintended harm. Being allowed to take action on the basis of the arrest without allowing some opportunity to challenge the decision, places individuals in a very precarious spot. If the criminal case had gone the regular route, the criminal case might not have been resolved before 2023. Within that time period, the parade of horribles that I outlined would have come to pass.