Assistive Care Services and Assisted Living for the Elderly Waiver

Assistive Care Services and Assisted Living for the Elderly Waiver Services
Coverage and Limitations Handbook
Description and Purpose, continued
Medicaid Fraud and
Abuse
Consult Chapter 5 of the Medicaid Provider Reimbursement Handbook
HCFA 1500 and Child Health Check-Up 221, for information regarding
Medicaid policy on provider abuse and fraud and Medicaid’s recoupment
policies.
Administrative
Responsibility
The assistive care service program is jointly administered by the Agency for
Health Care Administration (AHCA), and the Department of Children and
Families (DCF).
• AHCA is responsible for assuring compliance with federal program
requirements, developing Medicaid policy, program operations, and for
reimbursing Medicaid providers.
• DCF is responsible for determining the recipient’s OSS and Medicaid
eligibility.
Area Medicaid
Offices
Area Medicaid offices are located throughout Florida to assist Medicaid
service providers with questions and problems.
Note: See Appendix C of the Medicaid Provider Reimbursement
Handbook, HCFA-1500 and Child Health Check-Up 221, for a list of
area Medicaid office addresses and telephone numbers.
July 2001 1-3