On June 2, 2022, the Florida governor signed the Freedom First budget for State Fiscal Year 2022-2023 (the Law), which provided over $600 million in funding to the Agency for Health Care Administration (the Agency) specifically to increase the minimum wage for employees of Medicaid providers to at least $15.00 an hour. While the Law contains many ambiguous provisions, the Agency has recently issued Q&A guidance that has clarified some of the application issues raised by the Law. Below, we have provided the key points based on the text of the Law and on the Agency Q&A issued to date:

  • Deadline: All providers that bill for services under the impacted fee schedules must sign the Medicaid Provider Supplemental Wage Agreement by Oct. 1, 2022. Providers can log in to the Medicaid Provider Secure Web Portal and sign the Supplemental Wage Agreement on or after Aug. 4, 2022. The Supplemental Wage Agreement contains an attestation that the Medicaid provider is paying all applicable employees at least $15.00 per hour.
  • Applicable Providers: All Medicaid providers that are reimbursed for services under the Medicaid fee-for-service fee schedules, and that will therefore receive increased reimbursement, are required to pay applicable employees at least $15.00 per hour. The full list of impacted fee schedules can be found at the Agency's Medicaid Provider Minimum Wage requirements web page.
  • Applicable Employees: For all Medicaid providers other than nursing home providers, the requirement applies only to direct care workers (including 1099 workers) employed by the enrolled Medicaid provider. Only nursing home providers will be obligated to pay all employees a minimum wage of $15.00 per hour. A direct care worker is an individual who has direct contact with a Medicaid recipient for purposes of providing a Medicaid reimbursable service. Direct care workers do not include individuals who do not provide a Medicaid reimbursable service, whose primary duty is maintaining the physical environment of the workplace or whose duties are primarily administrative.
  • Consequences: Providers that fail to sign the agreement will be subject to recoupment of funds associated with the minimum wage requirement. Further, starting Jan. 1, 2023, employees not receiving at least $15.00 per hour may bring civil action against the provider for the full amount of back pay and the same amount in liquidated damages, plus reasonable attorney's fees.

The Agency continues to update its Q&A and, we hope, will provide additional guidance on the application of the Law to nursing homes. Employers subject to the Law should contact their attorney for guidance on application of the Law to their workforce.

The full text of the Freedom First budget for State Fiscal Year 2022-2023 can be found here. The Agency also published a list of FAQs, which it is actively updating, here.