Laura MacLafferty, Unit Manager
Hospital & Outpatient Services Unit
Bureau of Health Facility Regulation
2727 Mahan Drive, Mail Stop #31
Tallahassee, Florida 32308
Telephone: (850) 412-4549
Fax: (850) 922-4351
Email: Laura.MacLafferty@ahca.myflorida.com
Community Mental Health Centers / Partial Hospitalization Programs (CMHC/PHP)
This is a Medicare certification program for Partial Hospitalization Program for Community Mental Health providers. These programs include services for mental illness and substance abuse disorders.
License/Certification Requirements
Certification is achieved by adherence to requirements in section 1861(ff)(3)(b), of the Social Security Act and section 1916(c)(4), of the Public Health Services Act. This includes submission of application and other paperwork. At this time the Centers for Medicare and Medicaid Services (CMS) does not contract with the states to perform site-visits. In addition, effective March 1, 2004, some community mental health providers or partial hospitalization programs may require licensure as a "health care clinic". Additional information on licensure as a health care clinic can be obtained from the Agency's Health Care Clinic Unit.
Regulations/Guidance
Florida currently has outpatient licensure requirements only for substance abuse services and health care clinics. The Department of Children and Families regulates substance abuse services, and the Agency's Health Care Clinic Unit licenses health care clinics. Unless required by the "Health Care Clinic Act", there are no state licensing requirements imposed by the Agency.
- 42 CFR, Part 410, Subpart A, Sections 410.1-.5
- CMS State Operations Manual
(See Sections 2250-2252P
Forms
- Applicant Instructions (359K PDF)
- Health Insurance Benefit Agreement - CMS Form 1561
- Medicare Administrative Contractor Choice Form
- Crucial Data Extract – Attachment D
- Attestation Statement
- State Operations Manual Highlights
- Medicare Certification Civil Rights Information Request Form - OMB 0990-0243
Civil Rights Information and Forms
Updated April 17, 2013
