Whether Florida Administrative Code Emergency Rules 58AER17-1 and 59AER17-1 (collectively referred to as “the Emergency Rules”) are invalid exercises of delegated legislative authority and whether an immediate danger justified issuance of the Emergency Rules.Respondents failed to demonstrate the existence of an immediate danger. Also, Petitioners demonstrated that the Emergency Rules are invalid.

Does Petitioner, AHF MCO of Florida, Inc., d/b/a PHC Florida HIV/AIDS Specialty Plan (Positive), have standing to contest the intended award to Simply for Regions 10 and 11 or to seek rejection of all proposals? (Case No. 18-3507 and 18-3508) Should the intended decision of Respondent, Agency for Health Care Administration (Agency), to contract with Simply Healthcare Plans, Inc. (Simply), for Medicaid managed care plans for HIV/AIDS patients in Regions 10 (Broward County) and Region 11 (Miami-Dade and Collier Counties) be invalidated and all proposals rejected? (Case Nos. 18-3507 and 18-3508) Must the Agency negotiate with Petitioner, South Florida Community Care Network, LLC, d/b/a Community Care Plan (Community), about a plan to provide HIV/AIDS Medicaid managed care services in Region 10 because it was the only responsive proposer of services that was a Provider Service Network (PSN)? (Case No. 18-3512) Must the Agency negotiate with Community to provide Medicaid managed care services in Region 10 for people with Serious Mental Illnesses because Community is a PSN? (Case No. 18-3511) Must the Agency contract with Community to provide Medicaid managed care services for Children with Special Needs in Region 10 because Community is a PSN? (Case No. 18-3513) Must the Agency negotiate with Community to provide Medicaid managed care services for Child Welfare patients in Region 10 because Community is a PSN? (Case No. 18-3514)AHCA did not follow ITN ranking process. Required to reject all responses. AHCA did not follow requirement to negotiate with responsive Provider Service Network offering specialty Medicaid managed care plans. AHCA must negotiate. Evaluators qualified.

Does Petitioner, AHF MCO of Florida, Inc., d/b/a PHC Florida HIV/AIDS Specialty Plan (Positive), have standing to contest the intended award to Simply for Regions 10 and 11 or to seek rejection of all proposals? (Case No. 18-3507 and 18-3508) Should the intended decision of Respondent, Agency for Health Care Administration (Agency), to contract with Simply Healthcare Plans, Inc. (Simply), for Medicaid managed care plans for HIV/AIDS patients in Regions 10 (Broward County) and Region 11 (Miami-Dade and Collier Counties) be invalidated and all proposals rejected? (Case Nos. 18-3507 and 18-3508) Must the Agency negotiate with Petitioner, South Florida Community Care Network, LLC, d/b/a Community Care Plan (Community), about a plan to provide HIV/AIDS Medicaid managed care services in Region 10 because it was the only responsive proposer of services that was a Provider Service Network (PSN)? (Case No. 18-3512) Must the Agency negotiate with Community to provide Medicaid managed care services in Region 10 for people with Serious Mental Illnesses because Community is a PSN? (Case No. 18-3511) Must the Agency contract with Community to provide Medicaid managed care services for Children with Special Needs in Region 10 because Community is a PSN? (Case No. 18-3513) Must the Agency negotiate with Community to provide Medicaid managed care services for Child Welfare patients in Region 10 because Community is a PSN? (Case No. 18-3514)AHCA did not follow ITN ranking process. Required to reject all responses. AHCA did not follow requirement to negotiate with responsive Provider Service Network offering specialty Medicaid managed care plans. AHCA must negotiate. Evaluators qualified.

Does Petitioner, AHF MCO of Florida, Inc., d/b/a PHC Florida HIV/AIDS Specialty Plan (Positive), have standing to contest the intended award to Simply for Regions 10 and 11 or to seek rejection of all proposals? (Case No. 18-3507 and 18-3508) Should the intended decision of Respondent, Agency for Health Care Administration (Agency), to contract with Simply Healthcare Plans, Inc. (Simply), for Medicaid managed care plans for HIV/AIDS patients in Regions 10 (Broward County) and Region 11 (Miami-Dade and Collier Counties) be invalidated and all proposals rejected? (Case Nos. 18-3507 and 18-3508) Must the Agency negotiate with Petitioner, South Florida Community Care Network, LLC, d/b/a Community Care Plan (Community), about a plan to provide HIV/AIDS Medicaid managed care services in Region 10 because it was the only responsive proposer of services that was a Provider Service Network (PSN)? (Case No. 18-3512) Must the Agency negotiate with Community to provide Medicaid managed care services in Region 10 for people with Serious Mental Illnesses because Community is a PSN? (Case No. 18-3511) Must the Agency contract with Community to provide Medicaid managed care services for Children with Special Needs in Region 10 because Community is a PSN? (Case No. 18-3513) Must the Agency negotiate with Community to provide Medicaid managed care services for Child Welfare patients in Region 10 because Community is a PSN? (Case No. 18-3514)AHCA did not follow ITN ranking process. Required to reject all responses. AHCA did not follow requirement to negotiate with responsive Provider Service Network offering specialty Medicaid managed care plans. AHCA must negotiate. Evaluators qualified.

The issue to be determined in this bid protest matter is whether Respondent Department of Health’s (DOH or the Department) intended award of the contract arising out of Invitation to Negotiate No. DOH-17-026 (ITN) for the Children’s Medical Services Managed Care Plan (CMS Plan) to Intervenor Wellcare of Florida, Inc., d/b/a Staywell Health Plan (Staywell), was contrary to its governing statutes, rules, or the solicitation specifications.Petitioner did not prove that the Department's intended award of the contract to Intervenor was contrary to its governing statutes, rules, or the ITN's specifications.

Whether the Certificate of Need (“CON”) Application No. 10490 submitted by Baptist Hospital of Miami, Inc. (“Baptist Hospital” or “Baptist”), to establish a new adult autologous and allogeneic bone marrow transplant program in Florida’s Organ Transplant Service Area 4 (“TSA 4”) should be approved.Respondents demonstrated that not normal circumstances justified granting the application for a bone marrow transplant program.

Whether the Certificate of Need (CON) Application No. 10420 submitted by Baptist Hospital of Miami, Inc. (Baptist Hospital or Baptist), to establish a new adult autologous and allogeneic bone marrow transplant (BMT) program in Florida’s Organ Transplant Service Area 4 (TSA 4) should be approved.Consideration of applicable statutory and rule criteria compels a recommendation that an application for a new adult bone marrow transplant program in TSA 4 be denied.

The issue in this matter concerns the amount of monetary sanctions that the Agency for Health Care Administration may impose on Respondent pursuant to section 409.913, Florida Statutes, and Florida Administrative Code Rule 59G-9.070(7)(e) based on the overpayment of Medicaid reimbursements made to Respondent.Agency proved by clear and convincing evidence that an administrative fine should be imposed on Respondent based on overpayment of certain Medicaid claims.

Which certificate of need (CON) application seeking to establish a new community nursing home in Nursing Home District 3, Subdistrict 4 (Marion County), on balance, best satisfies the statutory and rule criteria for approval: Marion County Development, LLC's CON Application No. 10257; Marion County HRC, LLC's CON Application No. 10258; or CON APP Marion, LLC's CON Application No. 10256?Record supported Agency incipient policy to approve 120-bed CON for nursing home for short-term rehab patients who are Medicare patients. One competing applicant did not prove ability to finance or staff proposed facility.

Which certificate of need (CON) application seeking to establish a new community nursing home in Nursing Home District 3, Subdistrict 4 (Marion County), on balance, best satisfies the statutory and rule criteria for approval: Marion County Development, LLC's CON Application No. 10257; Marion County HRC, LLC's CON Application No. 10258; or CON APP Marion, LLC's CON Application No. 10256?Record supported Agency incipient policy to approve 120-bed CON for nursing home for short-term rehab patients who are Medicare patients. One competing applicant did not prove ability to finance or staff proposed facility.