I.b. ex rel. R.B. v. State, Agency for Health Care Administration

I.B. appeals the final order of the Florida Department of Children and Families’ Office of Appeal Hearings, affirming the Agency for Health Care Administration’s decision to reduce Medicaid-funded personal care assistance hours based on a Medicaid regulation in Florida that prohibits the hours be used for transporting recipients. We reverse and remand, concluding that the hearing officer erroneously relied upon an incorrect and inapplicable rule from the Florida Administrative Code to determine medical necessity and that the final order was not supported by competent, substantial evidence.

I.B.…