PAYMENT BEING MADE ON BEHALF OF CIVIL PATIENTS RESIDING AT FSH WHO RECEIVED OUTSIDE MEDICAL CARE…

The Florida Department of Children and Families awarded contract C76515 for medical expense reimbursement services on behalf of civil patients residing at Florida State Hospital (FSH). The contract, valued at $5,000.00, is effective from July 1, 2026, through June 30, 2027. The deliverable encompasses reimbursement for outside medical care accessed by FSH residents during the specified performance period, with payment structured according to insurance coverage status and applicable cost-sharing obligations.

The reimbursement methodology operates on a tiered basis dependent on residents' primary insurance coverage. For residents with Medicare or Medicaid, the contractor shall file claims with the primary insurance carrier first, with FSH responsible for covering applicable co-payments and deductibles following primary insurance adjudication. For residents without primary insurance coverage, FSH shall reimburse the full medical expense amount, with such payment constituting final settlement. The contract quantifies the reimbursement obligation at 5,000 units, with each unit representing one dollar of covered medical expense.