General Medicaid Policy

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.: RULE TITLE:

59G-1.050  General Medicaid Policy

NOTICE OF CHANGE

Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 43 No. 210, October 30, 2017 issue of the Florida Administrative Register.

59G-1.050 General Medicaid Policy

(1) through (6) No change.

(7) Out of State Services.

(a) No change.

(b) Non-Emergency. Florida Medicaid covers services performed out-of-state, in accordance with the service-specific coverage policy, when both of the following are met:

1. The recipient’s primary care or specialist physician refers the recipient for services.

2. Services are prior authorized by the Florida Medicaid quality improvement organization (QIO) in accordance with Florida Medicaid’s Authorization Requirements Policy, as incorporated by reference in Rule 59G-1.053, F.A.C. The policy is available on the Agency for Health Care Administration’s Web site at http://ahca.myflorida.com/Medicaid/Utilization_Review/index.shtml.

(c) No change.

(8) through (11) No change.