The purpose of the amendment to Rule 59G-4.070 is to incorporate by reference the Florida Medicaid Durable Medical Equipment and Supply Services Coverage and Limitations Handbook, March 2013. A revision to the handbook is needed to update the prior ...

 

AGENCY FOR HEALTH CARE ADMINISTRATION
Medicaid

RULE NO.:RULE TITLE:
59G-4.070Durable Medical Equipment and Medical Supplies
PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-4.070, F.A.C., is to incorporate by reference the Florida Medicaid Durable Medical Equipment and Supply Services Coverage and Limitations Handbook, March 2013. A revision to the handbook is needed to update the prior authorization requirements for durable medical equipment. This revision will clarify policy regarding 1) how to submit prior authorization requests and 2) the circumstances and qualifications under which Florida Medicaid will allow reimbursement for covered services. Other policies have been added and updated since the last promulgated handbook revision. The revised Florida Medicaid Durable Medical Equipment and Medical Supply Services Coverage and Limitations Handbook also provide guidelines for reimbursement of services performed by durable medical equipment providers.
SUBJECT AREA TO BE ADDRESSED: Florida Medicaid Durable Medical Equipment and Medical
Supply Services.
An additional area to be addressed during the workshop will be the potential regulatory impact the amendment to Rule 59G-4.070 will have as provided for under Sections 120.54 and 120.541, F.S.
RULEMAKING AUTHORITY: 409.919 FS.
LAW IMPLEMENTED: 409.902, 409.906, 409.907, 409.908, 409.912, 409.913 FS.
A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
DATE AND TIME: Tuesday, January 22, 2013, 3:00 p.m. - 4:00 p.m.
PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room D,
Tallahassee, Florida 32308-5407
Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 48 hours before the workshop/meeting by contacting: Dan Gabric at the Bureau of Medicaid Services, 850-412-4209 If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT IS: Dan Gabric, Medicaid Services, 2727 Mahan Drive, Mail Stop 20, Tallahassee, Florida 32308-5407, telephone: [phone], e-mail: [e-mail]

THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:

59G-4.070 Durable Medical Equipment and Medical Supplies.

(1) This rule applies to all durable medical equipment and supply providers enrolled in the Medicaid program.

(2) All durable medical equipment and medical supply providers enrolled in the Medicaid program must be in compliance with the Florida Medicaid Durable Medical Equipment and Medical Supply Services Coverage and Limitations Handbook, March 2013 July 2010, incorporated by reference., and the Florida Medicaid Provider Reimbursement Handbook, CMS-1500, which is incorporated by reference in Rule 59G-4.001, F.A.C. Both handbooks are This handbook is available from the Medicaid fiscal agent’s Web site Portal at www.mymedicaid-florida.com http://my medicaid-florida.com. Select Click on Public Information for Providers, then on Provider Support, and then on Provider Handbooks. Paper copies of the handbooks may be obtained by calling the Provider Services Contact Center at 1-800(800)289-7799 and selecting Option 7.

(3) Medicaid durable medical equipment and medical supply providers are required to use the following form, which is incorporated by reference: the Custom Wheelchair Evaluation form, AHCA-Med Serv Form, 015, July 2007, five pages. This form is available from the Medicaid fiscal agent’s Web site Portal at www.mymedicaid-florida.com http://mymedicaid-florida.com. Select Click on Public Information for Providers, then on Provider Support, and then on Forms. The form may also be photocopied from Appendix A in the Florida Medicaid Durable Medical Equipment and Medical Supply Services Coverage and Limitations Handbook.

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.906, 409.907, 409.908, 409.912, 409.913 FS. History–New 8-26-92, Formerly 10C-7.070, Amended 5-23-94, 1-7-96, 3-4-99, 10-18-00, 4-30-01, 10-1-08, 9-28-10,_________.