The purpose of the amendment to Rule 59G-4.050 is to incorporate by reference the Florida Medicaid Community Behavioral Health Services Coverage and Limitations Handbook, ______.

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.:RULE TITLE:

59G-4.050Community Behavioral Health Services

PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-4.050, F.A.C., is to incorporate by reference the Florida Medicaid Community Behavioral Health Services Coverage and Limitations Handbook, __________.

SUMMARY: The handbook is being revised to remove the enrollment requirement for Medicaid behavioral health providers to have an active contract with the Substance Abuse and Mental Health (SAMH) circuit or regional office for the location in which the provider renders services. This handbook adds descriptions and policy for the Medicaid behavioral health managed care plans. In addition, this handbook modifies various staff qualifications, policy requirements for community behavioral health services, and updates forms and fiscal agent information. The policies for behavioral health overlay, comprehensive behavioral health assessment, therapeutic group care, and specialized therapeutic foster care services are being removed from this handbook.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:

The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the agency.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: A checklist was prepared by the Agency to determine the need for a SERC. Based on this information at the time of the analysis and pursuant to Section 120.541, Florida Statutes, the rule will not require legislative ratification.

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY: 409.919 FS.

LAW IMPLEMENTED: 409.902, 409.906, 409.907, 409.908, 409.9081, 409.912, 409.913 FS.

A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:

DATE AND TIME: Tuesday, November 19, 2013, 10:00 a.m. − 11:30 a.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: Melissa Eddleman at the Bureau of Medicaid Services, [phone]. 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 IS: Melissa Eddleman, Medicaid Services, 2727 Mahan Drive, Mail Stop 20, Tallahassee, Florida 32308-5407, telephone: [phone], e-mail: [e-mail]

Please note that a preliminary draft of the reference material, if available, will be posted prior to the public hearing at http://ahca.myflorida.com/Medicaid/review/index.shtml.

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

59G-4.050 Community Behavioral Health Services.

(1) This rule applies to all providers of community behavioral mental health services who are providers enrolled in the Florida Medicaid program.

(2) All providers of community behavioral health services who are providers enrolled in the Florida Medicaid program must be in compliance with the provisions of the Florida Medicaid Community Behavioral Health Coverage and Limitations Handbook, 2004, 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. The handbooks is are available on the Medicaid fiscal agent’s Web site at www.mymedicaid-florida.com. Select Public Information for Providers, then Provider Support, and then Provider Handbooks. Paper copies of the handbook may be obtained by calling the Provider Services Contact Center at 1-800-289-7799 and selecting Option 7. Next, click on Provider Support, and then click on Handbooks.

(3) The following forms is that are included in the Florida Medicaid Community Behavioral Health Coverage and Limitations Handbook and is are incorporated by reference: Temporary Limited Service Authorization, AHCA Form 5000-3510. October 2004; Authorization for Comprehensive Behavioral Health Assessment, October 2004; Comprehensive Behavioral Health Assessment Provider Certification, October 2004; Specialized Therapeutic Foster Care Provider Agency Certification, October 2004; Authorization for Specialized Therapeutic Foster Care, October 2004; Authorization for Crisis Intervention, October 2004; Provider Agency Self Certification Form Behavioral Health Overlay Services –Department of Juvenile Justice, October 2004; Provider Agency Certification Form Behavioral Health Overlay Services Department of Juvenile Justice, October 2004; Certification of Eligibility for Behavioral Health Overlay Services –Department of Juvenile Justice, October 2004; Provider Agency Self-Certification Form Therapeutic Group Home Services, October 2004; Therapeutic Group Care Services Provider Agency Certification, October 2004; Authorization for Therapeutic Group Care Services, October 2004; Certification of Eligibility for Behavioral Health Overlay Services –Child Welfare, October 2004; Provider Agency Self-Certification Form Behavioral Health Overlay Services Child Welfare, October 2004; Provider Agency Certification Form Behavioral Health Overlay Services – Child Welfare, October 2004. This These forms is are available by photocopying it them from the Florida Medicaid Community Behavioral Health Coverage and Limitations Handbook. The handbook is available from the Medicaid fiscal agent.

Rulemaking Specific Authority 409.919 FS. Law Implemented 409.902, 409.906, 409.907, 409.908, 409.9081, 409.912, 409.913 FS. History–New 1-27-82, Amended 10-25-84, Formerly 10C-7.525, Amended 1-19-94, Formerly 10C-7.0525, Amended 9-21-98, 11-14-00, 1-19-05,______________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Melissa Eddleman

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Elizabeth Dudek

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: October 14, 2013

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: October 22, 2012