The purpose of the amendment to Rule 59G-4.200 is to incorporate by reference the Florida Medicaid Nursing Facility Services Coverage and Limitations Handbook, __________. The revisions to the handbook clarifies existing policy and updates forms and ...

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.:RULE TITLE:

59G-4.200Nursing Facility Services

PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-4.200, F.A.C., is to incorporate by reference the Florida Medicaid Nursing Facility Services Coverage and Limitations Handbook, __________. The revisions to the handbook clarifies existing policy and updates forms and processes regarding nursing facility services as follows: deletes references to the Florida Medicaid Provider Reimbursement Handbook, Institutional 021, which was obsolete July 1, 2008; requires nursing facility services providers to comply with the provisions of the Florida Medicaid Provider Reimbursement Handbook, UB-04; removes the Pre-Admission Screening and Resident Review (PASRR) process; clarifies policy relating to eligibility; and updates Medicare Part A crossover policy, procedures for prior authorization of the nursing home supplemental payments, and the Client Discharge/Change Notice, CF-ES 2506.

SUBJECT AREA TO BE ADDRESSED: Nursing Facility Services.

An additional area to be addressed during the workshop will be the potential regulatory impact of Rule 59G-4.200 as provided for under Sections 120.54 and 120.541, Florida Statutes.

RULEMAKING AUTHORITY: 409.919 FS.

LAW IMPLEMENTED: 409.902, 409.905, 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: Thursday, December 12, 2013, 10:30 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: Susan Rinaldi 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 DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT IS: Susan Rinaldi, 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 workshop at http://ahca.myflorida.com/Medicaid/review/index.shtml. Comments will be received until 5:00 p.m. on Thursday, December 19, 2013.

 

THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:

 

59G-4.200 Nursing Facility Services.

(1) This rule applies to all providers of nursing facility services who are enrolled facilities licensed under Chapter 400, Part II, F.S., certified by the Agency for Health Care Administration for participation in the Florida Medicaid program for nursing facility care under Section 409.902, F.S.

(2) All providers of participating nursing facility services providers must be in compliance comply with the provisions of the Florida Medicaid Nursing Facility Services Coverage and Limitations Handbook, ________ October 2003, updated July 2004, erratum to the July 2004 update, and the corresponding Florida Medicaid Provider Reimbursement Handbook, Institutional 021, October 2003, which are incorporated by reference. Both handbooks are available from the Medicaid fiscal agent. The handbook is available from 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.

(3) The following forms that are included in the Florida Medicaid Nursing Facility Services Coverage and Limitations Handbook are incorporated by reference: AHCA Form 5210-001, August 2000, Nurse Aide Training and Competency Evaluation Program Invoice, available from the Medicaid area offices; CF-ES 2506, Feb. 2003, Client Discharge/Change Notice, available from the Department of Children and Family Services district offices; CF-ES 2506A, May 2003, Client Referral/Notice, available from the Department of Children and Family Services district offices; PASRR Checklist, October 2003, may be photocopied from the Florida Medicaid Nursing Facility Services Coverage and Limitations Handbook; and AHCA Form 5000-3300, April 02, Medicaid Nursing Facility/ICF-DD Contribution Notice, available from the Medicaid area offices; Medical Certification for Nursing Facility/Home and Community Based-Services form, AHCA Med Serv Form 3008; Informed Consent Form, AHCA-Med Serv Form 2040; Notice of Hospice Election Nursing Facility, AHCA 5000-24; Project AIDS Care Physician Referral and Request for Level of Care Determination, CARES Form 607; AIDS Supplemental Payment Authorization Form, AHCA Med Serv Form 049, July 2008.

Rulemaking Specific Authority 409.919 FS. Law Implemented Chapter 400 Part II, 409.902, 409.905, 409.908, 409.912, 409.913 FS. History–New 1-1-77, Amended 6-13-77, 10-1-77, 1-1-78, 2-1-78, 12-28-78, 2-14-80, 4-5-83, 1-1-84, 8-29-84, 9-1-84, 9-5-84, 7-1-85, Formerly 10C-7.48, Amended 8-19-86, 6-1-89, 7-2-90, 6-4-92, 8-5-92, 11-2-92, 7-20-93, Formerly 10C-7.048, Amended 11-28-95, 5-9-99, 10-15-00, 10-4-01, 2-10-04, 9-28-04, 8-31-05, 7-23-06, ____________.