The Department intends to amend rules 65A-1.710, 65A-1.712, and 65A-1.713, F.A.C., to clarify the SSI-related Medicaid coverage groups, add an exception to the SSI resource limit, add the Program of All-Inclusive Care for the Elderly (PACE) to ...

 

DEPARTMENT OF CHILDREN AND FAMILIES

Economic Self-Sufficiency Program

RULE NOS.:RULE TITLES:

65A-1.710SSI-Related Medicaid Coverage Groups

65A-1.712SSI-Related Medicaid Resource Eligibility Criteria

65A-1.713SSI-Related Medicaid Income Eligibility Criteria

PURPOSE AND EFFECT: The Department intends to amend rules 65A-1.710, 65A-1.712, and 65A-1.713, F.A.C., to clarify the SSI-related Medicaid coverage groups, add an exception to the SSI resource limit, add the Program of All-Inclusive Care for the Elderly (PACE) to several subsections, and add provisions regarding the determination of SSI-related Medicaid payments for veterans.

SUMMARY: The amendments accomplish the following: (1) Add specificity to Institutional Care Program, Hospice Program, Home and Community Based Services, and Medically Needy Program coverage groups; (2) Add Qualifying Individuals 1 as an exception to the SSI resource limit; (3) Add and remove specific waivers for spousal impoverishment; (4) Require verification of excluded earned and unearned income, income placed in a qualified income trust, and interest and dividends on countable assets; and (5) Specify acceptable forms of verification.

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: The Department used a checklist to conduct an economic analysis and determine if there is an adverse impact or regulatory costs associated with this rule that exceeds the criteria in section 120.541(2)(a), F.S. Based upon this analysis, the Department has determined that the proposed rule is not expected to 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: 409.9102, 409.919 FS.

LAW IMPLEMENTED: 409.902, 409.903, 409.904, 409.906, 409.919 FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAR.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Jodi Abramowitz. Jodi can be reached at [phone] or [e-mail].

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

65A-1.710 SSI-Related Medicaid Coverage Groups.

The Department covers all mandatory coverage groups and the following optional coverage groups:

(1) MEDS-AD Demonstration Waiver. A Medicaid coverage group for aged or and disabled individuals (or couples), as provided in 42 U.S.C. §1396a(m).

(2) Institutional Care Program (ICP). A Medicaid coverage group that helps pay for the cost of care in a nursing facility for institutionalized aged, blind or disabled individuals (or couples) who would be eligible except for their institutional status and income as provided in 42 C.F.R. §§435.211 and 435.236. Institutional benefits include institutional provider payment or payment of Medicare coinsurance for skilled nursing facility care.

(3) Hospice Program. A Medicaid coverage group that provides care and support to individuals who are terminally ill and meets the specific Medicaid hospice eligibilty requirements as provided in 42 U.S.C. §1396d(a). subsection 65A-1.711(3) and 65A-1.713, F.A.C. A coverage group for terminally ill individuals (or couples) who elect hospice services and who meet all categorical or Medically Needy eligibility criteria, and who also meet special Medicaid hospice requirements as provided in 42 U.S.C. §1396d(a), subsection 65A-1.711(3) and Rule 65A-1.713, F.A.C.

(4) Home and Community Based Services (HCBS). A Medicaid coverage group for aged, blind or disabled individuals that provides coverage for services and activities to prevent institutionalization and allow the individual to remain in the community. The approved HCBS Waivers as permitted by 42 U.S.C. §1396n and 42 C.F.R. §435.217 are intended to prevent institutionalizing individuals who: A coverage group for aged, blind or disabled individuals (or couples) who would be eligible for Medicaid if institutionalized and who would require institutionalization if they did not receive HCBS in accordance with approved waivers as permitted by 42 U.S.C. §1396n and 42 C.F.R. §435.217. These programs are intended to prevent institutionalizing individuals who:

(a) Satisfy all SSI-Related Medicaid financial and non-financial eligibility criteria; and

(b) Have resources and income within Institutional Care or MEDS-AD Demonstration Waiver Program limits. and,

(c) Satisfy additional specific criteria, by receiving care in the community from specified providers.

(5) Medically Needy Program. A Medicaid coverage group, as allowed by 42 U.S.C. §§1396a and 1396d, for aged, blind or disabled individuals (or couples) whose countable income exceeds the applicable Medically Needy Income Level (MNIL) in subsection 65A-1.716(2), F.A.C. who do not qualify for categorical assistance due to their level of income or resources. The program does not cover nursing facility care, intermediate care for the developmentally disabled services, or other long-term care services.

(6) Traumatic Brain Injury and Spinal Cord Injury Waiver Program. Individuals must be: eligible for Supplemental Security Income, MEDS-AD Demonstration Waiver or HCBS; must be age 18 through 64; must not be enrolled in or eligible for the Medically Needy Program; and, must have a traumatic brain or spinal cord injury.

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.903, 409.904, 409.906, 409.919 FS. History–New 10-8-97, Amended 1-27-99, 4-1-03, 6-13-04, 8-10-06 (4), (6), 8-10-06 (6), (7), (8), 10-9-13. Amended___

 

65A-1.712 SSI-Related Medicaid Resource Eligibility Criteria.

(1) Resource Limits. If an individual’s total resources are equal to or below the prescribed resource limits at any time during the month, the individual is eligible on the factor of resources for that month. The resource limit is the SSI limit specified in Rule 65A-1.716, F.A.C., with the following exceptions:

(a) through (c) No change.

(d) For Specified Special Low Income Medicare Beneficiary (SLMB), an individual cannot have resources exceeding three times the SSI resource limit with increases based on the Consumer Price Index.

(e) For Qualifying Individuals 1 (QI1), an individual cannnot have resources exceeding three times the SSI resource limit with increases based on the Consumer Price Index.

(e) through (f) are redesignated (f) through (g) No change.

(2) Exclusions. The Department follows SSI policy prescribed in 20 C.F.R. §416.1210 and 20 C.F.R. §416.1218 in determining resource exclusions, with the exceptions in paragraphs (a) through (g) below, in accordance with 42 U.S.C. §1396a(r)(2).

(a) through (c) No change.

(d) The individual, and their spouse, may designate up to $2,500 each of their resources for burial funds for any month, including the three months prior to the month of application. The designated funds may be excluded regardless of whether the exclusion is needed to allow eligibility. The $2,500 is not reduced by the value of excluded life insurance policies or irrevocable burial contracts. The funds may be commingled in the retroactive period.

(e) through (g) No change.

(3) Transfer of Resources and Income. According to 42 U.S.C. §1396p(c), if an individual, the spouse, or their legal representative, disposes of resources or income for less than fair market value on or after the look back date, the Department must presume that the disposal of resources or income was to become Medicaid eligible and impose a period of ineligibility for ICP, Institutional Hospice or HCBS Waiver Programs. The Department will mail a Notice of Determination of Assets (or Income) Transfer, CF-ES 2264, 02/2007, incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXXX, to individuals who report a transfer for less than fair market value, incorporated herein by reference), advising of the opportunity to rebut the presumption and of the opportunity to request and support a claim of undue hardship per subparagraph (c)5., below. The Spanish version, CF-ES 2264S, and the Creole version, CF-ES 2264H, of the Notice of Determination of Assets (or Income) Transfer form are incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXXX and http://www.flrules.org/Gateway/reference.asp?No=Ref-XXXX, respectively. If the Department determines the individual is eligible for Medicaid on all other factors of eligibility except the transfer, the individual will be approved for general Medicaid (not ICP, Institutional Hospice or HCBS Waiver Programs) and advised of their penalty period using the Medicaid Transfer Disposition Notice, CF-ES 2358, 07/2013, http://www.flrules.org/Gateway/reference.asp?No=Ref-03212, incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXXX. The Spanish version, CF-ES 2358S, and the Creole version, CF-ES 2358H, of the Medicaid Transfer Disposition Notice are incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXXX and http://www.flrules.org/Gateway/reference.asp?No=Ref-XXXX, respectively. Transfers of resources or income made prior to January 1, 2010 are subject to a 36 month look back period, except in the case of a trust treated as a transfer in which case the look back period is 60 months. Transfers of resources or income made on or after January 1, 2010 are subject to a 60 month look back period.

(a) No change.

(b) When funds are transferred to a retirement fund, including annuities, within the transfer look back period the Department must determine if the individual will receive fair market compensation in their lifetime from the fund. If fair compensation will be received in their lifetime there has been no transfer without fair compensation. If not, the establishment of the fund must be regarded as a transfer without fair compensation. Fair compensation shall be calculated based on life expectancy tables published by the Office of the Actuary of the Social Security Administration. See Rule 65A-1.716, F.A.C.

1. No change.

2. A purchase of an annuity (and other transactions that change the course of an annuity payment or treatment of income or principal) made on or after November 1, 2007 (and within the look back period) will be considered a transfer of resources for less than fair market value unless the annuity meets all of the following criteria for applicants at the time of approval and recipients at the time of annual review: (a) the State of Florida, Agency for Health Care Administration, is named as the primary beneficiary (or secondary as appropriate pursuant to subparagraph (b) 1., above); (b) the annuity is irrevocable and non-assignable; (c) the annuity pays principal and interest in equal amounts during the term of the annuity, with no balloon or deferred payments; and (d) the annuity is actuarially sound based on standards published by the Office of the Chief Actuary of the Social Security Administration called the Period of Life Table as set forth in Rule 65A-1.716, F.A.C. (Life Expectancy Tables). If the annuity meets all of the above criteria, funds in the annuity are excluded as a resource and the periodic payments are counted as income in the eligibility determination and calculation of patient responsibility.

a. No change.

b. Annuities purchased on or after November 1, 2007 (and within the look back period), by or on behalf of the community spouse, must name the State of Florida, Agency for Health Care Administration, as primary (or secondary) beneficiary pursuant to subparagraph (b)1., above and must be actuarially sound based on the community spouse’s age and the life expectancy tables. Annuities purchased by or on behalf of the community spouse after approval of ICP, Institutional Hospice or HCBS Waiver Programs for the applicant spouse are not evaluated for transfer of resources provisions.

3. No change.

(c) No penalty or period of ineligibility shall be imposed against an individual for transfers described in 42 U.S.C. §1396p(c)(2).

1. In order for the transfer or trust to be considered to be for the sole benefit of the spouse, the individual’s blind or disabled child, or a disabled individual under age 65, the instrument or document must provide that:

a.(a) Nno individual or entity except the spouse, the individual’s disabled child, or disabled individual under age 65 can benefit from the resources transferred in any way, either at the time of the transfer or at any time in the future; and

b.(b) Tthe individual must be able to receive fair compensation or return of the benefit of the trust or transfer during their lifetime.

2. through 4. No change.

5. A transfer penalty shall not be imposed if the Department determines that the denial of eligibility due to transferred resources or income would impose work an undue hardship on the individual. Undue hardship exists when imposing a period of ineligibility would deprive an individual of medical care such that their life or health would be endangered. Undue hardship also exists when imposing a period of ineligibility would deprive the individual of food, clothing, shelter or other necessities of life. All efforts to access the resources or income must be exhausted before this exception applies. The facility in which the institutionalized individual is residing may request an undue hardship waiver on behalf of the individual with the consent of the individual or their designated representative.

(d) Except for allowable transfers described in 42 U.S.C. §1396p(c)(2), in all other instances the Department must presume the transfer occurred to become Medicaid eligible unless the individual can prove otherwise.

1. through 2. No change.

3. Promissory notes, loans and mortgages purchased on or after November 1, 2007 (and within the look back period) will be considered transfers of resources for less than fair market value to become Medicaid eligible unless the promissory notes, loans or mortgages meet all of the following criteria:

a.(a) Tthe repayment term is actuarially sound in accordance with the Life Expectancy Tables as referenced in subparagraph (b)2., above;

b.(b) Ppayments must be made in equal amounts during the term of the loan, with no deferral and no balloon payments being possible; and

c.(c) Ddebt forgiveness is not allowed. If these criteria are not met, for purposes of transfer of resources, the value of the promissory notes, loans or mortgages will be the outstanding balance due as of the date of application for ICP, Institutional Hospice or HCBS Waiver Programs.

4. through 5. No change.

(e) through (f) No change.

(g) For transfers prior to November 1, 2007 (and within the look back period), periods of ineligibility are calculated beginning with the month in which the transfer occurred and shall be equal to the actual computed period of ineligibility, rounded down to the nearest whole number. For transfers made on or after November 1, 2007 (and within the look back period), periods of ineligibility begin with the later of the following dates:

1.(1) Tthe day the individual is eligible (pursuant to Rules 65A-1.711 through 65A-1.713, F.A.C.) for Medicaid and would be receiving institutional level care services in a nursing home facility, an institution with a level of care equivalent to that of a nursing facility, or home or community-based services furnished under a waiver based on an approved application for such care but for the application of the penalty period; or

2.(2) No change.

3.(3) Tthe first day following the end of an existing penalty period. The Department shall not round down, or otherwise disregard, any fractional period of ineligibility of the penalty period but will calculate the period down to the day. There is no limit on the period of ineligibility. Once the penalty period is imposed, it will continue although the individual may no longer meet all factors of eligibility and may no longer qualify for Medicaid long-term care benefits, unless all assets or income are returned to the individual or fair market value compensation is paid for the transferred assets or income. If all transferred assets or income are returned to the individual, the penalty period is eliminated. Eligibility must be evaluated with returned assets included as though the individual had never transferred the assets or income. Returned assets or income must be counted as available when determining eligibility for retroactive months.

a.1. No change.

a. through c. are redesignated (I) through (III) No change.

b2. If an institutionalized individual is ineligible for ICP, Institutional Hospice or an HCBS Waiver Program due to a transfer of resources or income by the community spouse, and the community spouse becomes potentially eligible for ICP, HCBS, or Institutional Hospice, any remaining penalty period must be apportioned between the spouses. The Department shall apportion penalty periods by dividing any new or remaining penalty periods by two and attribute the quotient to each spouse. Any excess months may be attributed to the spouse that caused the penalty or according to the wishes of the couple or their representative.

c3. Individuals who are ineligible due solely to the uncompensated value of a transferred resource or income are ineligible for ICP, Institutional Hospice or HCBS Waiver services payment, but are eligible for other Medicaid benefits.

(4) Spousal Impoverishment. The Department follows policy in accordance with 42 U.S.C. §1396r-5 for resource allocation and income attribution and protection when an institutionalized individual, including a hospice recipient residing in a nursing facility, has a community spouse. Spousal impoverishment policies are not applied to individuals applying for, or receiving services under, HCBS Waiver Programs, except for individuals in the Familial Dysautonomia and Model (Katie Beckett) waivers. in the Long-Term Care Community Diversion Program, the Assisted Living Facility Waiver or the Cystic Fibrosis Waiver.

(a) through (e) No change.

(f) Either spouse may appeal the post-eligibility amount of the income allowance through the fair hearing process and the allowance may be adjusted by the hearing officer if the couple presents proof that exceptional circumstances resulting in significant inadequacy of the allowance to meet their needs exist. Exceptional circumstances that result in extreme financial duress include circumstances other than those taken into account in establishing maintenance standards for spouses. An example is when a community spouse incurs unavoidable expenses for medical, remedial and other support services which impact the community spouse’s ability to maintain themselves themself in the community and in amounts that they could not be expected to be paid from amounts already recognized for maintenance and/or amounts held in resources. Effective November 1, 2007, the hearing officers must consider all of the community spouse’s income and all of the institutionalized spouse’s income that could be made available to a community spouse. If the expense causing exceptional circumstances is a temporary expense, the increased income allowance must be adjusted to remove the expenses when no longer needed.

(g) The institutionalized spouse shall not be determined ineligible based on a community spouse’s resources if all of the following conditions are found to exist:

1. No change.

2. The institutional spouse assigns to the state any rights to support from the community spouse by submitting the Assignment of Rights to Support, CF-ES 2504, 10/2005, incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXX, signed by the institutionalized spouse or their representative. The Spanish version, CF-ES 2504S, and the Creole version, CF-ES 2504H, of the Assignment of Rights to Support are incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXXX and http://www.flrules.org/Gateway/reference.asp?No=Ref-XXXX, respectively; and,

3. through 4. No change.

(5) Other Resource Policies.

(a) The Department follows the policy for home equity interest in accordance with 42 U.S.C. §1396p(f). Individuals shall not be eligible for ICP, Institutional Hospice or HCBS Waiver Programs on or after November 1, 2007, if the equity interest in the home exceeds the home equity limit.

1. through 3. No change.

4. The home equity provision may be waived when denial of ICP, Institutional Hospice or HCBS Waiver Programs would result in demonstrated hardship to the institutionalized individual.

5. The Department will mail a Notice of Excess Home Equity Interest, CF-ES 2354, 05/2012, http://www.flrules.org/Gateway/reference.asp?No=Ref-01530, incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXXX, to individuals whose home equity interest exceeds the home equity limit, advising of the opportunity to have the home equity interest policy waived. The Spanish version, CF-ES 2354S, and the Creole version, CF-ES 2354H, of the Notice of Excess Home Equity Interest are incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXXX and http://www.flrules.org/Gateway/reference.asp?No=Ref-XXXX, respectively.

(b) through (c) No change.

(6) Copies of materials incorporated by reference in this rule are available from the Economic Self-Sufficiency Headquarters Office at 1317 Winewood Boulevard, Tallahassee, Florida 32399-0700. Forms are also available on the Department’s website at http://www.dcf.state.fl.us/DCFForms/Search/DCFFormSearch.aspx.

Rulemaking Authority 409.9102, 409.919 FS. Law Implemented 409.902, 409.903, 409.904, 409.906, 409.9102, 409.919 FS. History–New 10-8-97, Amended 1-27-99, 4-1-03, 9-28-04, 8-10-06 (1)(a), (f), 8-10-06 (1)(f), 8-10-06 (3)(g)1., 11-1-07, 12-24-09, 9-10-12, 10-6-13, Amended_____.

 

65A-1.713 SSI-Related Medicaid Income Eligibility Criteria.

(1) Income limits. An individual’s income must be within limits established by federal or state law and the Medicaid State Plan. The income limits are as follows:

(a) For Medicaid for the Aged or Disabled (MEDS-AD) Demonstration Waiver, income cannot exceed 88 percent of the federal poverty level (FPL) after application of exclusions specified in subsection 65A-1.713(2), F.A.C.

(b) For Qualified Medicare Beneficiary (QMB), income must be less than or equal to the FPL federal poverty level after application of exclusions specified in subsection 65A-1.713(2), F.A.C.

(c) For Working Disabled (WD), income must be less than or equal to 200 percent of the FPL federal poverty level after application of exclusions specified in subsection 65A-1.713(2), F.A.C.

(d) For Institutional Care Program (ICP), gross income cannot exceed 300 percent of the Supplemental Security Income (SSI) federal benefit rate after consideration of allowable deductions set forth in subsection 65A-1.713(2), F.A.C. Individuals with income over this limit may qualify for institutional care services by establishing an income trust which meets criteria set forth in subsection 65A-1.702(15), F.A.C.

(e) For Home and Community-Based Services (HCBS), gross income cannot exceed 300 percent of the SSI federal benefit rate after consideration of allowable deductions set forth in subsection 65A-1.713(2), F.A.C. Individuals with income over this limit may qualify for HCBS services by establishing a qualified income trust which meets criteria set forth in subsection 65A-1.702(15), F.A.C.

(f) No change.

(g) For Specified Low-Income Medicare Beneficiary (SLMB), income must be greater than 100 percent of the FPL federal poverty level but equal to or less than 120 percent of the FPL federal poverty level.

(h) through (i) No change.

(j) For a Qualified Individual 1 (QI1), income must be greater than 120 percent of the FPL federal poverty level, but equal to or less than 135 percent of the FPL federal poverty level. QI1 is eligible only for payment of the Part B Medicare premium through Medicaid.

(2) Included and Excluded Income. For all SSI-related coverage groups the Ddepartment follows the SSI policy specified in 20 C.F.R. §416.1100 (2007) (incorporated by reference) et seq., including exclusionary policies regarding the following: Veterans Administration (VA) benefits, such as VA aAid and aAttendance (A&A), housebound (HB), unreimbursed mMedical eExpenses (UME), and reduced VA iImproved pensions, to determine which income to exclude.  The following income types are exceptions and excluded:  what counts as income and what is excluded as income with the following exceptions:

(a) In-kind support and maintenance is not considered in determining income eligibility.

(b) Exclude Ttotal of irregular or infrequent earned income if it does not exceed $30 per calendar quarter.

(c) Exclude Ttotal of irregular or infrequent unearned income if it does not exceed $60 per calendar quarter.

(d) Income placed into a qualified income trust is not considered when determining if an individual meets the income standard for ICP, Iinstitutional Hospice program or HCBS.

(e) Interest and dividends on countable assets are excluded in determining eligibility and counted in post eligibility computations, or except when determining patient responsibility for ICP, HCBS and other institutional programs.

(3) Excluded earned or unearned income must be verified to determine the amount that is deducted from the individual’s gross income.

(a) Excluded income from a veteran’s payment (UME, A&A and HB benefits) must be verified at the source. The request for Veteran’s Benefits Information, a VA award letter specifying the amount and type of excludable income or a collateral contact with the Department of Veterans Affairs may be used to verify excludable VA benefits.

(b) Income placed into a qualified income trust must be verified at the source. Bank statements or records are acceptable verification of deposits.

(c) Interest and dividends on countable assets, at application, must be verified at the source. Financial records from the institution holding the asset are acceptable verification.

(4)(3) No change.

(5)(4) Income Budgeting Methodologies. To determine eligibility SSI budgeting methodologies are applied except where expressly prohibited by 42 U.S.C. §1396 (2000 Ed., Sup. IV) (incorporated by reference), or another less restrictive option is elected by the state under 42 U.S.C. §1396a(r)(2) (2000 Ed., Sup. IV) (incorporated by reference). When averaging income, all income from the most recent consecutive four weeks shall be used if it is representative of future earnings. A longer period of past time may be used if necessary to provide a more accurate indication of anticipated fluctuations in future income.

(a) For MEDS-AD Demonstration Waiver, Protected Medicaid, Medically Needy, WD Qualified Working Disabled Individual, QMB, SLMB, and QI1, and to compute the community spouse income allocation for spouses of ICP individuals, the following less restrictive methodology for determining gross monthly income is followed:

1. through 3. No change.

(b) No change.

(c) Medically Needy. The amount by which the individual’s countable income exceeds the Medically Needy income level, called the “share of cost,” shall be considered available for payment of medical care and services. The Ddepartment computes available income for each month eligibility is requested to determine the amount of excess countable income available to meet medical costs. If countable income exceeds the Medically Needy income level the Ddepartment shall deduct allowable medical expenses in chronological order, by day of service. Countable income is determined in accordance with subsection 65A-1.713(2), F.A.C. To be deducted the expenses must be unpaid, or if paid, must have been paid in the month for which eligibility is being determined or incurred and paid during the three previous calendar months to the month for which eligibility is being determined but no earlier than the three retroactive application months. The paid expense may not have been previously deducted from countable income during a period of eligibility. Medical expenses reimbursed by a state or local government not funded in full by federal funds, excluding Medicaid program payments, are allowable deductions. Any other expenses reimbursable by a third party are not allowable deductions. Examples of recognized medical expenses include:

1. through 2. No change.

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.903, 409.904, 409.906, 409.919 FS. History–New 10-8-97, Amended 1-27-99, 4-1-03, 6-13-04, 8-10-06 (1), (4), 8-10-06 (1), 2-20-07, 10-16-07, 5-6-08,_____.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Suzann Fauci

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Chad Poppell

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: November 4, 2019

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: November 12, 2019