The purpose of the amendment to Rule 59G-6.020 is to incorporate by reference the Florida Title XIX Inpatient Hospital Reimbursement Plan (the Plan), Version XLII, effective July 1, 2015. The amendment also specifies the rule is applicable to ...

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.: RULE TITLE:

59G-6.020: Payment Methodology for Inpatient Hospital Services

PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-6.020, F.A.C. is to incorporate by reference the Florida Title XIX Inpatient Hospital Reimbursement Plan (the Plan), Version XLII, effective July 1, 2015. The amendment also specifies the rule is applicable to Florida Medicaid fee-for-service providers.

SUBJECT AREA TO BE ADDRESSED: Rules 59G-6.020, F.A.C., Payment Methodology for Inpatient Hospital Services, and 59G-6.030, F.A.C., Payment Methodology for Outpatient Hospital Services.

An additional area to be addressed during the workshop will be the potential regulatory impact Rule 59G-6.020, and 59G-6.030, Florida Administrative Code, will have as provided for under sections 120.54 and 120.541, Florida Statutes.

RULEMAKING AUTHORITY: 409.919 FS.

LAW IMPLEMENTED: 409.905(5), 409.908, 409.909, 409.913, 409.9113, 409.9115, 409.9116, 409.9118, 409.9119 FS.

A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:

DATE AND TIME: December 3, 2015 from 11:00 a.m. to 12:00 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: Chanda Farcas 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, IF AVAILABLE, IS: Chanda Farcas, Bureau of Medicaid Program Finance, 2727 Mahan Drive, Mail Stop 23, Tallahassee, Florida 32308-5407, telephone: [phone], e-mail: [e-mail].

Comments will be received until 5:00 p.m., on December 4, 2015.

 

THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:

59G-6.020 Payment Methodology for Inpatient Hospital Services.

(1) Reimbursement to participating inpatient hospitals for services provided shall be in accordance with the Florida Title XIX Inpatient Hospital Reimbursement Plan (the Plan), Version XLII XLI, effective July 1, 2015, 2014, http//www.flrules.org/Gateway/reference.asp?No=Ref-05438 incorporated by reference. The Plan is applicable to the fee-for-service delivery system. 

(2) A copy of the Plan, as revised, may be obtained by writing to the Office of the Deputy Secretary for Medicaid, Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Mail Stop 8, Tallahassee, Florida 32308.

(3)(2) The following forms are included in the Plan and are incorporated by reference, in this rule: CMS-2552-96, June 2003;, and CMS-2552-10, October 2012. These forms are  available on the Centers for Medicare and Medicaid Services Web site at http://www.cms.gov/Research-Statistics-Data-and-Systems/Files-for-Order/CostReports/Hospital-1996-form.html and http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3P240f.pdf, respectively.

Rulemaking Authority 409.919 FS. Law Implemented 409.905(5), 409.908, 409.909, 409.913, 409.9113, 409.9115, 409.9116, 409.9118, 409.9119 FS. History–New 10-31-85, Formerly 10C-7.391, Amended 10-1-86, 1-10-89, 11-19-89, 3-26-90, 8-14-90, 9-30-90, 9-16-91, 4-6-92, 11-30-92, 6-30-93, Formerly 10C-7.0391, Amended 4-10-94, 8-15-94, 1-11-95, 5-13-96, 7-1-96, 12-2-96, 11-30-97, 9-16-98, 11-10-99, 9-20-00, 3-31-02, 1-8-03, 7-3-03, 2-1-04, 2-16-04, 2-17-04, 8-10-04, 10-12-04, 1-10-06, 4-19-06, 12-11-06, 3-4-08, 6-10-08, 1-11-09, 3-24-10, 7-5-10, 7-15-10, 2-23-11, 10-30-12, 4-23-14, 1-19-15, 6-15-15, _______.