The purpose of this rule amendment is to incorporate by reference the Florida Medicaid Provider Reimbursement Handbook, ADA Dental Claim Form, July 2008. The handbook replaces the Florida Medicaid Provider Reimbursement Handbook, Dental 111. Dental ...

AGENCY FOR HEALTH CARE ADMINISTRATION
Medicaid

RULE NO: RULE TITLE
59G-4.060: Dental Services
PURPOSE AND EFFECT: The purpose of this rule amendment is to incorporate by reference the Florida Medicaid Provider Reimbursement Handbook, ADA Dental Claim Form, July 2008. The handbook replaces the Florida Medicaid Provider Reimbursement Handbook, Dental 111. Dental providers are required to bill on the ADA Dental Claim Form when submitting paper claims. The handbook also contains updated references for the new Medicaid fiscal agent. The effect will be to incorporate by reference in rule the Florida Medicaid Provider Reimbursement Handbook, ADA Dental Claim Form, July 2008.
In the Notice of Rule Development, published in Volume 33, Number 48, Florida Administrative Weekly, dated November 30, 2008, we stated that the handbook effective date was March 2008. We changed this date to July 2008.
SUMMARY: The purpose of this rule amendment is to incorporate by reference in rule the revised Florida Medicaid Provider Reimbursement Handbook, Dental ADA Claim Form, July 2008. The effect will be to incorporate by reference in rule the Florida Medicaid Provider Reimbursement Handbook, Dental ADA Claim Form, July 2008.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: The Agency has determined that this rule amendment will not result in any additional regulatory costs.
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.
SPECIFIC AUTHORITY: 409.919 FS.
LAW IMPLEMENTED: 409.906, 409.908, 409.912 FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
DATE AND TIME: Monday, December 1, 2008, 2:00 p.m.
PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building #3, Conference Room D, Tallahassee, Florida
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Mary Cerasoli, Bureau of Medicaid Services, 2727 Mahan Drive, Mail Stop 20, Tallahassee, Florida, 32308, [phone], [e-mail]

THE FULL TEXT OF THE PROPOSED RULE IS:

59G-4.060 Dental Services.

(1) No change.

(2) All dental services providers enrolled in the Medicaid program must be in compliance with the Florida Medicaid Dental Services Coverage and Limitations Handbook, January 2006, updated January 2007, and the Florida Medicaid Provider Reimbursement Handbook, ADA Dental Claim Form 111, July 2008 October 2003, which are 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. All handbooks are available from the Medicaid fiscal agent’s Web Portal website at http://mymedicaid-florida.com floridamedicaid.acs-inc.com. 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 Medicaid fiscal agent, Provider Contact Center at [phone] and selecting Option 7 377-8216.

(3) No change.

(4) The following form that is included in Chapter 1 of the Florida Medicaid Provider Reimbursement Handbook, ADA Dental Claim Form, is incorporated by reference: ADA Dental Claim Form, ©2006 American Dental Association, J404. ADA Dental Claim Forms may be ordered from the American Dental Association at [phone] or online at www.adacatalog. org. They may also be ordered by calling the Medicaid fiscal agent’s Provider Contact Center at [phone] and selecting Option 7. The following form that is included in Chapter 3 of the handbook, Medically Needy Billing Authorization, DF-ES 2902, June 2003, is incorporated by reference in Rule 59G-4.001, F.A.C. The form is mailed by the Department of Children and Families to providers whose services are eligible for reimbursment.

Specific Authority 409.919 FS. Law Implemented 409.906, 409.908, 409.912 FS. History–New 7-10-80, Amended 2-19-81, 10-27-81, 7-21-83, Formerly 10C-7.523, Amended 9-11-90, 11-3-92, Formerly 10C-7.0523, Amended 6-29-93, Formerly 10P-4.060, Amended 7-19-94, 7-16-96, 3-11-98, 10-13-98, 12-28-98, 6-10-99, 4-23-00, 4-24-01, 7-5-01, 2-20-03, 8-5-03, 1-8-04, 10-12-04, 6-28-05, 7-2-06, 5-21-07,_________.

NAME OF PERSON ORIGINATING PROPOSED RULE: Mary Cerasoli
NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Holly Benson, Secretary
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: October 22, 2008
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: November 30, 2007