RULE NO: RULE TITLE
59G-5.020: Provider Requirements
- NOTICE OF CHANGENotice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 34 No. 41, October 10, 2008 issue of the Florida Administrative Weekly.
These changes are in response to comments received from the Joint Administrative Procedures Committee.
The rule incorporates by reference the Florida Medicaid Provider General Handbook, July 2008. The following revisions were made to the handbook.
Page 1-19 Managed Care Mandatory Assignment. We added the citations Sec. 1932. [42 U.S.C. ss.1369u-2](a)(2)(A)(iv) and (v) of the Social Security Act, which exempt foster care children and children in subsidized adoption arrangements from enrolling with a managed care provider.
Page 2-8 Enrollment on the Medicaid Fiscal Agents Web Portal. We corrected the Medicaid fiscal agents web portal address to read, http://mymedicaid-florida.com.
Page 2-23 Criminal History Check Exemption for Corporations. We deleted the policy permitting registered agents to submit their fingerprints instead of the corporations principles.
Page 2-30 Durable Medical Equipment Providers and Durable Medical Equipment Provider Surety Bond Exemptions. We added, In accordance with Section 409.908(48)(b), F.S., effective January 1, 2009, to the beginning of the first sentence.
Page 2-47 The Change of Ownership Process. We added to the beginning of the first sentence, second bullet, At least sixty (60) days before the anticipated date of the change of ownership. Also we changed must to shall. We revised the last sentence in bullet 4 to read, Medicaid Provider Enrollment may make exceptions on a case-by-case basis in order to ensure that recipients have continuity of care, pursuant to Sections 409.907(9)(a) and 409.907(11), F.S.
Page 3-17 CF-ES Form 2681. We deleted the reference to the Sep 2000 version on the form, because that version is now obsolete.
Page 3-19 CF-ES Form 2014. We deleted the reference to the Sep 2001 version on the form, because that version is now obsolete.
Page 4-10 How to Determine Medicaids Fee. We corrected the Medicaid fiscal agents web address.
Page 5-2 Reporting Suspected Abuse or to File a Complaint. After the web address, we added instructions to Click on the link Report Medicaid Abuse and Overpayment.
Page 5-4 Administrative Sanctions. We revised the section to read, AHCA shall impose sanctions on providers in accordance with Section 409.913, F.S. and Rule 59G-9.070, F.A.C. Sanctions include the following: suspension from participation in the Medicaid Program; termination from participation in the Medicaid Program; imposition of fines; imposition of liens against provider assets; prepayment reviews of claims; comprehensive follow-up reviews; and corrective-action plans.
