The purpose of the amendment to Rule 59G-6.020, Florida Administrative Code (F.A.C.), is to incorporate by reference the Florida Title XIX Inpatient Hospital Reimbursement Plan (the Plan), Version XLIII, effective July 1, 2016.

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.:RULE TITLE:

59G-6.020Payment Methodology for Inpatient Hospital Services

PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-6.020, Florida Administrative Code (F.A.C.), is to incorporate by reference the Florida Title XIX Inpatient Hospital Reimbursement Plan (the Plan), Version XLIII, effective July 1, 2016.

SUBJECT AREA TO BE ADDRESSED: Payment Methodology for Inpatient Hospital Services.

RULEMAKING AUTHORITY: 409.919 FS.

LAW IMPLEMENTED: 409.905, 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 21, 2016, from 9:00 a.m. to 10:00 a.m.

PLACE: In Person: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Tallahassee, Florida 32308-5407. Remote Listeners: Register to view the presentation at https://attendee.gotowebinar.com/register/4052109745805629442. A call number will be provided upon successful registration through which, remote attendees may listen to the discussion via telephone.

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: Charles McGillen. 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: Charles McGillen, Bureau of Medicaid Policy, 2727 Mahan Drive, Mail Stop 20, Tallahassee, Florida 32308-5407, telephone: [phone], email: [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. Official comments to be entered into the rule record will be received until 5:00 p.m. on December 22, 2016 and may be emailed to [e-mail]. For general inquiries and questions about the rule, please contact the person specified above.

 

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 XLIII XLII, effective July 1, 2016, 2015, available at [DOS place holder Ref-_______]http://www.flrules.org/Gateway/reference.asp?No=Ref-07021, 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 Bureau of Office of the Deputy Secretary for Medicaid Program Finance, Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Mail Stop 23 8, Tallahassee, Florida 32308.

(3) The Provider Reimbursement Manual CMS PUB. 15-1, is incorporated by reference, http://www.flrules.org/Gateway/reference.asp?No=Ref-07043, and available at  https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Paper-Based-Manuals-Items/CMS021929.html. The following cost reports are included in the Plan and are incorporated by reference: CMS-2552-96, June 2003, http://www.flrules.org/Gateway/reference.asp?No=Ref-07058; and CMS-2552-10, October 2012, http://www.flrules.org/Gateway/reference.asp?No=Ref-07059. These cost reports are available on the Centers for Medicare and Medicaid Services website 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, 7-11-16, _______.