Client Eligibility, Patient Selection and Referral, Contract Requirements

 

DEPARTMENT OF HEALTH

Division of Family Health Services

RULE NO.: RULE TITLE:

64F-11.002 Client Eligibility

64F-11.003 Patient Selection and Referral

64F-11.005 Contract Requirements

NOTICE OF CHANGE

Notice is hereby given that the following changes have been made to proposed rules in accordance with subparagraph 120.54(3)(d)1., F.S., published in the Florida Administrative Weekly, Vol. 31, No. 18 on May 6, 2005 and Vol. 31, No. 47 on November 23, 2005. The changes reflect comments received from the Joint Administrative Procedures Committee and additional changes to Section 766.1115, Florida Statutes, Chapter 2005-118, section 1. The changes are as follows:

1. Subsection (4) of proposed 64F-11.002, F.A.C., shall read as follows:

(4) "The governmental contractor is responsible for determining if applicants meet the eligibility criteria as established in the Department of Health Client Eligibility and Referral Process Training Guide, DH 1032G, (02/06), as incorporated herein by reference, for participation in the Volunteer Health Care Provider Program. A copy of the Client Eligibility and Referral Process Training Guide can be obtained through the department's Volunteer Health Services Program."

2. Client Eligibility and Referral Process Training Guide, DH 1032G, (02/06), Part 2, Instructions for Completing the Patient Referral Form, shall read as follows:

“A Patient Referral Form, DH 1032, (02/06) must be completed on each patient referred from the Department of Health to a health care provider participating in the Volunteer Health Care Provider Program. A referral form is valid for the initial medical/dental visit and all follow-up visits for the same condition with the same provider. In cases where a patient's medical/dental treatment plan for a specific medical/dental issue requires a pathologist, radiologist, anesthesiologist or laboratory services in addition to service rendered by the supervising provider, the referral form may include these providers. These ancillary providers must be identified by name on the referral form as soon as the participating providers become available. If a patient presents for a different medical/ dental issue or is scheduled to see a different provider, then a new referral must be completed. Blank Patient Referral Forms can not be signed and dated by the patient in anticipation of possible future referrals. However, a patient can be asked to sign incomplete referral form in anticipation that every effort will be made to schedule an appointment with an appropriate provider for a specific medical/dental issue as soon as possible. All signatures on the Patient Referral Form must be originals, "signature on file" is not an acceptable replacement for original signatures.”

3. The Patient Referral Form, DH 1032, (02/06) is modified to authorize the referral of a patient by the supervising provider to providers rendering ancillary services such as pathology, radiology, anesthesiology and laboratory tests. A copy of the Patient Referral Form, DH 1032, (02/06) can be obtained through the department's Volunteer Health Services Program.

4. Subsection (4) of proposed Rule 64F-11.003, F.A.C., shall read as follows:

(4) “The governmental contractor may convey to any provider the responsibility for determining eligibility and the referral of clients for the department. The provider may perform the eligibility and referral process in accordance with a Volunteer Health Care Provider Program contract, DH 1029, (02/06), as incorporated in Rule 64F-11.005, F.A.C., with the governmental contractor.”

5. Rule 64F-11.005, F.A.C., shall read as follows:

“The governmental contractor shall use the Volunteer Health Care Provider Program contract, DH 1029, (02/06) as incorporated herein by reference, developed by the department specifically for this program. Provisions of the contract shall include the requirements specified in Section 766.1115(4) and (10), F.S. Copies of the contract can be obtained through the department's Volunteer Health Services Program.”

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Mark Lundberg, Director, Volunteer Health Services Program, 4052 Bald Cypress Way, Bin #C23, Tallahassee, Florida 32399-1743, [phone], Fax [phone], e-mail: [e-mail]