The purpose of the amendment to Rule 59G-4.130 is to incorporate by reference the Home Health Services Coverage and Limitations Handbook, March 2013. The handbook is being revised to comply with mandates passed in the 2012 legislative session.

 

AGENCY FOR HEALTH CARE ADMINISTRATION
Medicaid

RULE NO.: RULE TITLE:
59G-4.130: Home Health Services
PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-4.130 is to incorporate by reference the Home Health Services Coverage and Limitations Handbook, March 2013. The handbook is being revised to comply with mandates passed in the 2012 legislative session.
SUMMARY: The mandates referenced above include: (1) limiting home health visits to three visits per day for non-pregnant adults and (2) implementing a Telephonic Home Health Service Delivery Monitoring and Verification Program statewide.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:
The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the agency.
The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: A checklist was prepared by the Agency to determine the need for a SERC. Based on this information at the time of the analysis and pursuant to Section 120.541, F.S., the rule will not require legislative ratification.
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.
RULEMAKING AUTHORITY: 409.919 FS.
LAW IMPLEMENTED: 409.902, 409.905, 409.908, 409.9081, 409.912, 409.913, 409. 9132, 409. 9133 FS.
A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
DATE AND TIME: Wednesday, March 13, 2013, 10:00 a.m.-12:00 p.m.
PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room A, 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: Claire Anthony-Davis at the Bureau of Medicaid Services, 850-412-4266. 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 IS: Claire Anthony-Davis, Medicaid Services, 2727 Mahan Drive, Mail Stop 20, Tallahassee, Florida 32308-5407, telephone: [phone], e-mail: [e-mail]. To download a draft copy of this rule, if available, go to http://ahca.myflorida.com/Medicaid/review/index.shtml.

THE FULL TEXT OF THE PROPOSED RULE IS:

59G-4.130 Home Health Services

(1) This rule applies to all home health agencies licensed under Chapter 400, Part III, Florida Statues F.S., and certified by the Agency for Health Care Administration for participation in the Florida Medicaid program for home health care.

(2) All home health agency providers enrolled in the Florida Medicaid program must be in compliance with the Florida Medicaid Home Health Services Coverage and Limitations Handbook, March 2013 December 2011, incorporated by reference, and the Florida Medicaid Provider Reimbursement Handbook, CMS-1500, which is incorporated in Rule 59G-4.001, F.A.C. The Both handbooks is are available from the Medicaid fiscal agent’s Web site at www.mymedicaid-florida.com. Select Public Information for Providers, then Provider Support, and then Provider Handbooks. Paper copies of the handbooks may be obtained by calling the Provider Services Contact Center Medicaid fiscal agent at 1-800-1(800) 289-7799 and selecting Option 7.

(3) When terminating, reducing, or denying private duty nursing or personal care services, Medicaid will provide written notification to the recipient or the recipient’s legal guardian. The notice will provide information and instructions regarding the recipient’s right to request a hearing.

(4) The following forms appendices are included in the Florida Medicaid Home Health Services Coverage and Limitations Handbook and are incorporated by reference: Appendix B, Home Health Certification and Plan of Care, Form CMS-485(C-3)(02-94) (Formerly HCFA-485), July 2008 December 2011; and in Appendix C, the Authorization for Private Duty Nursing Provided by a Parent or Legal Guardian, AHCA-Med Serv Form 5000-3541 046, February 2013; Appendix D, Guidelines for Evaluating Family Support and Care Supplements, December 2011; Appendix D E, Physician Visit Documentation Form, AHCA-Med Serv Form 5000-3502, Revised February 2013 October 2010; Appendix E F, Parent or Legal Guardian Medical Limitations, AHCA-Med Serv Form 5000-3501, Revised February 2013 October 2010; Appendix F G, Parent or Legal Guardian Work Schedule, AHCA-Med Serv Form 5000-3503, Revised February 2013 December 2011; Appendix G H, Parent or Legal Guardian Statement of Work Schedule, AHCA-Med Serv Form 5000-3504, Revised February 2013 December 2011; Appendix HI, Parent or Legal Guardian School Schedule, AHCA-Med Serv Form 5000-3505, Revised February 2013 December 2011; Appendix I J, Medicaid Instructions for Personal Care Services Plan of Care and Form, AHCA-Med Serv Form 5000-3506, September December 2011; Appendix J K, Medicaid Physician’s Written Prescription for Home Health Services, AHCA-Med Serv Form 5000-3525, Revised February 2013. December 2011; Appendix KL, Review Criteria for Private Duty Nursing Services, December 2011; and Appendix LM, Medicaid Review Criteria for Personal Care Services, December 2011. The forms are available by photocopying them from the handbook.

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.905, 409.907, 409.908, 409.9081, 409.912, 409.913, 409.9132, 409.9133 FS. History–New 1-1-77, Amended 4-1-78, 9-28-78, 1-24-79, 7-17-83, Formerly 10C-7.44, Amended 6-1-88, 4-9-89, 1-1-90, 5-26-93, Formerly 10C-7.044, Amended 3-14-95, 12-27-95, 5-7-96, 2-9-98, 5-30-00, 11-24-03, 10-30-07, 12-29-08, 6-25-12, ______________.

NAME OF PERSON ORIGINATING PROPOSED RULE: Claire Anthony-Davis
NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Elizabeth Dudek
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: February 8, 2013
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: July 27, 2012