The purpose of the amendment to Rule 59G-4.260 is to incorporate by reference the Prescribed Pediatric Extended Care Services Coverage and Limitations Handbook, May 2013. Prescribed Pediatric Extended Care (PPEC) centers provide medical, nursing, ...

 

AGENCY FOR HEALTH CARE ADMINISTRATION
Medicaid

RULE NO.: RULE TITLE:
59G-4.260: Prescribed Pediatric Extended Care Services
PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-4.260 is to incorporate by reference the Prescribed Pediatric Extended Care Services Coverage and Limitations Handbook, May 2013. Prescribed Pediatric Extended Care (PPEC) centers provide medical, nursing, and personal care to those children who are medically complex and require such services. This handbook is for Medicaid enrolled and potential Medicaid enrolled PPEC providers in the State of Florida.
SUMMARY: The handbook revises service authorization procedures, which are now handled by a Medicaid contracted Quality Improvement Organization. The language has been updated to include appropriate procedures for Medicaid reimbursement for PPEC providers. The handbook clarifies policy and reimbursement rules.
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, 409.907, 409.908, 409.912, 409.913 FS.
A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
DATE AND TIME: Wednesday, March 13, 2013, 3:30 p.m. - 5:00 p.m.
PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room B, 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: Kathleen Core at the Bureau of Medicaid Services, 850-412-4221. 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: Kathleen Core, 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-4.260 Prescribed Pediatric Extended Care Services.

(1) This rule applies to all Prescribed Pediatric Extended Care (PPEC) service providers enrolled in the Florida Medicaid program.

(2) All Florida Medicaid enrolled prescribed pediatric extended care service providers must be in compliance with the provisions of the Florida Medicaid Prescribed Pediatric Extended Care Services Coverage and Limitations Handbook, May 2013 February 2007, 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 website at www.mymedicaid-florida.com http://floridamedicaid.acs-inc.com. Select Public Information for Providers, then Click on Provider Support, and then on Provider Handbooks. Paper copies of the handbooks may be obtained by calling the Provider Services Contact Center at 1-800-289-7799 and selecting Option 7 Provider Enrollment at [phone].

(3) The following form is included in the Prescribed Pediatric Extended Care Services Coverage and Limitations Handbook and is incorporated by reference: Appendix B, Physician Plan of Care for PPEC Services Form, AHCA-Med Serv Form 5000-3507, Revised February 2013.

Rulemaking Specific Authority 409.919 FS. Law Implemented 409.902, 409.905, 409.907, 409.908, 409.912, 409.913 FS. History–New 8-27-91, Amended 4-21-92, 3-9-93, Formerly 10C-7.0471, Amended 2-11-96, 2-22-00, 5-11-04, 4-24-07, __________.

NAME OF PERSON ORIGINATING PROPOSED RULE: Kathleen Core
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: March 23, 2012