Definitions

AGENCY FOR HEALTH CARE ADMINISTRATION
Cost Management and Control

RULE NO: RULE TITLE
59B-9.031: Definitions

NOTICE OF CHANGE

Notice 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. 53, December 31, 2008 issue of the Florida Administrative Weekly.

59B-9.031 Definitions.

(1) through (2) No change.

(3) “Charity” means medical care provided by a health care entity to a person who has insufficient resources or assets to pay for needed the medical care without utilizing his resources which are required to meet the person’s his basic need for shelter, food, or clothing. No patient shall be considered charity care whose family income, as applicable for the twelve (12) months preceding the determination, exceeds 200 percent of the federal poverty guidelines, unless the amount of health care charges due from the patient exceeds 25 percent of annual family income. However, in no case shall the facility charges for a patient whose family income exceeds four times the federal poverty level for a family of four be considered charity. This information should be provided based on the patient’s status at time of reporting.

(3)(4) No change.

(4)(5) “E-code” means a Supplementary Classification of External Causes of Injury and Poisoning ICD-9-CM or ICD-10-CM codes where environmental events, circumstances, and conditions are the cause of injury, poisoning and other adverse effects as specified in the ICD-9-CM or ICD-10-CM manual and the conventions of coding.

(5)(6) “Executive Officer” means a reporting facility’s chief executive officer, chief financial officer, chief operating officer, president, or any vice president, of the facility in charge of a principal business unit, division or function (administration or finance).

(7) through (8) renumbered (6) through (7) No change.

(8)(9) “NUBC” means National Uniform Billing Committee. A national body that defines the data elements fields that are reported on the Uniform Bill UB-04 and annually publishes an Official UB-04 Data Specifications Manual, which is published annually.

(9)(10) No change.

(10)(11) “NPI” means National Provider Identification. A NPI is an A unique identification number assigned to a provider by the Centers for Medicare & Medicaid Services.

(12) through (14) renumbered (11) through (13) No change.