The purpose of this rule change is to allow the agency to process provider applications more efficiently by allowing the agency to close a provider application if the provider has not responded to a request for additional information within 45 days. ...

 

DEPARTMENT OF CHILDREN AND FAMILIES

Agency for Persons with Disabilities

RULE NO.:RULE TITLE:

65G-4.0215General Provisions

PURPOSE AND EFFECT: The purpose of this rule change is to allow the agency to process provider applications more efficiently by allowing the agency to close a provider application if the provider has not responded to a request for additional information within 45 days. The rule change does not prohibit a potential provider from resubmitting their application after it has been closed.

SUBJECT AREA TO BE ADDRESSED: Provider applications

RULEMAKING AUTHORITY: 120.60(1), 393.501(1), 393.0662 FS.

LAW IMPLEMENTED: 393.0662 FS.

IF REQUESTED IN WRITING AND NOT DEEMED UNNECESSARY BY THE AGENCY HEAD, A RULE DEVELOPMENT WORKSHOP WILL BE NOTICED IN THE NEXT AVAILABLE FLORIDA ADMINISTRATIVE REGISTER.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Lisa Kuhlman, Senior Attorney, Agency for Persons with Disabilities, 4030 Esplanade Way, Tallahassee, FL 32399, [phone], [e-mail]

 

THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:

 

(1) through (4) No change.

(5)(a) iBudget Waiver providers must have applied through the Agency for Persons with Disabilities to ensure that they meet the minimum qualifications to provide iBudget Waiver services. iBudget Waiver providers must also be enrolled as a Medicaid provider through the Agency or Healthcare Administration. However providers do not have to provide Medicaid State Plan services in order to provide waiver services. To enroll as a provider for iBudget Waiver Services, the provider must first submit an application to the Agency or Persons with Disabilities using the Regional iBudget Provider Enrollment Application – Waiver Support Coordinator (WSC) – APD 2015-02, effective date 7-1-2015, for waiver support coordinator applications, which is available at http://www.flrules.org/Gateway/reference.asp?No=Ref-07073, or the Regional iBudget Provider Enrollment Application – Non-WSC – APD 2015-03, effective date 7-1-2015, for all other provider applications, which is available at http://www.flrules.org/Gateway/reference.asp?No=Ref-07074. These forms are hereby incorporated by reference. On the application providers must identify the counties where they intend to provide services. The Agency for Persons with Disabilities will review the application, request missing documentation, and issue a decision about whether the provider meets the qualifications to provide services. The Agency for Persons with Disabilities may close the application if missing information is not provided within 45 calendar days of the request by the Agency. The qualifications to provide services are identified in the Handbook.

(b) If a waiver provider wishes to, expand by providing additional services, expand services geographically, or expand from solo to agency, the provider must notify the Agency regional office by submitting an Provider Expansion Request form – APD 2015-04, effective date 8-20-2013, which is hereby incorporated by reference and is available at http://www.flrules.org/Gateway/reference.asp?No=Ref-07076. The Agency regional office must approve any expansion prior to the provision of expanded services. Before the Agency regional office approves a provider for expansion, the Agency regional office must determine that the provider meets the provider qualifications and has:

1. An 85% or higher on their last Quality Assurance Organization (QIO) report. If a provider does not have a history of a QIO review, this does not prevent consideration for expansion,

2. No identified alerts (i.e., background screening, medication administration, and validation),

3. No unresolved billing discrepancies or plan of remediation,

4. No adverse performance history relating to the health and safety of individuals served; and,

5. No open investigations or referrals to the Agency for Health Care Administration (AHCA) and the Department of Children and Families (DCF).

Agency staff shall check with the provider’s home regional office to determine whether there is a history of complaints filed and logged on the remediation tracker, any open investigations or referrals to AHCA’s Medicaid Program Integrity (MPI) or the Attorney General’s Medicaid Fraud Control Unit (MFCU), or DCF. The Agency shall make the determination required under this paragraph in not more than 90 days.

(6) No change.

Rulemaking Authority 393.501(1), 393.0662 FS. Law Implemented 393.0662, 409.906 FS. History–New 7-7-16, Amended______.