The purpose of the amendment to Rule 59G-4.130 is to incorporate by reference the Florida Medicaid Home Health Services Coverage and Limitations Handbook, _____________.

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.:RULE TITLE:

59G-4.130Home Health Services

PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-4.130, F.A.C., is to incorporate by reference the Florida Medicaid Home Health Services Coverage and Limitations Handbook, _____________.

SUMMARY: The amendment clarifies existing personal care services, private duty nursing, and prior authorization for home health services language.

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, Florida Statutes, 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 FS.

A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:

DATE AND TIME: Monday, March 31, 2014, 10:00 a.m. ‒ 11:00 a.m.

PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room D, 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, [phone]. 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]

Please note that a preliminary draft of the reference material, if available, will be posted prior to the public hearing at http://ahca.myflorida.com/Medicaid/review/index.shtml. Comments will be received until 5:00 p.m. on Monday, April 7, 2014.

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

59G-4.130 Home Health Services.

(1) This rule applies to all providers of home health services who are enrolled in agencies licensed under Chapter 400, Part III, Florida Statutes, and certified by the Agency for Health Care Administration for participation in the Florida Medicaid program for home health care.

(2) All providers of home health services agency providers enrolled in the Florida Medicaid program must be in compliance with provisions of the Florida Medicaid Home Health Services Coverage and Limitations Handbook, __________ March 2013, incorporated by reference. The handbook is available from the Medicaid fiscal agent’s Web site at www.mymedicaid-florida.com. Select Public Information for Providers, then Provider Support, and then on Provider Handbooks. Paper copies of the handbook may be obtained by calling the Provider Services Contact Center at 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.

(3)(4) The following forms are included in the Florida Medicaid Home Health Services Coverage and Limitations Handbook and are incorporated by reference: Appendix B, Medicaid Instructions for CMS Form 485 – Plan of Care, AHCA Form 500-3544, April 2013; Appendix B, Home Health Certification and Plan of Care, Form CMS-485(C-3)(02-94) (Formerly HCFA-485), July 2008; Appendix C, Authorization for Private Duty Nursing Provided by a Parent or Legal Guardian, AHCA Form 5000-3541, February 2013; Appendix D, Physician Visit Documentation Form, AHCA-Med Serv Form 5000-3502, Revised February 2013; Appendix E, Parent or Legal Guardian Medical Limitations, AHCA-Med Serv Form 5000-3501, Revised February 2013; Appendix F, Parent or Legal Guardian Work Schedule, AHCA-Med Serv Form 5000-3503, Revised February 2013; Appendix G, Parent or Legal Guardian Statement of Work Schedule, AHCA-Med Serv Form 5000-3504, Revised February 2013; Appendix H, Parent or Legal Guardian School Schedule, AHCA-Med Serv Form 5000-3505, Revised__________ February 2013; Appendix I, Instructions for the Personal Care Services Plan of Care, AHCA Form 5000-3506, Revised__________ April 2013; Appendix J, Medicaid Physician’s Written Prescription for Home Health Services, AHCA-Med Serv Form 5000-3525, Revised February 2013; Appendix K, Review Criteria for Private Duty Nursing Services, AHCA Form 5000-3543, Revised___________ April 2013; and Appendix L, Review Criteria for Personal Care Services, AHCA Form 5000-3542, Revised__________ April 2013. 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 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, 6-25-13, ___________.

 

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 24, 2014

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: August 30, 2013