Certified Public Expenditures for Emergency Services

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.:RULE TITLE:

59G-6.035Certified Public Expenditures for Emergency Services

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. 43 No. 15, January 24, 2017 issue of the Florida Administrative Register.

59G-6.035Certified Public Expenditures Program for Emergency Transportation Services.

(1) No change.

(2) Now reads: Providers must submit AHCA Form 5000-0035,_____ Emergency Medical Transportation Integrated Disclosure and Medicaid Cost Report General Information and Certification, incorporated by reference, and available at http://ahca.myflorida.com/Medicaid/Finance/finance/LIP-DSH/PEMT/index.shtml, and at [DOS Placeholder] to the Agency for Health Care Administration (AHCA) annually, to be eligible to use certified public expenditure funds as state match in order to receive federal financial participation in accordance with the state’s Supplemental Payment for Publicly Owned or Operated Emergency Medical Transportation Providers, SPA 2015-014, incorporated by reference, available at http://ahca.myflorida.com/Medicaid/Finance/finance/LIP-DSH/PEMT/index.shtml and at [DOS Placeholder]. The form must be completed in accordance with AHCA Form 5000-0035A,_____ Emergency Medical Transportation Services Cost Report Instructions, incorporated by reference, and available at http://ahca.myflorida.com/Medicaid/Finance/finance/PEMT/index.shtml, and at [DOS Placeholder].

(3) Now reads: Funds are appropriated from the Medical Care Trust Fund for the Certified Public Expenditures Program for Emergency Transportation Services and are supplemental to the reimbursement rates on the Florida Medicaid Emergency Ambulance Transportation Services Fee Schedule, incorporated by reference in Rule 59G-4.002, Florida Administrative Code.

(4) Now reads: The Provider Reimbursement Manual CMS PUB. 15-1, April 5, 2012, is incorporated by reference, and available at https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Paper-Based-Manuals-Items/CMS021929.html, and at http://www.flrules.org/Gateway/reference.asp?No=Ref-07043.

(5) Now reads: The OMB Circular A-87, May 10, 2004, is incorporated by reference, and available at https://obamawhitehouse.archives.gov/omb/circulars_a087_2004 https://www.whitehouse.gov/omb/circulars_a087_2004, and at [DOS Placeholder___].

 

AHCA Form 5000-0035A,_____ Emergency Medical Transportation Services Cost Report Instructions

Page 2, Section 3. REPORTING REQUIREMENTS, now reads:

First paragraph: No change.

All costs must be reported in accordance with all of the following:

3. Centers for Medicare and Medicaid Services Provider Reimbursement Manual (CMS Pub. 15-1), April 5, 2012,  incorporated by reference in Rule 59G-6.035, Florida Administrative Code (F.A.C.), and available at https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Paper-Based-Manuals-Items/CMS021929.html

4. Reported costs that do not comply with these provisions are subject to review by AHCA and will be adjusted accordingly.

5. Allowable costs specified in OMB Circular A-87, May 10, 2004, incorporated by reference in Rule 59G-6.035, F.A.C., and available at https://obamawhitehouse.archives.gov/omb/circulars_a087_2004 .

 

AHCA Form 5000-0035,_________ Emergency Medical Transportation Integrated Disclosure and Medicaid Cost Report General Information and Certification, now reads:

AHCA Form 5000-0035,_________ Emergency Medical Transportation Integrated Disclosure and Medicaid Cost Report General Information.

First tab, Certification now reads:

Title: General Information

Paragraph below line 27, now reads:

For the purpose of this document, “provider” is a Publicly Owned or Operated Emergency Medical Transportation Services provider.

To be Executed by Officer or Administrator of the Fire Department / Agency

First sentence now reads:

I, ___________________ attest:

Fifth sentence, now reads:

The provider acknowledges and understands that the Agency for Health Care Administration must deny payments for any claim submitted if it is determined that the report is not adequately supported for purposes of Federal Financial Participation.

Sixth sentence, now reads:

That I am the responsible person of the subject Fire Department / Agency and am duly authorized to sign this document and that, to the best of my knowledge and information, each statement and amount in the accompanying schedules are to be true, and correct.

Contact for questions: [e-mail]