The purpose of the amendment to Rule 59G-4.250 is to incorporate by reference the Florida Medicaid Prescribed Drug Services Coverage, Limitations and Reimbursement Handbook, _____________.

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.:RULE TITLE:

59G-4.250Prescribed Drug Services

PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-4.250, F.A.C., is to incorporate by reference the Florida Medicaid Prescribed Drug Services Coverage, Limitations and Reimbursement Handbook, _____________.

SUMMARY: This amendment adds service limitations language regarding reimbursement for amphetamines, removes language referring to examples under Medicare Part D, and clarifies and updates policy regarding counseling documentation requirements when prescriptions are dispensed to recipients.

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: 409.906(20), 409.908, 409.912 FS.

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

DATE AND TIME: Thursday, April 24, 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: Pierce Withers 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: Pierce Withers, 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 Thursday, May 1, 2014.

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

59G-4.250 Prescribed Drug Services.

(1) This rule applies to all providers of prescribed drug services who are providers enrolled in the Florida Medicaid program.

(2) All providers of participating prescribed drug services providers enrolled in the Medicaid program must be in compliance with the provisions of the Florida Medicaid Prescribed Drug Services Coverage, Limitations, and Reimbursement Handbook, __________, June 2012, is incorporated by reference. The handbook is available from the Medicaid fiscal agent’s Web site at www.mymedicaid-florida.com. Select Click on Public Information for Providers, then on Provider Support, and then on Provider Handbooks. Paper copies of the handbooks may be obtained by calling Provider Inquiry at [phone].

(3) The following forms are incorporated by reference: MPDS2012-1-22, Recipient Lock-in Letter Form, June 2012; MPDS2012-1-23, Request for Reconsideration Form, June 2012; MPDS2012-1-24 Your right to a Request for Fair Hearing Form, June 2012; MPDS2012-1-25, Request to Change Lock-in Pharmacy, June 2012; and MPDS2012-1-26, Recipient Pharmacy Prescribed Drugs Lock-in Referral Form, June 2012. These forms may be accessed at www.ahca.myflorida.com/Medicaid/Prescribed_Drug/lockin.shtml.

Rulemaking Authority 409.919 FS. Law Implemented 409.906(20), 409.908, 409.912 FS. History–New 1-1-77, Amended 6-30-77, 10-1-77, 2-1-78, 4-1-78, 9-28-78, 6-1-79, 2-28-80, 11-11-81, 7-3-84, Formerly 10C-7.42, Amended 3-11-86, 12-5-88, 6-4-90, 10-29-90, 5-20-92, 4-11-93, Formerly 10C-7.042, Amended 12-28-95, 8-3-97, 2-11-98, 9-13-99, 7-20-00, 1-29-01, 4-24-01, 10-6-02, 12-7-06, 11-3-08, 6-19-12,___________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Pierce Withers

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Elizabeth Dudek

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: March 17, 2014

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: December 4, 2013