The purpose of the amendment to Rule 59G-4.295, Florida Administrative Code (F.A.C.) is to incorporate by reference the Florida Medicaid Therapeutic Group Care Services Coverage Policy, _________.

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.: RULE TITLE:

59G-4.295   Specialized Therapeutic Services

PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-4.295, Florida Administrative Code (F.A.C.) is to incorporate by reference the Florida Medicaid Therapeutic Group Care Services Coverage Policy, _________.

SUMMARY: The incorporated coverage policy will specify recipient eligibility, provider requirements, service coverage, and reimbursement information. The amendment also revises the rule title to Therapeutic Group Care Services.

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, 409.961 FS.

LAW IMPLEMENTED: 409.902, 409.906, 409.907, 409.908, 409.912, 409.913, 409.973 FS.

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

DATE AND TIME: June 14, 2017, 2:30 p.m. to 3:00 p.m.

PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, 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: LaKera Reddick. 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: Lakera Reddick, Bureau of Medicaid Policy, 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. Official comments to be entered into the rule record will be received until 5:00 p.m. on June 15, 2017 and may be e-mailed to [e-mail]. For general inquiries and questions about the rule, please contact the person specified above.

 

THE FULL TEXT OF THE PROPOSED RULE IS:

59G-4.295 Specialized Therapeutic Group Care Services.

(1) This rule applies to all providers rendering Florida Medicaid of specialized therapeutic group care services to recipients who are enrolled in the Florida Medicaid program.

(2) All providers of specialized therapeutic services must be in compliance with the provisions of the Florida Medicaid Specialized Therapeutic Group Care Services Coverage Policy and Limitations Handbook, March 2014, available at http://www.flrules.org/Gateway/reference.asp?No=Ref-03750,______, incorporated by reference. The policy handbook is available on the Agency for Health Care Administration’s Medicaid fiscal agent’s Web site at http://ahca.myflorida.com/Medicaid/review/index.shtml, and at [DOS place holder Ref-_______] www.mymedicaid-florida.com. Select Public Information for Providers, then Provider Support, and then 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) The following forms are included in the Florida Medicaid Specialized Therapeutic Services Coverage and Limitations Handbook and are incorporated by reference: Authorization for Comprehensive Behavioral Health Assessment, AHCA Form 5000-3511, Revised March 2014; Comprehensive Behavioral Health Assessment Agency and Practitioner Self-Certification, AHCA Form 5000-3512, Revised March 2014; Specialized Therapeutic Foster Care Provider Agency Self-Certification, AHCA Form 5000-3513, Revised March 2014; Authorization for Specialized Therapeutic Foster Care, AHCA Form 5000-3514, Revised March 2014; Authorization for Crisis Intervention, AHCA Form 5000-3515, Revised March 2014; Provider Agency Acknowledgement for Therapeutic Group Care Services, AHCA Form 5000-3519, Revised March 2014; and Authorization for Therapeutic Group Care Services, AHCA Form 5000-3521, Revised March 2014. These forms are available by photocopying them from the Florida Medicaid Specialized Therapeutic Services Coverage and Limitations Handbook.

Rulemaking Authority 409.919,  409.961 FS. Law Implemented 409.902, 409.906, 409.907, 409.908, 409.912, 409.913, 409.973 FS. History–New 3-13-14, Amended______.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: LaKera Reddick

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Justin Senior

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: April 26, 2017

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: April 20, 2017