AGENCY FOR HEALTH CARE ADMINISTRATION
RULE NO.:RULE TITLE:
59G-4.150Inpatient Hospital 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. 42 No. 77, April 20, 2016 issue of the Florida Administrative Register.
59G-4.150Inpatient Hospital Services
(1) No change.
(2) No change.
(3) The United States Department of Health and Human Services’ Consent for Sterilization Form - HHS-687 (10/12), is incorporated by reference and available at http://www.hhs.gov/opa/pdfs/consent-for-sterilization-english-updated.pdf.
The following changes have been made to the Inpatient Hospital Services Coverage Policy:
Section 6.2, Specific Criteria, bullets now read:
•State of Florida Abortion Certification Form - AHCA-Med Serv Form 011,_____
•State of Florida Exception to Hysterectomy Acknowledgement Requirement – ETA-5001,____
•State of Florida Hysterectomy Acknowledgement Form – HAF-5000,_____
