The purpose of Rule 59G-1.060, Florida Administrative Code, is to incorporate by reference the Florida Medicaid Provider Enrollment Policy, __________.

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.:RULE TITLE:

59G-1.060Enrollment Policy

PURPOSE AND EFFECT: The purpose of Rule 59G-1.060, Florida Administrative Code, is to incorporate by reference the Florida Medicaid Provider Enrollment Policy, __________.

SUMMARY: The incorporated policy will specify enrollment requirements for individuals, groups, and entities seeking and maintaining enrollment as providers in the Florida Medicaid program.

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: 409.907, 409.973 FS.

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

DATE AND TIME: May 28, 2019, 2:00 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: [e-mail]. 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: [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 from the date of this notice until 5:00 p.m., May 29, 2019. Comments may be e-mailed to [e-mail].

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

59G-1.060 Provider Enrollment Policy.

(1) This rule applies to all individuals, groups, and entities that are seeking to enroll, renew, or maintain enrollment as an authorized provider for the Florida Medicaid program.

(2) All providers must be in compliance with the provisions of the Florida Medicaid Provider Enrollment Policy, __________, incorporated by reference. The policy is available on the Agency for Health Care Administration’s Web site at http://ahca.myflorida.com/Medicaid/review/index.shtml, and at [DOS place holder Ref-_______].

(3) The following forms are incorporated by reference and available on the Florida Medicaid Web portal at http://portal.flmmis.com/flpublic, and as follows:

(a) Case Manager Certification, AHCA Form 5000-3537, May 2014, http://www.flrules.org/Gateway/reference.asp?No=Ref-______.

(b) Case Manager Supervisor Certification Targeted Case Management for Children at Risk of Abuse and Neglect, AHCA Form 5000-3536,  May 2014 , http://www.flrules.org/Gateway/reference.asp?No=Ref-_______. 

(c) Certification of Funds, AHCA Form 5000-3532, May 2014, http://www.flrules.org/Gateway/reference.asp?No=Ref-_______.

(d) Comprehensive Behavioral Health Assessment Agency and Practitioner Self-Certification, AHCA Form 5000-3512, May 2014, http://www.flrules.org/Gateway/reference.asp?No=Ref-_______.

(e) Contractor Certification for Children’s Services Council, AHCA Form 5000-3535, May 2014, http://www.flrules.org/Gateway/reference.asp?No=Ref-_______.

(f ) County Health Department Agreement Provider Credentialing of Behavioral Health Providers and Social Workers, AHCA Form 5000-1066, _______, http://www.flrules.org/Gateway/reference.asp?No=Ref-_____.

(g) Electronic Data Interchange Agreement, AHCA Form 5000-1062, ______, http://www.flrules.org/Gateway/reference.asp?No=Ref-_____.

(h) Florida Medicaid Electronic Funds Transfer (EFT) Authorization Agreement, AHCA Form 5000-1063, _______, http://www.flrules.org/Gateway/reference.asp?No=Ref-_____.

(i) Florida Medicaid National Provider Identifier (NPI) Registration, AHCA Form 5000-1060,_______, http://www.flrules.org/Gateway/reference.asp?No=Ref-_____.

(j) Group Membership Authorization Form, AHCA Form 5000-1061, _______,

http://www.flrules.org/Gateway/reference.asp?No=Ref-_____. 

(k)  Medical Foster Care Children’s Medical Services Local Medical Foster Care (MFC) Program Care Coordinator Attestation Checklist, AHCA Form 5000-1069, _______, http://www.flrules.org/Gateway/reference.asp?No=Ref-_______.

(l) Physician Group Certificate of Ownership, AHCA Form 5000-1068, ______, http://www.flrules.org/Gateway/reference.asp?No=Ref-_____.

(m) Practitioner Collaborative Agreement, AHCA Form 5000-1067, _______, http://www.flrules.org/Gateway/reference.asp?No=Ref-_____.

(n) Provider Agency Certification for Children’s Services Council, AHCA Form 5000-3539, May 2014, http://www.flrules.org/Gateway/reference.asp?No=Ref-_____.

(o) School District Assurance Agreement Provider Credentialing of Behavior Analysts, AHCA Form 5000-1162, ______, http://www.flrules.org/Gateway/reference.asp?No=Ref-_____.

(p) School District Assurance Agreement Provider Credentialing of Behavioral Sciences Staff, AHCA Form 5000-1160, _______, http://www.flrules.org/Gateway/reference.asp?No=Ref-_____.

(q) School District Assurance Agreement Provider Credentialing of Mental Health Counselors and Family Therapists, AHCA Form 5000-1161, _______, http://www.flrules.org/Gateway/reference.asp?No=Ref-________.

(r) School District Assurance Agreement Provider Credentialing of Psychologists, Behavior Analysts, and Social Workers, AHCA Form 5000-1163, _______, http://www.flrules.org/Gateway/reference.asp?No=Ref-________.

(s) School District Assurance Agreement Provider Credentialing of Registered Nurses and Licensed Practical Nurses,  AHCA Form 5000-1164, ________, http://www.flrules.org/Gateway/reference.asp?No=Ref-_____.

(t) School District Assurance Agreement Provider Credentialing of School Health Aides,  AHCA Form 5000-1165, ________, http://www.flrules.org/Gateway/reference.asp?No=Ref-_____.

(u) School District Assurance Agreement Provider Credentialing of Therapists and Therapy Assistants, AHCA Form 5000-1162, ________, http://www.flrules.org/Gateway/reference.asp?No=Ref-_____.

(v) State of Florida Agency for Health Care Administration Florida Medicaid Provider Surety Bond, AHCA Form 5000-1064, _________, http://www.flrules.org/Gateway/reference.asp?No=Ref-_____.

(w) Therapeutic Foster Care Provider Agency Self-Certification, AHCA Form 5000-3513, March 2014, http://www.flrules.org/Gateway/reference.asp?No=Ref-_______.

Rulemaking Authority 409.919, 409.961 FS. Law Implemented 409.907,409.973 FS. History-New ________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Mary McCullough

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Mary C. Mayhew

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: April 15, 2019

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: February 2, 2016