The purpose of the amendment to Rule 59G-4.230, F.A.C., is to incorporate by reference the Florida Medicaid Physician Services Coverage and Limitations Handbook, January 2010. The effect of the update will provide for new Medicaid policy that allows ...

AGENCY FOR HEALTH CARE ADMINISTRATION
Medicaid

RULE NO: RULE TITLE
59G-4.230: Physician Services
PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-4.230, F.A.C., is to incorporate by reference the Florida Medicaid Physician Services Coverage and Limitations Handbook, January 2010. The effect of the update will provide for new Medicaid policy that allows coverage for intrathecal baclofen therapy (ITB) used to manage severe spasticity of spinal cord or cerebral origin.
SUMMARY: It will include limitations of coverage, prior authorization requirements for the ITB infusion pump, and conditions of payment for this device.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared.
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.
SPECIFIC AUTHORITY: 409.919 FS.
LAW IMPLEMENTED: 409.902, 409.905, 409.907, 409.908, 409.9081, 409.912, 409.913 FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
DATE AND TIME: Tuesday, June 1, 2010, 11:00 a.m. – 12:00 Noon
PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room B, 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 hours before the workshop/meeting by contacting: Alyssa Anderson 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: Alyssa Anderson, Medicaid Services, 2727 Mahan Drive, Mail Stop 20, Tallahassee, Florida 32308-5407, telephone: [phone], e-mail: [e-mail]

THE FULL TEXT OF THE PROPOSED RULE IS:

59G-4.230 Physician Services.

(1) No change.

(2) All physician services providers enrolled in the Medicaid program must be in compliance with the Florida Medicaid Physician Services Coverage and Limitations Handbook, January 2010 January 2007, errata January 2007, updated January 2007 and May 2007, which is incorporated by reference, and the Florida Medicaid Provider Reimbursement Handbook, CMS-1500, which is incorporated by reference in Rule 59G-4.001, F.A.C. Both handbooks are available from the Medicaid fiscal agent’s website at www.mymedicaid-florida.com http://floridamedicaid.acs-inc. com. Click on Public Information for Providers, Provider Support, and then on Provider Handbooks. Paper copies of the handbooks may be obtained by calling Provider Enrollment at [phone].

(3) through (5) No change.

Rulemaking Specific Authority 409.919 FS. Law Implemented 409.902, 409.905, 409.907, 409.908 ,409.9081, 409.912, 409.913 FS. History–New 1-1-77, Revised 2-1-78, 4-1-78, 1-2-79, 1-1-80, Amended 2-8-82, 3-11-84, Formerly 10C-7.38, Amended 1-10-91, 11-5-92, 1-7-93, Formerly 10C-7.038, Amended 6-29-93, 9-6-93, Formerly 10P-4.230, Amended 6-13-94, 2-9-95, 3-10-96, 5-28-96, 3-18-98, 9-22-98, 8-25-99, 4-23-00, 8-5-01, 2-20-03, 8-5-03, 8-3-04, 8-18-05, 8-31-05, 10-26-06, 2-11-07, 5-7-07, 7-2-07, 11-15-07, ____________.

NAME OF PERSON ORIGINATING PROPOSED RULE: Alyssa Anderson
NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Thomas W. Arnold
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: April 26, 2010
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: January 22, 2010