The purpose of the amendment to Rule 59G-6.020 is to incorporate by reference the Title XIX Inpatient Hospital Reimbursement Plan (the Plan), Version XL, effective July 1, 2013. The rule will update the Plan to reflect changes authorized in Senate ...

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.:RULE TITLE:

59G-6.020Payment Methodology for Inpatient Hospital Services

PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-6.020 is to incorporate by reference the Title XIX Inpatient Hospital Reimbursement Plan (the Plan), Version XL, effective July 1, 2013. The rule will update the Plan to reflect changes authorized in Senate Bill 1500, 2013-14 General Appropriations Act, Specific Appropriation 208, and Senate Bill 1502, Section 6, 2013-14 Implementing Bill. The changes include the criteria for certain hospitals to adjust their prior Medicaid inpatient trend adjustment, adjustments for inpatient reimbursement limitations, the methodology for a Diagnosis Related Group (DRG) based reimbursement system, the elimination of the methodology for cost based hospital reimbursement, special Medicaid payments to Winter Haven Hospital, and a reconciliation of transitional DRG payments. Finally, the implementation of the Statewide Medicaid Residency Program as established in Senate Bill 1520, which creates s.409.909, Florida Statutes.

SUBJECT AREA TO BE ADDRESSED: Adjustments for prior Medicaid inpatient trend adjustments and inpatient reimbursement limitations, the implementation of an inpatient hospital DRG reimbursement methodology, special Medicaid payments, a reconciliation of transitional DRG payments, and the implementations of a Statewide Medicaid Residency Program.

RULEMAKING AUTHORITY: 409.919 FS.

LAW IMPLEMENTED: 409.908, 409.909, 409.911, 409.9113, 409.9115, 409.9116, 409.911, 409.9118, 409.9119 FS.

IF REQUESTED IN WRITING AND NOT DEEMED UNNECESSARY BY THE AGENCY HEAD, A RULE DEVELOPMENT WORKSHOP WILL BE NOTICED IN THE NEXT AVAILABLE FLORIDA ADMINISTRATIVE REGISTER.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Edwin Stephens, Medicaid Program Finance, Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Tallahassee, Florida 32308, [phone] or by e-mail at [e-mail]

 

THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS NOT AVAILABLE.