The purpose of the amendment to Rule 59G-13.131 is to incorporate by reference the Florida Medicaid Traumatic Brain Injury and Spinal Cord Injury Waiver Services Fee Schedule, ___________________. The amendment updates services and procedure codes.

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.:RULE TITLE:

59G-13.131Traumatic Brain Injury and Spinal Cord Injury Waiver Services Fee Schedule

PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-13.131, F.A.C., is to incorporate by reference the Florida Medicaid Traumatic Brain Injury and Spinal Cord Injury Waiver Services Fee Schedule, _______________. The amendment updates services and procedure codes.

SUMMARY: The revised fee schedule will reflect the services currently being provided and the procedure code, modifier, reimbursement per unit, and limits for each service. The procedure code for adaptive health and wellness is being deleted. The following procedure codes are being added: emergency alert response system installation, emergency alert response system monitoring and maintenance, occupational therapy, physical therapy, and residential habilitation.

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.

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 FS.

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

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

DATE AND TIME: August 12, 2013, 10:00 a.m. − 11:00 a.m.

PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room D, 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: Caryl Jefferson 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: Caryl Jefferson, Medicaid Services, 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.

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

59G-13.131 Traumatic Brain Injury and Spinal Cord Injury Waiver Services Fee Schedule.

(1) This rule applies to all providers of All traumatic brain injury and spinal cord injury waiver services who are enrolled in the Florida Medicaid program providers.

(2) All providers of traumatic brain injury and spinal cord injury waiver services and their billing agents, who submit claims on the provider’s their behalf, must be in compliance with the provisions of the Florida Medicaid Traumatic Brain Injury and Spinal Cord Injury Waiver Services Fee Schedule, _________________ July 2009, which is incorporated by reference. The fee schedule is available from the Medicaid fiscal agent’s Web site at www.mymedicaid-florida.com. Select Public Information for Providers, then Provider Support, and then Fee Schedules. Paper copies of the fee schedule may be obtained by calling the Provider Services Contact Center at 1-800-[phone] and selecting Ooption 7.

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.906, 409.907, 409.908, 409.912, 409.913 FS. History–New 8-5-09, Amended 9-21-11,________

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Caryl Jefferson

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Elizabeth Dudek

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: July 10, 2013

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: January 4, 2013