The purpose of the amendment to Rule 59G-5.020 is to incorporate by reference the Florida Medicaid Provider General Handbook, __________________. The amendment clarifies existing language and updates policy.

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.:RULE TITLE:

59G-5.020Provider Requirements

PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-5.020, F.A.C., is to incorporate by reference the Florida Medicaid Provider General Handbook, _______________. The amendment clarifies existing language and updates policy.

SUBJECT AREA TO BE ADDRESSED: Provider Requirements.

RULEMAKING AUTHORITY: 409.919 FS.

LAW IMPLEMENTED: 409.902, 409.905, 409.906, 409.907, 409.908, 409.912, 409.913 FS.

A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:

DATE AND TIME: Tuesday, August 20, 2013, 1:00 p.m. − 5:00 p.m.

PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room A, 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: Margaret Reilly 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 DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT IS: Margaret Reilly, 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 workshop at http://ahca.myflorida.com/Medicaid/review/index.shtml

 

THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:

 

59G-5.020 Provider Requirements.

(1) This rule applies to all All Medicaid providers who are enrolled in the Florida Medicaid program and billing agents who submit claims to Medicaid on behalf of an enrolled Florida Medicaid provider.

(2) All providers must be in compliance comply with the provisions of the Florida Medicaid Provider General Handbook, ____________, July 2012, which is incorporated by reference. The handbook is and available from the Medicaid fiscal agent’s Web site at www.mymedcaid-florida.com. Select Public Information for Providers, then Provider Support, and then Provider Handbooks. Paper copies A paper copy of the handbook may be obtained by calling the Provider Services Contact Center at 1(800)289-7799 [phone] and selecting Option 7.

(3)(2) The following forms that are included in the Florida Medicaid Provider General Handbook and are incorporated by reference. In Chapter 3, Temporary Emergency Medicaid Identification Card, July 2008; CF-ES 2681, Notice and Proof of Presumptive Eligibility for Medicaid for Pregnant Women, CF-ES 2681, Feb 2003; CF-ES Form 2014, Authorization for Medicaid/Medikids Eligibility, CF-ES 2014, Feb 2003; AHCA Form 5240-006, Unborn Activation Form, AHCA Form 5240-006, January 2007; CF-ES 2039, Medical Assistance Referral, CF-ES 2039, Sep 2002;. In Chapter 4, AHCA-Med Serv 038, Crossover with TPL Claim and/or Adjustment Form, AHCA-Med Serv 038, July 2008; AHCA Form 5000-3527, Medicare Part C - Medicaid CMS-1500 Crossover Invoice, AHCA Form 5000-3527, June 2012; and AHCA Form 5000-3528, Medicare Part C - Medicaid UB-04 Crossover Invoice, AHCA Form 5000-3528, June 2012. Appendix D, AHCA Med Serv Form 2000-0016, Medicaid Out-of-State Prior-Authorization Request Form, January 2012. The CF-ES forms are available from the Department of Children and Family Services. The other forms are available from the Medicaid fiscal agent’s Web site at www.mymedcaid-florida.com. Select Public Information for Providers, then Provider Support, and then Forms. Paper copies of the forms may be obtained by calling the Provider Services Contact Center at 1(800)289-7799 [phone] and selecting Option 7.

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.905, 409.906, 409.907, 409.908, 409.912, 409.913 FS. History–New 9-22-93, Formerly 10P-5.020, Amended 7-8-97, 1-9-00, 4-24-01, 8-6-01, 10-8-03, 1-19-05, 5-24-07, 2-25-09, 6-13-13,___________.