Payment Methodology for Services in Facilities Not Publicly Owned and Not Publicly Operated

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.:RULE TITLE:

59G-6.045Payment Methodology for Services in Facilities Not Publicly Owned and Not Publicly Operated

NOTICE OF CHANGE

Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 47 No. 129, July 6, 2021 issue of the Florida Administrative Register.

59G-6.045 Payment Methodology for Services in Facilities Not Publicly Owned and Not Publicly Operated. (Facilities Formerly Known as ICF-MR/DD Facilities).

(1) No change.

(2) Definitions.

(a) through (h) No change.

(i) Patient Responsibility – Florida Medicaid deducts The amount a recipient is required to pay the ICF/IID, as determined by the Department of Children and Families (DCF), based upon the portion of a recipient’s monthly income, as determined by the Department of Children and Families (DCF), that the recipient is required to pay.

(j) Property cost per diem – A calculation based upon those  Those costs related to the ownership or leasing of an ICF/IID. Such costs may include property taxes, insurance, interest and depreciation, or rent divided by the total resident days.

(k) No change.

(l) Rate setting due date – February 1 of each year shall be the rate setting due date. All cost reports received by AHCA on or before February 1 shall be used to establish the reimbursement rates for the upcoming rate period. If February 1 falls on the weekend, the due date shall be the first business day following February 1.

(m) Reimbursement Class – Designated provider reimbursement level for the provision of services to  recipients residing in an ICF/IID, as follows: Reimbursement rates shall be calculated separately for the following two levels of reimbursement:

1. Developmental Residential and Developmental Institutional - A reimbursement level for recipients who are ambulatory or self-mobile using mechanical devices and who can are able to transfer themselves without human assistance but may require assistance and oversight to ensure safe evacuation.

2. No change.

(n) No change

(o) Return on Equity (ROE) or use allowance cost per diem – Net Income or Profits or Shareholder’s Equity divided by the total resident days.

(p) No change.

(3) through (9) No change.

Rulemaking Authority 409.919 , 409.9083 FS. Law Implemented 409.908, 409.9083 FS. History–New 3-14-99, Amended 10-12-04, 2-22-06, 4-12-09, 3-3-10, 2-23-11, 7-16-12, 2-13-14, 2-4-15, 6-15-15, 7-11-16, 6-27-17, 3-11-18,________.