Definitions. , Client Eligibility. , Patient Selection and Referral. , Volunteer Provider Eligibility. , Contract Requirements. , Covered Services. , Annual Report.
Division of Health Access and Tobacco
RULE NOS.:RULE TITLES:
64I-2.001Definitions.
64I-2.002Client Eligibility.
64I-2.003Patient Selection and Referral.
64I-2.004Volunteer Provider Eligibility.
64I-2.005Contract Requirements.
64I-2.006Covered Services.
64I-2.009Annual Report.
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. 41 No. 14, January 22, 2015 issue of the Florida Administrative Register.
The Volunteer Health Care Provider Program Eligibility form, DH 1032E, 12/14, has been amended to reflect the change in definition of “family,” and to make a technical change to require the DOH volunteer or employee to print their name.
The Patient Referral form, DH 1032, 12/14, has been amended to require the DOH referring person to print, in addition to sign, their name; to change the “Date Service Received” to “Date of Initial Service Received;” and to add a statement and check box underneath the Volunteer Health Care Provider’s signature to clearly indicate that the provider may provide progress notes in lieu of a signature.
The Client/Patient Eligibility and Referral Process Training Guide, DH 1032G, 12/14, has been amended to reflect the change to the definition of family; to add a statement about an applicant’s self-attestation regarding the availability of Medicaid services in their area on page 2, Section 2, Number 2; to correct the abbreviation of temporary cash assistance on page 3, Section 2, Number 2; and to make the corrections to the appendix documents (DH 1032E and 1032) identified above.
The Volunteer Health Care Provider Program contract, DH 1029, 12/14, has been amended to correct the statutory and rule references in Section I.I.; to add a paragraph to address statutory changes to Section 768.28, Florida Statutes, regarding 30-day continuation of care after a patient has been deemed ineligible for the program; to move the opt-out option for the online listing from Section II.D. to the signature page; and to remove the automatic one-year termination language from Section III.D.
In addition to the changes made to the incorporated forms, the Department is also making the following changes to the rule text.
64I-2.001 Definitions.
For the purpose of this chapter, the following definitions will apply:
(1) “Family” means one or more persons living in one dwelling place who are related by blood, marriage, law, or conception, or who are cohabitating partners. A pregnant woman and her unborn child or children are considered to be two or more family members. If the dwelling place includes more than one family or more than one unrelated individual, the poverty guidelines are applied separately to each famly or unrelated individual and not to the dwelling place as a whole. A single adult, 18 and older over 18, living with relatives is considered to be a separate family for income determination purposes. A student, age 18-21, living at the dwelling place, shall be considered a family member.
(2) “Gross family income” means the sum of income available to a family at the time of application. Gross family income shall be based on all income earned or received in the last four (4) weeks. Income shall not include Supplemental Security Income (SSI), income from trusts fully funded by SSI payments, and Temporary Cash Assistance (TCA). Gross family income shall include but not be limited to the following: wages and salary, child support, alimony, unemployment compensation, worker’s compensation, veteran’s pension, social security, pensions and annuities, dividends and interest on savings, stocks, and bonds, income from estates and trusts, net rental income or royalties, net income from self-employment, and cash contributions received from any other source.
(3) “Net family income” means gross family income minus the standard work related, child care, and child support deductions as used in determining presumptive eligibility for Medicaid.
(3) “Poverty guidelines or federal poverty level” as used in this chapter and its incorporated materials means the poverty guidelines, as published in Vol. 80, No. 14 of the Federal Register on January 22, 2015, by the U.S. Department of Health and Human Services under the authority of 42 U.S.C. 9902(2), which are incorporated by reference and available at .
(4) through (5) No change.
Rulemaking Authority 766.1115(11) FS. Law Implemented 766.1115 FS. History–New 1-20-93, Formerly 10D-122.002, Amended 4-11-06, Formerly 64F-11.001, Amended .
64I-2.002 Client Eligibility.
(1) through (4) No change.
(5) The governmental contractor or provider shall use net family income to determine eligibility.
(6) renumbered as (5) No change.
Rulemaking Authority 766.1115(11) FS. Law Implemented 766.1115 FS. History–New 1-20-93, Formerly 10D-122.003, Amended 4-11-06, Formerly 64F-11.002, Amended .
64I-2.003 Patient Selection and Referral.
Rulemaking Authority 766.1115(11) FS. Law Implemented 766.1115 FS. History–New 1-20-93, Formerly 10D-122.004, Amended 4-11-06, Formerly 64F-11.003, Repealed .
64I-2.004 Volunteer Provider Eligibility.
(1) In order to participate in this program, a health care provider shall comply with the following:
(a) through (e) No change.
(f) Accept for treatment only patients that have been qualified quailfied as eligible and who have a completed referral form, which is incorporated in Rule 64I-2.002(5)(6).
(2) No change.
Rulemaking Authority 766.1115(11) FS. Law Implemented 766.1115 FS. History–New 1-20-93, Formerly 10D-122.005, Amended 4-11-06, Formerly 64F-11.004, Amended .
64I-2.005 Contract Requirements.
Rulemaking Authority 766.1115(11) FS. Law Implemented 766.1115 FS. History–New 1-20-93, Formerly 10D-122.006 Amended 4-11-06, Formerly 64F-11.005, Repealed .
64I-2.006 Covered Services.
Rulemaking Authority 766.1115(10) FS. Law Implemented 766.1115 FS. History–New 1-20-93, Formerly 10D-122.007, Amended 4-11-06, Formerly 64F-11.006, Repealed .
64I-2.009 Annual Report.
Each governmental contractor and provider, by August 31 of each year, shall submit to the Department of Health information required to prepare the annual report to the Legislature as specified in Section 766.1115, F.S., including, but not limited to, participating clinics and organizations, the number of providers, the number of patients, the number of patient visits, and the value of services and donations rendered from July 1 to June 30.
Rulemaking Authority 766.1115(11) FS. Law Implemented 766.1115 FS. History–New 1-20-93, Formerly 10D-122.012, Amended 4-11-06, Formerly 64F-11.009, Amended .
