The purpose of the amendment to Rule 59G-1.010, Florida Administrative Code (F.A.C.), is to establish the definition for medical necessity/medically necessary and to incorporate by reference the Florida Medicaid Definitions Policy, __________.

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.:RULE TITLE:

59G-1.010Definitions

PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-1.010, Florida Administrative Code (F.A.C.), is to establish the definition for medical necessity/medically necessary and to incorporate by reference the Florida Medicaid Definitions Policy, __________.

SUMMARY: The incorporated policy defines medical necessity/medically necessary and other terms commonly used in Florida Medicaid policies and Rule Division 59G, F.A.C.

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.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: A checklist was prepared by the Agency to determine the need for a SERC. Based on this information at the time of the analysis and pursuant to section 120.541, Florida Statutes, the rule will not require legislative ratification.

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, 409.961 FS.

LAW IMPLEMENTED: 409.901-.9201, 409.973 FS.

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

DATE AND TIME: June 7, 2017, 10:00 a.m. to 11:00 a.m.

PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, 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: Mary McCullough. 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: Mary McCullough, Bureau of Medicaid Policy, 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. Official comments to be entered into the rule record will be received from the date of this notice until 5:00 p.m., June 8, 2017. Comments may be e-mailed to [e-mail]. For general inquiries and questions about the rule, please contact the person specified above.

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

Substantial rewording of Rule 59G-1.010, Florida Administrative Code (F.A.C.), follows. See the F.A.C. for present text.

59G-1.010 Definitions.

(1) This rule applies to all providers rendering Florida Medicaid services to recipients.

(2) All providers must be in compliance with the provisions of the Florida Medicaid Definitions Policy, __________, incorporated by reference. The policy is available on the Agency for Health Care Administration’s Web site at http://ahca.myflorida.com/Medicaid/review/index.shtml, and at [DOS place holder Ref-_______].

Rulemaking Authority 409.919,409.961 FS. Law Implemented 409.901-.9201, 409.973 FS. History–New 4-29-93, Formerly 10P-1.010, Amended 6-24-98, 4-16-06,__________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Mary McCullough

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Justin M. Senior

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: May 2, 2017

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: November 5, 2015