The purpose of the amendment to Rule 59G-5.010, F.A.C., is to incorporate by reference The Florida Medicaid Enrollment Application, April 2010. The amendment will update the fiscal agent information, clarify background screening procedures and ...

AGENCY FOR HEALTH CARE ADMINISTRATION
Medicaid

RULE NO: RULE TITLE
59G-5.010: Provider Enrollment
PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-5.010, F.A.C., is to incorporate by reference The Florida Medicaid Enrollment Application, April 2010. The amendment will update the fiscal agent information, clarify background screening procedures and associated fees, and simplify the overall enrollment process.
SUMMARY: The amendment to Rule 59G-5.010, F.A.C., provides for a revised Medicaid Provider Enrollment application which is aligned with the new Florida Medicaid Management Information System (FMMIS).
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared.
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.
SPECIFIC AUTHORITY: 409.919 FS.
LAW IMPLEMENTED: 409.902, 409.907, 409.9071, 409.908, 409.912, 409.913 FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
DATE AND TIME: Tuesday June 1, 2010, 10:00 a.m. – 11:00 a.m.
PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room C, 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: Ellen Emenheiser at Medicaid Contract Management, [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: Ellen Emenheiser, Medicaid Contract Management, 2562 Executive Center Circle E, Montgomery Building, Suite 100, Tallahassee, Florida 32301, [phone], e-mail: [e-mail]

THE FULL TEXT OF THE PROPOSED RULE IS:

59G-5.010 Provider Enrollment.

(1) Unless otherwise specified in Chapter 59G-4, F.A.C., all providers and billing agents are required to enroll in the Medicaid program and submit a completed Florida Medicaid Provider Enrollment Application, AHCA Form 2200-0003 (April 2010) (December 2004). AHCA Form 2200-0003 is the application to be completed by applicants and is incorporated by reference in Rule 59G-5.010, F.A.C. AHCA Form 2200-0003 is available from the Medicaid fiscal agent’s Web Portal Portal@http://mymedicaid-florida.com. Click on Public Information for Providers, then on Provider Support, and then on Enrollment. and incorporated in this rule by reference. AHCA Form 2200-0003 is the application to be completed by applicants.

(2) through (5) No change.

(6) Enrollment of a Medicaid provider applicant is effective no earlier than the date of the approval of the provider application. “Approved application” means an accurately and fully completed application with all the requirements which includes background screenings and onsite inspections resolved and completed with approval of the agency or its designee.

Rulemaking Specific Authority 409.919 FS. Law Implemented 409.902, 409.907, 409.9071, 409.908, 409.912, 409.913 FS. History– New 9-22-93, Formerly 10P-5.010, Amended 7-8-97, 9-8-98, 7-5-99, 7-10-00, 5-7-03, 7-7-05,________.

NAME OF PERSON ORIGINATING PROPOSED RULE: Ellen Emenheiser
NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Thomas W. Arnold
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: April 26, 2010
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: December 24, 2009