The purpose of this rulemaking is to update language to reflect a redetermination of clinical eligibility to a three-year cycle, from an annual cycle.

 

DEPARTMENT OF HEALTH

Division of Children’s Medical Services

RULE NO.:RULE TITLE:

64C-2.003Redetermination of CMS Managed Care Plan Clinical Eligibility

PURPOSE AND EFFECT: The purpose of this rulemaking is to update language to reflect a redetermination of clinical eligibility to a three-year cycle, from an annual cycle.

SUMMARY: CMS Managed Care Plan Clinical Eligibility will be determined every three years rather than annually.

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: Based on the SERC checklist, this rulemaking will not have an adverse impact on regulatory costs in excess of $1 million within five years as established in s.120.541(2)(a), F.S.

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: 391.026(18) FS.

LAW IMPLEMENTED: 391.026(3), 391.029 FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAR.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Joni Hollis, 4052 Bald Cypress Way, Bin A-06, Tallahassee, FL 32399, [phone], [e-mail].

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

64C-2.003 Redetermination of CMS Managed Care Plan Clinical Eligibility.

All CMS Managed Care Plan participants shall have their clinical eligibility for the CMS Managed Care Plan redetermined every three years on an annual basis.

Rulemaking Authority 391.026(18) FS. Law Implemented 391.021, 391.026(3), 391.029 FS. History–New 1-1-77, Amended 11-18-82, Formerly 10J-2.09, Amended 3-28-96, Formerly 10J-2.009, Amended 1-20-03, 1-11-16, ________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Cheryl Young, Director, Office of the CMS Managed Care Plan and Specialty Programs

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Scott A. Rivkees, MD, Surgeon General and Secretary

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: August 15, 2019

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: September 18, 2018