The purpose of the amendment to Rule 59G-1.060, Florida Administrative Code (F.A.C.), is to revise provider enrollment requirements and update the rule text.

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.:RULE TITLE:

59G-1.060Provider Enrollment Policy

PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-1.060, Florida Administrative Code (F.A.C.), is to revise provider enrollment requirements and update the rule text.

SUMMARY: The amendment removes health care clinic licensure as a provider requirement, aligns the policy to comport with legislative mandates, and adds new forms developed to streamline the enrollment process along with required sunset rule review language to the rule text.

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, (F.S.) 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 F.S.

LAW IMPLEMENTED: 409.907, 409.973 F.S.

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

DATE AND TIME: October 19, 2021, 2:30 – 3:00 p.m.

PLACE: The Agency is offering both a remote and an in-person option to attend the hearing at the Agency for Health Care Administration, 2727 Mahan Drive, Tallahassee, Florida 32308-5407.

Remote Listeners: Attendees may register for the hearing at https://attendee.gotowebinar.com/register/7637672178114920973. After registering, the registrant will receive a confirmation email containing information about joining the webinar, and opportunities to offer comments and questions will be available.

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 7 days before the workshop/meeting by contacting: [e-mail]. 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: [e-mail]. Please note that a preliminary draft of the reference material, if available, will be posted prior to the hearing at http://ahca.myflorida.com/Medicaid/review/index.shtml. Official comments to be entered into the rule record will be received until 5:00 p.m. on October 20, 2021 and may be e-mailed to [e-mail].

 

THE FULL TEXT OF THE PROPOSED RULE IS:

59G-1.060 Provider Enrollment Policy.

(1) This rule applies to all individuals, groups, and entities that are seeking to enroll, renew, or maintain enrollment as an authorized provider for the Florida Medicaid program.

(2) All providers must be in compliance with the provisions of the Florida Medicaid Provider Enrollment Policy, __________December 2019, incorporated by reference. The policy is available on the Agency for Health Care Administration’s website Web site at http://ahca.myflorida.com/Medicaid/review/index.shtml, and at http://www.flrules.org/Gateway/reference.asp?No=_________Ref-11331.

(3) The following forms are incorporated by reference and available on the Florida Medicaid Web portal at http://portal.flmmis.com/flpublic, and as follows:

(a) Case Manager Certification, AHCA Form 5000-3537, May 2014, http://www.flrules.org/Gateway/reference.asp?No=Ref-11332.

(b) Case Manager Supervisor Certification Targeted Case Management for Children at Risk of Abuse and Neglect, AHCA Form 5000-3536, May 2014, http://www.flrules.org/Gateway/reference.asp?No=Ref-11333.  

(c) Comprehensive Behavioral Health Assessment Agency and Practitioner Self-Certification, AHCA Form 5000-3512, May 2014, http://www.flrules.org/Gateway/reference.asp?No=Ref-11334. 

(d) Contractor Certification for Children’s Services Council, AHCA Form 5000-3535, May 2014, http://www.flrules.org/Gateway/reference.asp?No=Ref-11335. 

(e) County Health Department Agreement Provider Credentialing of Behavioral Health Providers and Social Workers, AHCA Form 5000-1066, June 2019, http://www.flrules.org/Gateway/reference.asp?No=Ref-11336.

(f) Electronic Data Interchange Agreement, AHCA Form 5000-1062, June 2019, http://www.flrules.org/Gateway/reference.asp?No=Ref-11350. 

(g) Florida Medicaid Provider Enrollment Application Out-of-State Fee for Service, AHCA Form 5000-1260, (JAN 2021), http://www.flrules.org/Gateway/reference.asp?No=Ref-_________. 

(h) Florida Medicaid Provider Enrollment Change of Ownership (CHOW) Disclosure Form-Hospital, Institutional Care (ICF) and Skilled Nursing Facility ONLY, AHCA Form 5000-1264, (JAN 2021), http://www.flrules.org/Gateway/reference.asp?No=Ref-_________. 

(ig) Medical Foster Care Children’s Medical Services Local Medical Foster Care (MFC) Program Care Coordinator Attestation Checklist, AHCA Form 5000-1069, June 2019, http://www.flrules.org/Gateway/reference.asp?No=Ref-11337.

(j) Non-profit Organization Certification – Fingerprinting Exemption, AHCA Form 5000-1261, (JAN 2021), http://www.flrules.org/Gateway/reference.asp?No=Ref-_________.

(kh) Physician Group Certificate of Ownership, AHCA Form 5000-1068, June 2019, http://www.flrules.org/Gateway/reference.asp?No= Ref-11338.

(li) Practitioner Collaborative Agreement, AHCA Form 5000-1067, June 2019, http://www.flrules.org/Gateway/reference.asp?No=Ref-11339.

(mj) Provider Agency Certification for Children’s Services Council, AHCA Form 5000-3539, May 2014, http://www.flrules.org/Gateway/reference.asp?No=Ref-11340.

(nk) School District Assurance Agreement Provider Credentialing of Behavior Analysts, AHCA Form 5000-1162, June 2019, http://www.flrules.org/Gateway/reference.asp?No=Ref-11341.

(ol) School District Assurance Agreement Provider Credentialing of Behavioral Sciences Staff, AHCA Form 5000-1160, June 2019, http://www.flrules.org/Gateway/reference.asp?No=Ref-11342.

(pm) School District Assurance Agreement Provider Credentialing of Mental Health Counselors and Family Therapists, AHCA Form 5000-1161, June 2019, http://www.flrules.org/Gateway/reference.asp?No=Ref-11343.

(qn) School District Assurance Agreement Provider Credentialing of Psychologists, Behavior Analysts, and Social Workers, AHCA Form 5000-1163, June 2019, http://www.flrules.org/Gateway/reference.asp?No=Ref-11344.

(ro) School District Assurance Agreement Provider Credentialing of Registered Nurses and Licensed Practical Nurses, AHCA Form 5000-1164, June 2019, http://www.flrules.org/Gateway/reference.asp?No=Ref-11345.

(sp) School District Assurance Agreement Provider Credentialing of School Health Aides, AHCA Form 5000-1165, June 2019, http://www.flrules.org/Gateway/reference.asp?No=Ref-11346.

(tq) School District Assurance Agreement Provider Credentialing of Therapists and Therapy Assistants, AHCA Form 5000-1166, June 2019, http://www.flrules.org/Gateway/reference.asp?No=Ref-11347.

(u) Special Exempt Entity Certification – Fingerprinting Exemption, AHCA Form 5000-1262, (JAN 2021), http://www.flrules.org/Gateway/reference.asp?No=Ref-­­­­________.

(vr) State of Florida Agency for Health Care Administration Florida Medicaid Provider Surety Bond, AHCA Form 5000-1064, June 2019, http://www.flrules.org/Gateway/reference.asp?No=Ref-11348.

(xs) Therapeutic Foster Care Provider Agency Self-Certification, AHCA Form 5000-3513, March 2014, http://www.flrules.org/Gateway/reference.asp?No=Ref-11349.

(4) This rule is effective for five years after the effective date.

Rulemaking Authority 409.919, 409.961 FS. Law Implemented 409.907, 409.973 FS. History–New 12-25-19,__________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Susan Hamrick

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Simone Marstiller

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: August 30, 2021

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: January 13, 2021