Rules Review by JAPC
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59. Agency for Health Care Administration |
| 59g. AHCA, MEDICAID |
| 59G-1.002. General Medicaid Provisions |
| 59G-1.010. Definitions |
| 59G-1.020. Definition Of County Of Residence |
| 59G-1.025. Medicaid County Billing |
| 59G-1.030. Administrative Proceedings |
| 59G-1.035. Determining Generally Accepted Professional Medical Standards |
| 59G-1.036. Clinical Trials |
| 59G-1.040. Pre-Admission Screening And Resident Review |
| 59G-1.045. Medicaid Forms |
| 59G-1.050. General Medicaid Policy |
| 59G-1.052. Third-Party Liability Requirements |
| 59G-1.053. Authorization Requirements |
| 59G-1.054. Recordkeeping And Documentation Requirements |
| 59G-1.056. Copayments And Coinsurance |
| 59G-1.057. Telemedicine |
| 59G-1.058. Eligibility |
| 59G-1.100. Medicaid Fair Hearings |
| 59G-3.010. Medicaid Services Complementing Medicare |
| 59G-4.001. Medicaid Providers Who Bill On The Cms-1500 |
| 59G-4.002. Provider Reimbursement Schedules And Billing Codes |
| 59G-4.003. Medicaid Providers Who Bill On The Ub-04 |
| 59G-4.010. Advanced Registered Nurse Practitioner Services |
| 59G-4.013. Allergy Services |
| 59G-4.015. Emergency Transportation Services |
| 59G-4.020. Ambulatory Surgical Center Services |
| 59G-4.022. Anesthesia Services |
| 59G-4.025. Assistive Care Services |
| 59G-4.026. Gastrointestinal Services |
| 59G-4.027. Behavioral Health Overlay Services |
| 59G-4.028. Behavioral Health Assessment Services |
| 59G-4.029. Behavioral Health Medication Management Services |
| 59G-4.030. Reproductive Services |
| 59G-4.031. Behavioral Health Community Support Services |
| 59G-4.032. Integumentary Services |
| 59G-4.033. Cardiovascular Services |
| 59G-4.035. Medicaid Certified School Match Program |
| 59G-4.040. Chiropractic Services |
| 59G-4.050. Community Behavioral Health Services |
| 59G-4.052. Behavioral Health Therapy Services |
| 59G-4.055. County Health Department Clinic |
| 59G-4.058. Medicaid County Health Department School Based Services |
| 59G-4.060. Dental Services |
| 59G-4.070. Durable Medical Equipment And Medical Supplies |
| 59G-4.071. Durable Medical Equipment And Medical Supply Services Provider Fee Schedules |
| 59G-4.080. Child Health Check-Up |
| 59G-4.085. Early Intervention Services |
| 59G-4.087. Evaluation And Management Services |
| 59G-4.090. Family Planning Services |
| 59G-4.100. Federally Qualified Health Center |
| 59G-4.105. Dialysis Services |
| 59G-4.106. Freestanding Dialysis Center Provider Fee Schedule |
| 59G-4.108. Genitourinary Services |
| 59G-4.110. Hearing Services |
| 59G-4.120. Statewide Inpatient Psychiatric Program |
| 59G-4.125. Behavior Analysis Services |
| 59G-4.130. Home Health Services |
| 59G-4.132. Home Health Electronic Visit Verification Program |
| 59G-4.140. Hospice Services |
| 59G-4.150. Inpatient Hospital Services |
| 59G-4.160. Outpatient Hospital Services |
| 59G-4.165. Inpatient Mental Health And Tuberculosis Hospital Services |
| 59G-4.170. Intermediate Care Facility Services |
| 59G-4.171. Intermediate Care Facilities For The Mentally Retarded/Developmentally Disabled; Recipient Eligibility Criteria |
| 59G-4.180. Intermediate Care Services |
| 59G-4.190. Laboratory Services |
| 59G-4.192. Statewide Medicaid Managed Care Long-Term Care Program |
| 59G-4.193. Statewide Medicaid Managed Care Long-Term Care Waiver Program Prioritization And Enrollment |
| 59G-4.195. Licensed Midwife Services |
| 59G-4.197. Medical Foster Care Services |
| 59G-4.199. Mental Health Targeted Case Management |
| 59G-4.200. Nursing Facility Services |
| 59G-4.201. Neurology Services |
| 59G-4.205. Practitioner Services |
| 59G-4.207. Oral And Maxillofacial Services |
| 59G-4.210. Visual Care Services |
| 59G-4.211. Orthopedic Services |
| 59G-4.215. Personal Care Services |
| 59G-4.220. Podiatry Services |
| 59G-4.222. Pain Management Services |
| 59G-4.230. Physician Services |
| 59G-4.231. Physician Assistant Services |
| 59G-4.235. Respiratory System Services |
| 59G-4.240. Radiology And Nuclear Medicine Services |
| 59G-4.250. Prescribed Drug Services |
| 59G-4.251. Prescribed Drugs Reimbursement Methodology |
| 59G-4.255. Prescription Drug Coverage Denials |
| 59G-4.260. Prescribed Pediatric Extended Care Services |
| 59G-4.261. Private Duty Nursing Services |
| 59G-4.264. Regional Perinatal Intensive Care Center Services |
| 59G-4.266. Qualified Evaluator Network |
| 59G-4.270. Registered Nurse First Assistant Services |
| 59G-4.280. Rural Health Clinic |
| 59G-4.290. Skilled Nursing Services |
| 59G-4.295. Therapeutic Group Care Services |
| 59G-4.300. State Mental Health Hospital Services |
| 59G-4.310. Targeted Case Management For Children At Risk Of Abuse And Neglect |
| 59G-4.318. Occupational Therapy Services |
| 59G-4.320. Physical Therapy Services |
| 59G-4.322. Respiratory Therapy Services |
| 59G-4.324. Speech-Language Pathology Services |
| 59G-4.330. Non-Emergency Transportation Services |
| 59G-4.340. Visual Aid Services |
| 59G-4.360. Transplant Services |
| 59G-5.005. Purpose |
| 59G-5.010. Provider Enrollment |
| 59G-5.020. Provider Requirements |
| 59G-5.030. Provider Participation Requirements |
| 59G-5.050. Enrollment Of Out-Of-State Providers |
| 59G-5.060. Assignment Of Provider Numbers |
| 59G-5.070. Tax Identification Numbers |
| 59G-5.080. Confidentiality And Release Of Recipient Records |
| 59G-5.090. Time Limits For Submission Of Claims |
| 59G-5.100. Exceptions To Time Limits |
| 59G-5.110. Direct Reimbursement To Recipients |
| 59G-6.005. Reimbursement Methodology For Services Provided By Medical School Faculty |
| 59G-6.010. Payment Methodology For Nursing Home Services |
| 59G-6.020. Payment Methodology For Inpatient Hospital Services |
| 59G-6.030. Payment Methodology For Outpatient Hospital Services |
| 59G-6.031. Enhanced Ambulatory Patient Grouping Reimbursement Methodology For Hospital Outpatient Services And Ambulatory Surgical Centers |
| 59G-6.035. Certified Public Expenditures For Emergency Transportation Services |
| 59G-6.040. Payment Methodology For Icf/Mr-Dd Services In Publicly Owned And Publicly Operated Facilities |
| 59G-6.045. Payment Methodology For Services In Facilities Not Publicly Owned And Not Publicly Operated |
| 59G-6.050. Payment Methodology For Medicaid Non-Institutional Provider Services |
| 59G-6.080. Payment Methodology For Federally Qualified Health Center And Rural Health Center Services |
| 59G-6.090. Payment Methodology For County Health Departments |
| 59G-7.001. Office Of Medicaid Third Party Liability |
| 59G-7.002. Definitions |
| 59G-7.003. Medicaid Third Party Liability Responsibility And Notices |
| 59G-7.004. Forms |
| 59G-7.005. Medicaid Third Party Liability |
| 59G-7.007. Health Insurance Premium Payment Program |
| 59G-7.020. Cost Avoidance - Basis |
| 59G-7.021. Determining Liability Of Third Parties |
| 59G-7.022. Third Party Liability Primary |
| 59G-7.023. Probable Existence Of Third-Party Liability Established |
| 59G-7.024. Federal Waiver |
| 59G-7.030. Payment And Recovery Of Reimbursement - Basis |
| 59G-7.031. Payment |
| 59G-7.032. Recovery Of Reimbursement - General |
| 59G-7.033. Recovery Of Reimbursement; Substantive Rights; Casualty And Liability |
| 59G-7.034. Settlement Agreements |
| 59G-7.035. Fees Of Recipient'S Attorney |
| 59G-7.041. Judicial Proceedings |
| 59G-7.042. Reimbursement Required To Be Ordered |
| 59G-7.043. Administrative Proceedings |
| 59G-7.044. Initiation Of Administrative Proceedings |
| 59G-7.045. Venue |
| 59G-7.046. Evidence Of Administrative Proceedings |
| 59G-7.047. Speedy Disposition Of Proceedings |
| 59G-7.051. Required To Seek Reimbursement |
| 59G-7.052. Casualty And Tort Claims |
| 59G-7.053. Hospital Third-Party Liability Plan |
| 59G-7.054. Prompt Repayment |
| 59G-7.055. Payment In Full |
| 59G-7.056. Benefits Under Certain Plans |
| 59G-7.057. Provider Third-Party Liability Audits |
| 59G-7.058. Billing Statement And Medical Records |
| 59G-7.060. Cooperation Required |
| 59G-7.061. Duty To Inform |
| 59G-7.062. Notice Of Proceedings Or Claim |
| 59G-7.063. Settlement And Notice |
| 59G-7.064. Appearance To Provide Information |
| 59G-7.065. Information Under Penalty Of Perjury |
| 59G-7.066. Person Required To Provide Notice |
| 59G-7.071. Fraud Control - Basis |
| 59G-7.072. Administrative Subpoenas |
| 59G-7.073. Proceeds Of Tort Recovery Required To Be Held In Trust |
| 59G-7.0211. Exchange Of Medicaid Data With Health Insurers |
| 59G-7.0321. No Applicable Equitable Remedies |
| 59G-7.0322. Conflicting Claims By Medicare And Medicaid |
| 59G-7.0331. Small Claim Exception Under Paragraph (11)(F) Of The Mtpla |
| 59G-7.331. Small Claim Exception Under Paragraph (11)(F) Of The Mtpla |
| 59G-7.0332. All Medical Assistance; Medicaid Program Repaid First |
| 59G-7.0581. Statements As Notice |
| 59G-7.0601. Non-Cooperation |
| 59G-7.0602. Waiver Of Cooperation For Good Cause |
| 59G-8.100. Medicaid Contracts For Prepaid Health Plans |
| 59G-8.200. Home And Community-Based Services Waivers |
| 59G-8.201. The Supervision Of Self-Administration Of Medications And The Administration Of Medications To Developmental Services (Ds) Waiver Recipients, By Unlicensed Direct Service Providers |
| 59G-8.202. Definitions |
| 59G-8.203. Medication Administration Training And Medication Administration Skills Validation Requirements For The Unlicensed Direct Service Provider |
| 59G-8.204. Requirements For Administration Of Medication |
| 59G-8.205. Requirements For Supervision Of Self-Administration Of Medication |
| 59G-8.206. Storage Requirements For Prescription Medications |
| 59G-8.207. Additional Requirements |
| 59G-8.208. Required Record Keeping For The Administration Of Medications Or The Supervisions Of Self-Administration Of Medication, By Validated Direct Service Providers |
| 59G-8.209. Special Requirements For Recipients Who Require Medication While Traveling Or Away For A Visit |
| 59G-8.210. Informed Consent |
| 59G-8.211. Requests For Exemption |
| 59G-8.300. Medicaid Case Management |
| 59G-8.400. Medicaid Physician Access System |
| 59G-8.500. Recipient Case Management |
| 59G-8.600. Disenrollment From Managed Care Plans |
| 59G-8.700. Child Health Services Targeted Case Management |
| 59G-8.800. Financial Compliance Audits Of Medicaid Prepaid Plans |
| 59G-9.010. Administrative Sanctions |
| 59G-9.020. Guidelines For Administrative Sanctions |
| 59G-9.030. Determinations Of Overpayments |
| 59G-9.040. Peer Review |
| 59G-9.060. Utilization Control In Institutional Care Facilities |
| 59G-9.070. Administrative Sanctions On Providers, Entities, And Persons |
| 59G-10.010. Audits Of Nursing Homes Participating In The Florida Medicaid Program |
| 59G-11.001. Purpose |
| 59G-11.002. Definitions |
| 59G-11.003. Agency Certification Process And Requirements |
| 59G-11.004. Revocation Of A 211 Number |
| 59G-11.010. Excluded Services |
| 59G-11.020. Special Open Enrollment |
| 59G-11.030. Reinstatement Of Coverage |
| 59G-12.001. Purpose |
| 59G-12.002. Definitions |
| 59G-12.003. Eligibility/Enrollment |
| 59G-12.004. Program Administration |
| 59G-12.005. Program Forms |
| 59G-13.001. Medicaid Providers Who Bill On The Non-Institutional 081 |
| 59G-13.015. Adult Cystic Fibrosis Waiver Services Procedure Codes And Fee Schedule |
| 59G-13.030. Aged And Disabled Adult Waiver Services |
| 59G-13.031. Aged And Disabled Adult Waiver Services Procedure Codes And Fee Schedule |
| 59G-13.032. Aged And Disabled Adult Waiver Disposable Incontinence Medical Supplies Fee Schedule And Minimum |
| 59G-13.050. Assisted Living Waiver Services |
| 59G-13.051. Assisted Living For The Elderly Waiver Services Procedure Codes And Fee Schedule |
| 59G-13.052. Assisted Living Waiver Disposable Incontinence Medical Supplies Fee Schedule And Minimum Quality Standards |
| 59G-13.070. Developmental Disabilities Individual Budgeting Waiver Services |
| 59G-13.075. Home And Community Based Services Settings |
| 59G-13.080. Home And Community-Based Services Waivers |
| 59G-13.081. Developmental Disabilities Individual Budgeting Waiver Services Provider Rate Table |
| 59G-13.082. Developmental Disabilities Waiver Services Procedure Codes |
| 59G-13.083. Developmental Disabilities Waiver Services |
| 59G-13.084. Developmental Disabilities Waiver Residential Habilitation Services In A Licensed Facility Provider Rate Table |
| 59G-13.086. Developmental Disabilities Individual Budgeting Waiver Disposable Incontinence Medical Supplies Fee Schedule |
| 59G-13.088. Consumer-Directed Care Plus Program |
| 59G-13.091. Family And Supported Living Waiver Provider Rate Table |
| 59G-13.092. Family And Supported Living Waiver Services Procedure Codes |
| 59G-13.102. Familial Dysautonomia Waiver Disposable Incontinence Medical Supplies Fee Schedule And Minimum Quality Standards |
| 59G-13.110. Project Aids Care Waiver Services |
| 59G-13.112. Project Aids Care Waiver Disposable Incontinence Medical Supplies Fee Schedule And Minimum Quality Standards |
| 59G-13.130. Traumatic Brain And Spinal Cord Injury Waiver Services |
| 59G-13.131. Traumatic Brain Injury And Spinal Cord Injury Waiver Services Fee Schedule |
| 59G-13.132. Traumatic Brain And Spinal Cord Injury Waiver Disposable Incontinence Medical Supplies Fee Schedule |
| 59G-14.001. Florida Kidcare Dispute Review And Grievance Process |
| 59G-14.002. Confidentiality |
| 59G-14.003. Federal Compliance |
| 59G-14.004. Florida Kidcare Dispute Review Process |
| 59G-14.005. Florida Kidcare Grievance Committee |
| 59G-14.006. Florida Kidcare Grievance Procedures |
| 59G-14.007. Health Services Complaints And Disputes |