The purpose of the amendment to Rule 59G-4.160 is to incorporate by reference the Florida Medicaid Outpatient Hospital Services Coverage Policy, __________. The incorporated coverage policy will specify recipient eligibility, provider requirements, ...

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.:RULE TITLE:

59G-4.160Outpatient Hospital Services

PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-4.160, F.A.C. is to incorporate by reference the Florida Medicaid Outpatient Hospital Services Coverage Policy, __________. The incorporated coverage policy will specify recipient eligibility, provider requirements, service coverage, and reimbursement information.

SUBJECT AREA TO BE ADDRESSED: Rules 59G-4.160, F.A.C., Outpatient Hospital Services and 59G-4.150, F.A.C., Inpatient Hospital Services.

An additional area to be addressed during the workshop will be the potential regulatory impact Rules 59G-4.160 and 59G-4.150, Florida Administrative Code, will have as provided for under sections 120.54 and 120.541, Florida Statutes.

RULEMAKING AUTHORITY: 409.919 FS.

LAW IMPLEMENTED: 409.902, 409.905, 409.907, 409.908, 409.912, 409.913 FS.

A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:

DATE AND TIME: November 30, 2015, 9:00 a.m. ‒ 10:00 a.m.

PLACE: : Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room D, 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: Luc Toussaint. 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 DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Luc Toussaint, 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 workshop at http://ahca.myflorida.com/Medicaid/review/index.shtml. Comments will be received until 5:00 p.m., on December 1, 2015.

 

THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:

 

59G-4.160 Outpatient Hospital Services.

(1) This rule applies to any person or entity prescribing or reviewing a request for outpatient hospital services and to all hospital providers of outpatient hospital services who are enrolled in or registered with the Florida Medicaid program.

(2) All persons or entities described in subsection (1) hospital providers enrolled in the Medicaid program must be in compliance comply with the provisions of the Florida Medicaid Outpatient Hospital Services Coverage Policy, __________and Limitations Handbook, December 2011, incorporated by reference. available at http://www.flrules.org/Gateway/reference.asp?No=Ref-01232. The policy handbook is available from the Florida Medicaid fiscal agent’s Web site at http://portal.flmmis.com/flpublic.www.mymedicaid-florida.com. Select Public Information for Providers, then Provider Support, and then Provider Handbooks. Paper copies of the handbooks may be obtained by calling the Provider Contact Center at 1(800) 289-7799 and selecting Option 7.

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.905, 409.907, 409.908, 409.9081, 409.912, 409.913 FS. History–New 1-1-77, Revised 12-7-78, 1-18-82, Amended 7-1-83, 7-16-84, 7-1-85, 10-31-85, Formerly 10C-7.40, Amended 9-16-86, 2-28-89, 5-21-91, 5-13-92, 7-12-92, 1-5-93, 6-30-93, 7-20-93, 12-21-93, Formerly 10C-7.040, Amended 6-13-94, 12-27-94, 2-21-95, 9-11-95, 11-12-95, 2-20-96, 10-27-98, 5-12-99, 10-18-99, 3-22-01, 8-12-01, 2-25-03, 8-14-03, 11-28-04, 8-18-05, 1-10-06, 4-16-06, 2-25-09, 6-25-12,________.