The purpose of the amendment to Rule 59G-4.130, Florida Administrative Code (F.A.C.), is to remove language that is contained in Rules 59G-4.215 and 59G-4.261, F.A.C., incorporate by reference the Florida Medicaid Home Health Visit Services Coverage ...

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.:RULE TITLE:

59G-4.130Home Health Services

PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-4.130, Florida Administrative Code (F.A.C.), is to remove language that is contained in Rules 59G-4.215 and 59G-4.261, F.A.C., incorporate by reference the Florida Medicaid Home Health Visit Services Coverage Policy, __________, and revise the rule title.

SUMMARY: The incorporated coverage policy will specify recipient eligibility, provider requirements, service coverage, and reimbursement information. The rule title is changed to Home Health Visit Services.

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, 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 FS.

LAW IMPLEMENTED: 409.902, 409.905, 409.907, 409.908, 409.9081, 409.912, 409.913, 409.973 FS.

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

DATE AND TIME: September 13, 2016, 10:30 a.m. to 11:00 a.m.

PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, 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: Shameria Davis. 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: Shameria Davis, 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 public hearing at http://ahca.myflorida.com/Medicaid/review/index.shtml. Official comments to be entered into the rule record will be received from the date of this notice until 5:00 p.m. on September 14, 2016. Comments may be e-mailed to [e-mail]. For general inquiries and questions about the rule, please contact the person specified above.

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

59G-4.130Home Health Visit Services.

(1) This rule applies to all providers rendering Florida Medicaid to all providers of home health visit services to recipients who are enrolled in the Florida Medicaid program.

(2) All providers providers of home health services must be in compliance with the provisions of the Florida Medicaid Home Health Visit Services Coverage Policy and Limitations Handbook,________,October 2014, available at http://www.flrules.org/Gateway/reference.asp?No=Ref-04598, incorporated by reference. The policy handbook is available on from the Agency for Health Care Administration’s (AHCA) Medicaid fiscal agent’s website Web site at http://ahca.myflorida.com/Medicaid/review/index.shtml, and available at [DOS place holder Ref-_______]. www.mymedicaid-florida.com. Select Public Information for Providers, then Provider Support, and then Provider Handbooks.

(3) The following forms are incorporated by reference and are available on the AHCA website at http://ahca.myflorida.com/Medicaid/review/index.shtml:

(a) Parent or Legal Guardian Medical Limitations, AHCA Form 5000-3501,_____, http://www.flrules.org/Gateway/reference.asp?No=Ref-____.

(b) Parent or Legal Guardian Work Schedule, AHCA Form 5000-3503,______, http://www.flrules.org/Gateway/reference.asp?No=Ref-____.

(c) Parent or Legal Guardian Statement of Work Schedule, AHCA Form 5000-3504,_____, http://www.flrules.org/Gateway/reference.asp?No=Ref-____.

(d) Parent or Legal Guardian School Schedule, AHCA Form 5000-3505,_____, http://www.flrules.org/Gateway/reference.asp?No=Ref-____.

included in the Florida Medicaid Home Health Services Coverage and Limitations Handbook and are incorporated by reference: Medicaid Instructions for CMS Form 485 – Plan of Care, AHCA Form 5000-3544, Revised October 2014; Home Health Certification and Plan of Care, Form CMS-485 (C-3) (02-94) (Formerly HCFA-485), Authorization for Private Duty Nursing Provided by a Parent or Legal Guardian, AHCA Form 5000-3541, February 2013; Physician Visit Documentation Form, AHCA Form 5000-3502, Revised February 2013; Parent or Legal Guardian Medical Limitations, AHCA Form 5000-3501, Revised February 2013; Parent or Legal Guardian Work Schedule, AHCA Form 5000-3503, Revised February 2013; Parent or Legal Guardian Statement of Work Schedule, AHCA Form 5000-3504, Revised February 2013; Parent or Legal Guardian School Schedule, AHCA Form 5000-3505, Revised October 2014; Instructions for the Personal Care Services Plan of Care, AHCA Form 5000-3506, Revised October 2014; Physician’s Written Prescription for Home Health Services, AHCA Form 5000-3525, Revised February 2013; Review Criteria for Private Duty Nursing Services, AHCA Form 5000-3543, Revised October 2014; and Review Criteria for Personal Care Services, AHCA Form 5000-3542, Revised October 2014. The forms are available by photocopying them from the handbook.

Rulemaking Authority 409.919, 409.961 FS. Law Implemented 409.902, 409.905, 409.907, 409.908, 409.9081, 409.912, 409.913, 409.973 FS. History–New 1-1-77, Amended 4-1-78, 9-28-78, 1-24-79, 7-17-83, Formerly 10C-7.44, Amended 6-1-88, 4-9-89, 1-1-90, 5-26-93, Formerly 10C-7.044, Amended 3-14-95, 12-27-95, 5-7-96, 2-9-98, 5-30-00, 11-24-03, 10-30-07, 12-29-08, 6-25-12, 6-25-13, 10-14-14,__________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Shameria Davis

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Elizabeth Dudek

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: August 08, 2016

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: October 16, 2015