Purpose


The Secretary of the Agency for Health Care Administration, after consultation with the Agency for Persons with Disabilities, hereby issues the following statement of facts and reasons, in support of adopting Emergency Rules 59GER11-06, 07, 08, 09, 10 which repeal Emergency Rules 59GER11-01, 02, 03, 04, and 05, respectively. 1. The Agency for Health Care Administration (“AHCA”) is the “single state agency” responsible for the administration of the Florida Medicaid program. § 409.902, Fla. Stat.; 42 U.S.C. § 1396a(a)(5). As the single state agency, AHCA has the authority to make rules, regulations, and policies that it follows in administering the state’s Medicaid program. § 409.919, Fla. Stat.; 42 U.S.C. § 431.10(b)(2). No other state agency has the “authority to change or disapprove any administrative decision of [AHCA], or otherwise substitute its judgment for that of the Medicaid agency with respect to application of policies, rules, and regulations issued by the Medicaid agency.” 42 C.F.R. § 431.10(e)(3). 2. The Agency for Persons with Disabilities (“APD”) is responsible for the administration of the Developmental Disabilities Home and Community Based Medicaid Waiver programs (the “waiver”). § 393.0661, Fla. Stat. APD’s waiver serves over 30,000 people with developmental disabilities, which Florida law defines as persons diagnosed with intellectual disability (formerly known as mental retardation), cerebral palsy, autism, spina bifida, or Prader-Willi syndrome. § 393.063(9), Fla. Stat. 3. On March 31, 2011, AHCA filed emergency rules 59ER11-01, 02, 03, 04 and 05 (“the emergency rules”). The emergency rules reduced waiver provider reimbursement rates. 4. The underlying emergency justifying the emergency rules was a $174 million budget deficit at APD. 5. The emergency rules were one part of a larger plan to address the budget shortfall. 6. On April 14, 2011, the Legislature agreed to appropriate funds to address the budget shortfall that prompted the emergency rules. This fact, once carried through, will eliminate the emergency that justified the emergency rules and obviate the need for the emergency rules. 7. Accordingly, AHCA is repealing the emergency rules effective April 16, 2011. 8. Billing for services rendered from April 1, 2011 up to and including April 15, 2011 will be reimbursed according to the rates promulgated by the emergency rules. The emergency rules will not apply to billings for services rendered after April 15, 2011. 9. The emergency rules were one part of a larger plan to address APD’s budget deficit. This repeal of the emergency rules is a repeal only of the provider rate reductions in the emergency rules. Other portions of the larger plan that were not covered by the emergency rules remain in place.