Purpose


The purpose of this rule amendment is to incorporate by reference the revised Florida Medicaid Nursing Facility Services Coverage and Limitations Handbook, May 2009, and delete the reference to the Florida Medicaid Provider Reimbursement Handbook, Institutional 021, which was obsolete July 1, 2008. The revised Nursing Facility Handbook includes updated Pre-Admission Screening and Resident Review (PASRR) requirements and forms, revised Medical Certification for Nursing Facility/Home and Community Based Services Form (previously named the Patient Transfer and Continuity of Care Form) and instructions, updated Medicare Part A crossover policy, and revised policy for requesting supplemental payment for residents with AIDS. The revised handbook reiterates the nursing facility’s requirement to enter the recipient’s responsibility on the claim and eliminates the Medicaid Nursing Facility/ICF-DD Contribution Notices, AHCA Form 5000-3300. The rule was revised to require nursing facility services providers to comply with the provisions of the Florida Medicaid Provider Reimbursement Handbook, UB-04, which replaced the Florida Medicaid Provider Reimbursement Handbook, Institutional 021. The authorization policies for supplemental payments for medically-fragile recipients under the age of 21 and recipients with AIDS and the Client Discharge/Change Notice, CF-ES 2506, that were in Chapter 2 of the Florida Medicaid Provider Reimbursement Handbook, Institutional 021, were moved to the revised Nursing Facility Handbook. In the Notice of Rule Development we stated the effective date of the handbook was July 2008. We changed this date to May 2009. The effect will be to incorporate by reference in rule the revised Florida Medicaid Nursing Facility Services Coverage and Limitations Handbook, May 2009; delete the reference to the Florida Medicaid Provider Reimbursement Handbook, Institutional 021; and require providers to comply with the provisions of the Florida Medicaid Provider Reimbursement Handbook, UB-04.