Purpose


The purpose of the amendment to Rule 59G-1.010 is to update definitions and adopt a definition of "usual and customary charge." The definition comports with the plain meaning of the term and is consistent with the requirement of cost effective purchasing of health services in the Florida Medicaid program for independent laboratory service providers in the Florida Medicaid program. The rule will require independent laboratory service providers enrolled in Florida Medicaid, when listing their "usual and customary charge" to provide the price or fee that is most often or frequently accepted as payment by the provider for the particular service. The rule also explains the time period to be applied in calculating the usual and customary charge.