This is a second public hearing on a proposed rule amendment to 59G-4.140, Hospice Services. The purpose of the rule amendment is to incorporate by reference update January 2007 to the Florida Medicaid Hospice Services Coverage and Limitations Handbook. The handbook update removes the January 2006 fee schedule for direct care services provided by physicians. The January 2007 fee schedule has been incorporated by reference in rule 59G-4.002, Medicaid Provider Reimbursement Schedule. The handbook update also corrects the room and board policy to read that room and board for hospice residents in a nursing facility does not include the day of discharge. It also clarifies that if a hospice has no cost history, the hospice will be paid 95 percent of the average Medicaid nursing facility per diem rate in the county in which the hospice is located. These policies will be effective on the date that rule is adopted