10038838, 59G-4.130 - Florida Administrative Rules, Law, Code, Register

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Florida Department of State and Division of Library and Information Services

Notice: 10038838

Notice of Proposed Rule

Department:

AGENCY FOR HEALTH CARE ADMINISTRATION

Division:

Medicaid

Chapter:

MEDICAID POLICY

Overview

RULE:

59G-4.130

Home Health Visit Services

PURPOSE:

The purpose of the amendment to Rule 59G-4.130, F.A.C., is to incorporate by reference the Florida Medicaid Home Health Services Coverage and Limitations Handbook, September 2011. The handbook was revised to comply with changes to Section 409.905(4), F.S.

SUMMARY:

Changes to the handbook include requiring prior authorization for all home health visits (skilled nursing and home health aide services), private duty nursing, and personal care. The ordering physician cannot be employed by or under contract with the home health service provider that is rendering the services and must have provided an examination or medical consultation to the recipient within 30 days preceding the request for services. The ordering physician’s National Provider Identifier, Medicaid Provider Number, or medical license number must be written on the order for services and the prior authorization request. In addition, the update includes numerous policy clarifications and the addition of mandatory forms to assist providers and recipients in their efforts to submit the required documentation.

RULEMAKING AUTHORITY:

409.919 FS.

LAW:

409.902, 409.905, 409.907, 409.908, 409.9081, 409.912, 409.913 FS.

PRINT PUBLISH DATE:

6/24/2011 Vol. 37/25

COMMENTS:

From 6/24/2011 To 7/15/2011 (21 Days)
The public comment period for this notice has already expired.

REFERENCE MATERIALS:

No reference(s).

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