11888434, 59G-5.020 - Florida Administrative Rules, Law, Code, Register

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Florida Department of State and Division of Library and Information Services

Notice: 11888434

Notice of Proposed Rule

Department:

AGENCY FOR HEALTH CARE ADMINISTRATION

Division:

Medicaid

Chapter:

PROVIDER ENROLLMENT AND PROVIDER REQUIREMENTS

Overview

RULE:

59G-5.020

Provider Requirements

PURPOSE:

The purpose of the amendment to Rule 59G-5.020 is to incorporate by reference the Florida Medicaid Provider General Handbook, July 2012. The handbook is updated to add policy relating to special services necessary for children and detailing the direction on requesting these services; give providers direction on requesting non-emergency out-of-state services by providing general guidelines, adding non-emergency out-of-state services, and requiring a new form; add policy regarding enrollment of cross-over only providers; reflect Medicaid Qualified Medicare Beneficiary (QMB) cost-sharing requirements and Medicaid cost-sharing for Medicare Part A and Part C services; and increase the oversight of the Medicaid program through the provision of general guidelines on termination, suspensions, and administrative sanctioning of Medicaid providers as directed by legislation.

SUMMARY:

Overall, the amendment updates policy, clarifies existing policy, updates forms, and updates fiscal agent information. Existing policies have been clarified and updated to ensure a better understanding of policy requirements.

RULEMAKING AUTHORITY:

409.919 FS.

LAW:

409.902, 409.905, 409.906, 409.907, 409.908, 409.9081, 409.910, 409.912, 409.913 FS.

PRINT PUBLISH DATE:

8/17/2012 Vol. 38/33

COMMENTS:

From 8/17/2012 To 9/7/2012 (21 Days)
The public comment period for this notice has already expired.

REFERENCE MATERIALS:

No reference(s).

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