14096348, 59G-6.030 - Florida Administrative Rules, Law, Code, Register

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Notice: 14096348

Notice of Proposed Rule

Department:

AGENCY FOR HEALTH CARE ADMINISTRATION

Division:

Medicaid

Chapter:

REIMBURSEMENT TO PROVIDERS

Overview

RULE:

59G-6.030

Payment Methodology for Outpatient Hospital Services

PURPOSE:

The purpose of this rule is to incorporate by reference the Florida Title XIX Outpatient Hospital Reimbursement Plan (the Plan), effective July 1, 2012.  The amendment to Rule 59G-6.030 will update the Plan to reflect changes authorized in House Bill 5001, 2012-13 General Appropriations Act, Specific Appropriation 198, which provides for hospital buy backs, exemptions from ceilings, and a reimbursement rate reduction.  Additionally, no changes to providers’ rates will be allowed after October 31 of each year, and references to the Bureau of Medicaid Program Analysis have been changed to the Bureau of Medicaid Program Finance.  The methodology used to calculate the upper payment limit (UPL) has been added as an appendix to the Plan.

SUMMARY:

Rule 59G-6.030 updates the Title XIX Outpatient Hospital Reimbursement Plan to reflect changes authorized in House Bill 5001, 2012-13 General Appropriations Act, Specific Appropriation 198, which provides for hospital buy backs, exemptions from ceilings, and a reimbursement rate reduction.  Additionally, no changes to providers’ rates will be allowed after October 31 of each year, and references to the Bureau of Medicaid Program Analysis have been changed to the Bureau of Medicaid Program Finance.  The methodology used to calculate the upper payment limit (UPL) has been added as an appendix to the Plan.

RULEMAKING AUTHORITY:

409.919 FS

LAW:

409.908, 409.913 FS.

PRINT PUBLISH DATE:

1/23/2014 Vol. 40/15

COMMENTS:

From 1/23/2014 To 2/13/2014 (21 Days)
The public comment period for this notice has already expired.

REFERENCE MATERIALS:

No reference(s).

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