14970706, 59G-1.010 - Florida Administrative Rules, Law, Code, Register

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Florida Department of State and Division of Library and Information Services

Notice: 14970706

Notice of Development of Rulemaking

Department:

AGENCY FOR HEALTH CARE ADMINISTRATION

Division:

Medicaid

Chapter:

GENERAL MEDICAID

Overview

RULE:

59G-1.010

Definitions

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 all providers, except for pharmacy providers (as a definition already exists in the Florida Medicaid Prescribed Drug Services Coverage, Limitations and Reimbursement Handbook, July 2014). The rule will require Medicaid enrolled providers, except for pharmacy providers, 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.

SUBJECT:

An additional area to be addressed during the workshop will be the potential regulatory impact the amendment to Rule 59G-1.010 will have as provided for under sections 120.54 and 120.541, F.S.

RULEMAKING AUTHORITY:

409.919 F.S.

LAW:

409.901-.9201 F.S.

PRINT PUBLISH DATE:

8/22/2014 Vol. 40/164

RELATED STATUTES
AND LAWS:

409.919 F.S., 409.901-.9201 F.S.

OVERSIGHT COMMITTEE:

Joint Administrative Procedures Committee
Florida Administrative Law Central Online Network (F.A.L.C.O.N.)

RELATED COURT CASES:

Division of Administrative Hearings

FEDERAL eRULEMAKING
WEB PORTAL:

Regulations.gov

HOW TO LINK TO
THIS NOTICE:

http://flrules.org/gateway/ruleno.asp?id=59G-1.010&PDate=8/22/2014&Section=1

REFERENCE MATERIALS:

No reference(s).

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