59G-13.081: Developmental Disabilities Waiver Provider Rate Table
PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-13.081, F.A.C., is to incorporate by reference the Developmental Disabilities Medicaid Home and Community Based Waiver Services Tiers 1 through 4 and Individual Budgeting (iBudget) Waivers Provider Rate Tables. The new rate tables will be available upon adoption of the rule.
SUMMARY: This rule will implement a four (4) percent rate reduction for all Developmental Disabilities Medicaid Waiver’s services enacted during the 2011 legislative session and provided for in Senate Appropriations Act 2000. Tiers 1-4 Waivers:
This rate table contains the 4% reduction for all rates, required by statute in General Appropriations Act (GAA) for FY 2011-12. It incorporates Companion rate change, limits Transportation units and frequencies, standardizes Residential Habilitation Intensive Behavior rates, and Nursing services and Nursing and Therapy Assessments to align with Medicaid State Plan rates in conjunction with the September 1, 2011 Legislative Cost Containment Plan.
iBudget:
This rate table contains the 4% reduction for all rates, required by statute in General Appropriations Act (GAA) for FY 2011-12, and rates applicable to combined services. It incorporates Life Skills Development Level 1 (formerly Companion) rate change, limits Transportation units and frequencies, standardizes Residential Habilitation Intensive Behavior rates, and Nursing services and Nursing and Therapy Assessments to align with Medicaid State Plan rates in conjunction with the September 1, 2011 Legislative Cost Containment Plan.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:
The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has been prepared by the agency.
There is no additional regulatory cost associated with this rule. The Florida Legislature mandated a 4% rate reduction for the Developmental Disabilities Home and Community Based Services Waivers, effective July 1, 2011. The Agency for Persons with Disabilities (APD) in consultation with AHCA, instituted cost savings measures under the authority in Section 393.0661(8)-(9), F.S. Providers of Developmental Disabilities waiver services enter into a voluntary contract with the Florida Medicaid program; therefore there is no regulatory effect from these rate cuts. The accompanying waiver coverage and limitations handbooks for the waiver programs that describe the services have reduced regulation and will continue to be reviewed for further opportunities to streamline regulations while still maintaining health and safety standards requirements for these services. The APD was spending more than its appropriation of $805 million. For fiscal year 2010-2011, service expenditures were approximately 958 million. Additionally, the Florida Legislature required that the APD submit a cost containment plan. These rate changes are aligned with the cost containment plan developed in September 2011.
The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: Refer to Summary of Statement of Estimated Regulatory Costs above.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
RULEMAKING AUTHORITY: 409.919 FS.
LAW IMPLEMENTED: 393.0661, 409.902, 409.906, 409.908, 409.912, 409.913 FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
DATE AND TIME: Monday, August 20, 2012, 1:00 p.m. – 3:00 p.m.
PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room A, Tallahassee, Florida 32308-5407
Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 48 hours before the workshop/meeting by contacting: Susan DeBeaugrine at the Bureau of Medicaid Services, (850)412-4261. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Susan DeBeaugrine, Medicaid Services, 2727 Mahan Drive, Mail Stop 20, Tallahassee, Florida 32308-5407, telephone: (850)412-4261, e-mail: susan.debeaugrine@ahca.myflorida.com
THE FULL TEXT OF THE PROPOSED RULE IS:
59G-13.081 Developmental Disabilities Home and Community Based Medicaid Waiver Services Tiers 1 through 4 and Individual Budgeting Waivers Provider Rate Tables.
(1) This rule applies to all developmental disabilities home and community based services Tiers 1 through 4 Waiver providers and Individual Budgeting Waiver providers enrolled in the Medicaid program.
(2) All developmental disabilities home and community based services Tiers 1 through 4 providers and Individual Budgeting providers enrolled in the Medicaid program must be in compliance with the Developmental Disabilities Home and Community Based Services Tiers 1 through 4 and Individual Budgeting Waivers Provider Rate Tables, which is incorporated by reference. In accordance with the Agency for Persons with Disabilities Cost Containment Plan, dated September 1, 2011, as required by the 2011/2012 General Appropriations Act, the following services were implemented on the dates specified herein: August 1, 2011 for Companion; September 1, 2011 for Transportation (trip); January 1, 2012 for Residential Habilitation Intensive Behavior in a Licensed Facility (Levels 1-6); and April 1, 2012 for Nursing Assessment Registered Nurse, Occupational Therapy Assessment, Physical Therapy Assessment, Private Duty Nursing Licensed Practical Nurse (LPN) and Registered Nurse (RN), Residential Nursing Services LPN and RN, Respiratory Therapy Assessment, Skilled Nursing LPN and RN, and Speech Therapy Assessment. The rate tables are available from the Medicaid fiscal agent’s Web site at www.mymedicaid-florida.com. Select Public Information for Providers, then Provider Support, and then Fee Schedules. Paper copies of the reimbursement schedule may be obtained by calling the Provider Contact Center at (800)289-7799 and selecting Option 7.
Developmental Disabilities Waiver Provider Rate Table.
(1) This rule applies to all developmental disabilities waiver services providers enrolled in the Medicaid program.
(2) All developmental disabilities waiver services providers enrolled in the Medicaid program must be in compliance with the Developmental Disabilities Home and Community-Based Services Waiver Provider Rate Table, July 1, 2008, which is incorporated by reference. The rate table is available from the Medicaid fiscal agent’s Web Portal at http://mymedicaid-florida.com. Click on Public Information for Providers, then on Provider Support, and then on Fee Schedules. Paper copies of the rate table may be obtained from the Agency for Health Care Administration, Bureau of Medicaid Services, 2727 Mahan Drive, M.S. 20, Tallahassee, Florida 32308.
Rulemaking Authority 409.919 FS. Law Implemented 393.0661, 409.902, 409.906, 409.908, 409.912, 409.913 FS. History–New 5-29-06, Amended 11-15-07, 10-13-08,_________.