59G-4.130: Home Health Services
PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-4.130 is to remove language that is contained in Rules 59G-4.215 and 59G-4.261 F.A.C., and to incorporate by reference the Florida Medicaid Home Health Visit Services Coverage Policy, __________. The incorporated coverage policy will specify recipient eligibility, provider requirements, service coverage, and reimbursement information. The amendment also revises the rule title to Home Health Visit Services.
SUBJECT AREA TO BE ADDRESSED: Rules 59G-4.130, Home Health Services, 59G-4.215, Personal Care Services, and 59G-4.261, Private Duty Nursing Services.
An additional area to be addressed during the workshop will be the potential regulatory impact Rules 59G-4.130, 59G-4.215, and 59G-4.261, Florida Administrative Code, will have as provided for under sections 120.54 and 120.541, Florida Statutes.
RULEMAKING AUTHORITY: 409.919 FS.
LAW IMPLEMENTED: 409.902, 409.905, 409.907, 409.908, 409.9081, 409.912, 409.913 FS.
A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
DATE AND TIME: October 30, 2015 from 10:00 a.m. to 12:00 p.m.
PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room D, 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: Claire Anthony-Davis. 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 DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Claire Anthony-Davis, Bureau of Medicaid Policy, 2727 Mahan Drive, Mail Stop 20, Tallahassee, Florida 32308-5407, telephone: 850-412-4266 e-mail: Claire.Davis@ahca.myflorida.com.
Please note that a preliminary draft of the reference material, if available, will be posted prior to the workshop at http://ahca.myflorida.com/Medicaid/review/index.shtml. Comments will be received until 5:00 p.m., on the day of the workshop.
THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:
59G-4.130 Home Health Visit Services.
(1) This rule applies to any person or entity prescribing or reviewing a request for home health visit services and to all providers of home health visit services who are enrolled in or registered with the Florida Medicaid program.
(2) All providers of home health visit services must be in compliance with the provisions of the Florida Medicaid Home Health Visit Services Coverage Policy and Limitations Handbook,_____, October 2014, available at http://www.flrules.org/Gateway/reference.asp?No=Ref-04598, incorporated by reference. The policy handbook is available from the Florida Medicaid fiscal agent’s Web site at http://portal.flmmis.com/flpublic www.mymedicaid-florida.com. Select Public Information for Providers, then Provider Support, and then Provider Handbooks.
(3) The following forms are included in the Florida Medicaid Home Health Services Coverage and Limitations Handbook and are incorporated by reference: Medicaid Instructions for CMS Form 485 – Plan of Care, AHCA Form 5000-3544, Revised October 2014; Home Health Certification and Plan of Care, Form CMS-485 (C-3) (02-94) (Formerly HCFA-485), Authorization for Private Duty Nursing Provided by a Parent or Legal Guardian, AHCA Form 5000-3541, February 2013; Physician Visit Documentation Form, AHCA Form 5000-3502, Revised February 2013; Parent or Legal Guardian Medical Limitations, AHCA Form 5000-3501, Revised February 2013; Parent or Legal Guardian Work Schedule, AHCA Form 5000-3503, Revised February 2013; Parent or Legal Guardian Statement of Work Schedule, AHCA Form 5000-3504, Revised February 2013; Parent or Legal Guardian School Schedule, AHCA Form 5000-3505, Revised October 2014; Instructions for the Personal Care Services Plan of Care, AHCA Form 5000-3506, Revised October 2014; Physician’s Written Prescription for Home Health Services, AHCA Form 5000-3525, Revised February 2013; Review Criteria for Private Duty Nursing Services, AHCA Form 5000-3543, Revised October 2014; and Review Criteria for Personal Care Services, AHCA Form 5000-3542, Revised October 2014. The forms are available by photocopying them from the handbook.
Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.905, 409.907, 409.908, 409.9081, 409.912, 409.913 FS. History–New 1-1-77, Amended 4-1-78, 9-28-78, 1-24-79, 7-17-83, Formerly 10C-7.44, Amended 6-1-88, 4-9-89, 1-1-90, 5-26-93, Formerly 10C-7.044, Amended 3-14-95, 12-27-95, 5-7-96, 2-9-98, 5-30-00, 11-24-03, 10-30-07, 12-29-08, 6-25-12, 6-25-13, 10-14-14,____.