RULE NO: RULE TITLE
59G-7.003: Medicaid Third Party Liability Responsibility and Notices
59G-7.004: Forms
59G-7.0211: Exchange of Medicaid Data with Health Insurers
59G-7.023: Probable Existence of Third-Party Liability Established
59G-7.032: Recovery of Reimbursement - General
59G-7.0322: Conflicting Claims by Medicare and Medicaid
59G-7.0331: Small Claim Exception under Paragraph (11)(f) of the MTPLA
59G-7.0332: All Medical Assistance; Medicaid Program Repaid First
59G-7.034: Settlement Agreements
59G-7.035: Fees of Recipient's Attorney
59G-7.051: Required to Seek Reimbursement
59G-7.053: Hospital Third-Party Liability Plan
59G-7.054: Prompt Repayment
59G-7.056: Benefits under Certain Plans
59G-7.057: Provider Third-Party Liability Audits
59G-7.058: Billing Statement and Medical Records
59G-7.0581: Statements as Notice
59G-7.060: Cooperation Required
59G-7.0601: Non-cooperation
59G-7.061: Duty to Inform
59G-7.062: Notice of Proceedings or Claim
59G-7.063: Settlement and Notice
59G-7.064: Appearance to Provide Information
59G-7.073: Proceeds of Tort Recovery Required to Be Held in Trust
PURPOSE AND EFFECT: To repeal rules which are either repetitive or are obsolete.
SUMMARY: The proposed repeal eliminates certain repetitive or obsolete rules. The rules are either repetitive as their language is in the Medicaid Third-Party Liability Act, Section 409.910, F.S. or reflect obsolete programs.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared.
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.
SPECIFIC AUTHORITY: 20.05, 120.53,(1)(b), (c), 409.026(1), (6), (8), 409.285, 409.910(21), (22), (23), 409.919 FS.
LAW IMPLEMENTED: 120.52(16), 120.53(1)(b), (c), 120.57, 120.58, 120.68, 409.257, 409.901 FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN FAW.
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Lee Peacock, Third Party Liability, 2727 Mahan Drive, Mail Stop 19, Tallahassee, Florida 32308-5407, (850)487-2622

THE FULL TEXT OF THE PROPOSED RULE IS:

59G-7.003 Medicaid Third Party Liability Responsibility and Notices.

Specific Authority 409.026(8), 409.910(23), 409.919 FS. Law Implemented 409.910 FS. History–New 11-13-91, Formerly 10C-35.003, Amended 10-3-96, Repealed________.

59G-7.004 Forms.

Specific Authority 120.53(1)(b), (c), 409.026(1), (6), (8), 409.910(23), 409.919 FS. Law Implemented 120.52(16), 120.53(1), 409.910 FS. History–New 11-13-91, Formerly 10C-35.004, Amended 10-3-96, Repealed________.

59G-7.0211 Exchange of Medicaid Data with Health Insurers.

Specific Authority 409.026(8), 409.910(22), (23), 409.919 FS. Law Implemented 409.910(20), 624.424(9), 641.261, 641.411 FS. History– New 11-14-89, Formerly 10C-7.0302, Amended 11-13-91, Formerly 10C-35.0211, Amended 10-3-96, Repealed________.

59G-7.023 Probable Existence of Third-Party Liability Established.

Specific Authority 409.026(8), 409.910(23), 409.919 FS. Law Implemented 409.910(1), (3) FS. History–New 11-13-91, Formerly 10C-35.023, Amended 10-3-96, Repealed________.

59G-7.032 Recovery of Reimbursement – General.

Specific Authority 409.026(8), 409.910(23), 409.919 FS. Law Implemented 409.910 FS. History–New 11-13-91, Formerly 10C-35.032, Amended 10-3-96, Repealed________.

59G-7.0322 Conflicting Claims by Medicare and Medicaid.

Specific Authority 120.53(1)(b), (c), 409.026(8), 409.910(23), 409.919 FS. Law Implemented 120.53(1)(b), (c), 409.910 FS. History–New 11-13-91, Formerly 10C-35.0322, Amended 10-3-96, Repealed________.

59G-7.331 Small Claim Exception under Paragraph (11)(f) of the MTPLA.

Specific Authority 120.53(1), 409.026(8), 409.910(23), 409.919 FS. Law Implemented 120.53(1), 409.910 FS. History–New 11-13-91, Formerly 10C-35.0331, Amended 10-3-96, Repealed________.

59G-7.0332 All Medical Assistance; Medicaid Program Repaid First.

Specific Authority 409.026(8), 409.910(23), 409.919 FS. Law Implemented 409.910 FS. History–New 11-13-91, Formerly 10C-35.0332, Amended 10-3-96, Repealed________.

59G-7.034 Settlement Agreements.

Specific Authority 20.05, 120.53(1)(b), (c), 409.026(8), 409.285, 409.910(23), 409.919 FS. Law Implemented 120.53(1)(b), (c), 120.57, 120.58, 409.285, 409.902, 409.910 FS. History–New 11-13-91, Formerly 10C-35.034, Amended 10-3-96, Repealed________.

59G-7.035 Fees of Recipient’s Attorney.

Specific Authority 409.026(8), 409.910(23), 409.919 FS. Law Implemented 409.910 FS. History–New 11-13-91, Formerly 10C-35.035, Amended 10-3-96, Repealed________.

59G-7.051 Required to Seek Reimbursement.

Specific Authority 409.026(8), 409.910(23), 409.919 FS. Law Implemented 409.902, 409.907, 409.908, 409.910, 409.912, 409.913, 409.920 FS. History–New 11-13-91, Formerly 10C-35.051, Amended 10-3-96, Repealed________.

59G-7.053 Hospital Third-Party Liability Plan.

59G-7.054 Prompt Repayment.

59G-7.056 Benefits under Certain Plans.

Specific Authority 409.026(8), 409.910(21), 409.919 FS. Law Implemented 409.902, 409.907, 409.908, 409.910, 409.912, 409.913, 409.920 FS.; 42 U.S.C. ss. 1396a(a)(25), (a)(27), (a)(45), 1396k (Social Security Act ss. 1902(a)(25), (a)(27), (a)(45), 1912); 42 C.F.R. ss. 433.135-433.140, 447.15, 447.20, 447.21. History–New 11-13-91, Formerly 10C-35.056, Repealed________.

59G-7.057 Provider Third-Party Liability Audits.

59G-7.058 Billing Statement and Medical Records.

59G-7.0581 Statements as Notice.

59G-7.060 Cooperation Required.

Specific Authority 120.53, 409.026(8), 409.910(23), 409.919 FS. Law Implemented 120.57, 120.58, 120.68, 409.901, 409.902, 409.910, 409.920(2)(a), (c) FS. History–New 11-13-91, Formerly 10C-35.060, Amended 10-3-96, Repealed________.

59G-7.0601 Non-cooperation.

59G-7.061 Duty to Inform.

Specific Authority 409.026(8), 409.910(23), 409.919 FS. Law Implemented 409.901, 409.902, 409.910, 409.920(2)(a), (c) FS. History–New 11-13-91, Formerly 10C-35.061, Amended 10-3-96, Repealed________.

59G-7.062 Notice of Proceedings or Claim.

Specific Authority 409.026(8), 409.910(23), 409.919 FS. Law Implemented 409.901, 409.902, 409.910, 409.920(2)(a), (c) FS. History–New 11-13-91, Formerly 10C-35.062, Amended 10-3-96, Repealed________.

59G-7.063 Settlement and Notice.

Specific Authority 409.026(8), 409.910(23), 409.919 FS. Law Implemented 409.901, 409.902, 409.910, 409.920(2)(a), (c) FS. History–New 11-13-91, Formerly 10C-35.063, Amended 10-3-96, Repealed________.

59G-7.064 Appearance to Provide Information.

Specific Authority 409.026(8), 409.910(23), 409.919 FS. Law Implemented 120.58, 409.257, 409.901, 409.902, 409.910, 409.920(2)(a), (c) FS. History–New 11-13-91, Formerly 10C-35.064, Amended 10-3-96, Repealed________.

59G-7.073 Proceeds of Tort Recovery Required to Be Held in Trust.

Specific Authority 409.026(8), 409.910(23), 409.919 FS. Law Implemented 409.910 FS. History–New 11-13-91, Formerly 10C-35.073, Amended 10-3-96, Repealed________.