Notice of Change/Withdrawal

DEPARTMENT OF FINANCIAL SERVICES
Division of Risk Management
RULE NO: RULE TITLE
69H-2.008: Other Forms Adopted
NOTICE OF CHANGE
Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 35 No. 25, June 26, 2009 issue of the Florida Administrative Weekly.

These changes are being made to address concerns expressed by the Joint Administrative Procedures Committee.

The Purpose and Use Statement, required by Section 119.071(5), Florida Statutes, on forms DFS-D0-1990, “Medicare Secondary Payer Reporting Questionnaire” and DFS-D0-1991, “Medicare Beneficiary/Eligibility Information” in subsection 69H-2.008(1), F.A.C., has been modified to read as follows:

“The collection of the social security number on this form is imperative for the performance of the Department’s duties and responsibilities as prescribed by Section 111 (42 U.S.C. 1395y (b) (8)). The social security number will be used to submit a query to the Center for Medicare Services (CMS) database to determine current eligibility for Medicare. The data collected under Section 111 reporting will be used by CMS in processing claims billed to Medicare for reimbursement for items and services furnished to Medicare beneficiaries and for recovery efforts, as appropriate. The social security number may also be used for any other purpose specifically required or authorized by state or federal law.”

The remainder of the rule reads as previously published.