59G-13.030: Aged and Disabled Adult Waiver Services
59G-13.031: Aged and Disabled Adult Waiver Services Procedure Codes and Fee Schedule
PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-13.030, F.A.C., is to incorporate by reference the revised Aged and Disabled Adult Waiver Services Coverage and Limitations Handbook, May 2009. The effect will be to give providers information on services and procedures on the waiver program.
The purpose of the amendment to Rule 59G-13.031, F.A.C., is to incorporate by reference the Aged and Disabled Adult Waiver Services Procedure Codes and Fee Schedule, May 2009. The effect will be to give providers updated reimbursement rates for services under the waiver program.
SUMMARY: The revised handbook contains updated policies and procedures for Aged and Disabled Adult Waiver providers and policy for the Aging Out Program. The procedure codes and fee schedule give current reimbursement rates for providers under the waiver program.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: A SERC has been prepared for the amendment to Rule 59G-30.031, F.A.C. The amendment to Rule 59G-13.031, F.A.C., will increase the reimbursement rate for physical and occupational therapy and home delivered meals and add reimbursement for Case Management Aging Out Enhanced. This will result in increased revenues for Aged and Disabled Adult waiver physical and occupational therapy providers, home delivered meal providers and case management agencies.
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: 409.919 FS.
LAW IMPLEMENTED: 409.906, 409.907, 409.908, 409.912 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: Tuesday, February 9, 2010, 10:00 a.m. – 11:00 a.m.
PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room B, 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: Carol Schultz at the Bureau of Medicaid Services, (850)922-7349. 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: Carol Schultz, Medicaid Services, 2727 Mahan Drive, Mail Stop 20, Tallahassee, Florida 32308-5407, e-mail: schultzc@ahca.myflorida.com
THE FULL TEXT OF THE PROPOSED RULE IS:
59G-13.030 Aged and Disabled Adult Waiver Services.
(1) No change.
(2) All aged and disabled adult waiver services providers enrolled in the Medicaid program must be in compliance with the Florida Medicaid Aged and Disabled Adult Waiver Services Coverage and Limitations Handbook, May 2009 March 2004, updated August 2005, incorporated by reference, and the Florida Medicaid Provider Reimbursement Handbook, CMS-1500, Non-Institutional 081 which is incorporated by reference in Rule 59G-4.001 13.001, F.A.C. Both handbooks are available from the Medicaid fiscal agent’s Web Portal at http://mymedicaid-florida.com. Select Public Information for Providers, then Provider Support, and then Provider Handbooks. Paper copies of the handbook may be obtained by calling the Medicaid fiscal agent at (800)289-7799 and selecting option 7.
(3) The following forms that are included in the Florida Medicaid Aged and Disabled Adult Waiver Services Coverage and Limitations Handbook are incorporated by reference:
(a) Appendix A contains the Adult Services Client Assessment, CF-AA 3019, PDF 10/2005, eight pages. The form is available at the Department of Children and Families website at http://www.dcf.state.fl.us/DCFForms/Search/DCFFormSearch.aspx.
Appendix B contains the AS Screening for Consideration for Community Based Programs, CF AA Form 1022, PDF 08/2004, four pages; Appendix C contains the Florida Department of Children and Family Services and Florida Department of Elder Affairs, CF MED 3008, Oct. 96, two pages;
(b) Appendix D contains the Notification of Level of Care, DOEA-CARES Form 603 (Revised March 2003), one page.; The form is mailed to the provider by the Department of Elder Affairs, CARES Unit.
(c) Appendix E contains the Aged and Disabled Adult Services Waiver Agreement of Expectations, AHCA-Med Serv Form 033, May 2009, two pages. The form is available by photocopying it from the handbook. Notice of Hospice Election Waiver, AHCA Form 5000 29, March 2004, one page, and the Cooperative Agreement for a Hospice and Medicaid Waiver Enrolled Recipient, AHCA Form 5000 30, March 2004, two pages. Appendix B also contains the Department of Elder Affairs Assessment Instrument, DOEA Form 701B, which is incorporated by reference in Rule 58A-1.010, F.A.C. The Department of Children and Family Services (DCFS) forms are available from DCFS. The Department of Elder Affairs (DOEA) forms are available from DOEA. The Agency for Health Care Administration (AHCA) forms are available by photocopying the forms in this handbook.
(d) Appendix G contains the Request for Approval of Care Plan Services Increase, CF-AA 1116, PDF 05/2004, two pages. The form is available from the Department of Children and Families website at http://www.dcf.state.fl.us/DCFForms/Search/DCFFormSearch.aspx.
(e) Appendix H contains the Aged/Disabled Adult Waiver Aging Out Plan of Care, AHCA-Med Serv Form 047, May 2009, five pages. The form is available by photocopying it from the handbook.
Rulemaking Specific Authority 409.919 FS. Law Implemented 409.906, 409.907, 409.908, 409.912 FS. History–New 6-1-05, Amended 4-17-06,_________.
59G-13.031 Aged and Disabled Adult Waiver Services Procedure Codes and Fee Schedule.
(1) This rule applies to all aged and disabled adult waiver services providers enrolled in the Medicaid program.
(2) All aged and disabled adult waiver services providers enrolled in the Medicaid program must be in compliance with the Aged and Disabled Adult Waiver Services Procedure Codes and Fee Schedule, May 2009, which is incorporated by reference. The Procedure Codes and Fee Schedule are 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 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 409.906, 409.908 FS. History–New_________.