59G-4.230: Physician Services
PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-4.230, F.A.C., is to incorporate by reference the Florida Medicaid Physician Services Coverage and Limitations Handbook, January 2010. The effect of the update will provide for new Medicaid policy that allows coverage for intrathecal baclofen therapy (ITB) used to manage severe spasticity of spinal cord or cerebral origin. It will include limitations of coverage, prior authorization requirements for the ITB infusion pump, and conditions of payment for this device.
SUBJECT AREA TO BE ADDRESSED: Physician Services.
SPECIFIC AUTHORITY: 409.919 FS.
LAW IMPLEMENTED: 409.905, 409.907, 409.908, 409.9081 FS.
IF REQUESTED IN WRITING AND NOT DEEMED UNNECESSARY BY THE AGENCY HEAD, A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
TIME AND DATE: Friday, February 19, 2010, 9:00 a.m. – 10:00 a.m.
PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building #3, Conference Room B, Tallahassee, Florida
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: Alyssa Anderson at the Bureau of Medicaid Services, (850)487-3056. 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: Alyssa Anderson, Bureau of Medicaid Services, 2727 Mahan Drive, Mail Stop 20, Tallahassee, Florida 32308, (850)487-3056
THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:
59G-4.230 Physician Services.
(1) No change.
(2) All physician services providers enrolled in the Medicaid program must be in compliance with the Florida Medicaid Physician Services Coverage and Limitations Handbook, January 2010 January 2007, errata January 2007, updated January 2007 and May 2007, which is incorporated by reference, and the Florida Medicaid Provider Reimbursement Handbook, CMS-1500, which is incorporated by reference in Rule 59G-4.001, F.A.C. Both handbooks are available from the Medicaid fiscal agent’s website at www.mymedicaid-florida.com http://floridamedicaid.acs-inc.com. Click on Public Information for Providers, Provider Support, and then on Provider Handbooks. Paper copies of the handbooks may be obtained by calling Provider Enrollment at (800)377-8216.
(3) through (5) No change.
Rulemaking Specific Authority 409.919 FS. Law Implemented 409.905, 409.907, 409.908, 409.9081 FS. History–New 1-1-77, Revised 2-1-78, 4-1-78, 1-2-79, 1-1-80, Amended 2-8-82, 3-11-84, Formerly 10C-7.38, Amended 1-10-91, 11-5-92, 1-7-93, Formerly 10C-7.038, Amended 6-29-93, 9-6-93, Formerly 10P-4.230, Amended 6-13-94, 2-9-95, 3-10-96, 5-28-96, 3-18-98, 9-22-98, 8-25-99, 4-23-00, 8-5-01, 2-20-03, 8-5-03, 8-3-04, 8-18-05, 8-31-05, 10-26-06, 2-11-07, 5-7-07, 7-2-07, 11-15-07,_________.