59G-13.130: Traumatic Brain and Spinal Cord Injury Services
PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-13.130, F.A.C., is to incorporate by reference in rule the revised Florida Medicaid Traumatic Brain and Spinal Cord Injury Waiver Services Coverage and Limitations Handbook, July 2010. The handbook includes a revised Prioritization Screening Instrument, AHCA-Med Serv Form 042; clarifies that services cannot be reimbursed through the waiver if they are available through another funding source; updates references for the new Medicaid fiscal agent; replaces references to the Florida Medicaid Provider Reimbursement Handbook, Non-Institutional 081, with the Florida Medicaid Provider Reimbursement Handbook, CMS-1500; adds language describing the addition of Medicaid Waiver Specialists to the operating structure of the waiver and identifies their functions; and adds language describing Nursing Home Transition activities and the two services added to the waiver to assist individuals with transition from nursing home to community setting.
SUBJECT AREA TO BE ADDRESSED: Traumatic Brain and Spinal Cord Injury Waiver Services.
SPECIFIC AUTHORITY: 409.919 FS.
LAW IMPLEMENTED: 409.902, 409.906, 409.907, 409.908, 409.912, 409.913 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: Monday, May 24, 2010, 2:00 p.m. – 3:00 p.m.
PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room C, 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: Arlene Walker at the Bureau of Medicaid Services, (850)412-4270. 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: Arlene Walker, Medicaid Services, 2727 Mahan Drive, Mail Stop 20, Tallahassee, Florida 32308-5407, telephone: (850)412-4270, e-mail: arlene.walker@ahca.myflorida.com
THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:
59G-13.130 Traumatic Brain and Spinal Cord Injury Services.
(1) No change.
(2) All traumatic brain and spinal cord injury waiver services providers enrolled in the Medicaid program must be in compliance with the Florida Medicaid Traumatic Brain and Spinal Cord Injury Waiver Services Coverage and Limitations Handbook, July 2010 April 2006, 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 59G-13.001, F.A.C. Both handbooks 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 Provider Handbooks. Paper copies of the handbooks may be obtained by calling the Provider Contact Center at (800)289-7799 and selecting Option 7.
(3) The following forms that are included in the Florida Medicaid Traumatic Brain and Spinal Cord Injury Waiver Services Coverage and Limitations Handbook are incorporated by reference:
(a) Appendix B C contains the Home and Community-Based Waiver Referral Agreement, AHCA Med-Serv Form 039, April 2006, seven pages. The form is available by photocopying it from the handbook.;
(b) Appendix C D contains the Brain and Spinal Cord Injury Program Request for Level of Care, AHCA Med Serv Form 040, April 2006, two pages. The form is available by photocopying it from the handbook.;
(c) Appendix D E contains the Notification of Level of Care, DOEA-CARES Form 603 (Revised March 2003), which is incorporated by reference in Rule 59G-13.030, F.A.C. The form is mailed to the provider by the Department of Elder Affairs, CARES Unit.;
(d) Appendix E F contains the Brain and Spinal Cord Injury Program Waiting List Policy for the Traumatic Brain/ Spinal Cord Injury Medicaid Waiver Program, April 2006, five pages, and the Home and Community-Based Medicaid Waiver Referral Prioritization Screening Instrument, AHCA-Med Serv Form 042, January 2009 April 2006, four pages. The form is available by photocopying it from the handbook.;
(e) Appendix F G contains the Notice of Decision, AHCA-Med Serv Form 043, April 2006, two pages. The form is mailed to the recipient by the Medicaid Waiver Specialist.;
(f) Appendix G H contains the Brain and Spinal Cord Injury Program Medicaid Home and Community-Based Waiver Service Plan, AHCA-Med Serv Form 044, April 2006, one page. The form is available by photocopying it from the handbook.
Rulemaking Specific Authority 409.919 FS. Law Implemented 409.902, 409.906, 409.907, 409.908, 409.912, 409.913 FS. History– New 5-31-06, Amended________.