8807326, 59G-6.045 - Florida Administrative Rules, Law, Code, Register

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Notice: 8807326

Notice of Development of Rulemaking

Department:

AGENCY FOR HEALTH CARE ADMINISTRATION

Division:

Medicaid

Chapter:

REIMBURSEMENT TO PROVIDERS

Overview

RULE:

59G-6.045

Payment Methodology for Services in Facilities Not Publicly Owned and Not Publicly Operated (Facilities Formerly Known as ICF-MR/DD Facilities)

PURPOSE:

The purpose and effect of the proposed rule development is to incorporate changes to the Florida Title XIX Intermediate Care Facilities (ICF) for the Mentally Retarded and the Developmentally Disabled Facilities not Publicly Owned and not Publicly Operated Reimbursement Plan (the Plan) Effective July 1, 2010, the Agency will amend Florida Title XIX Intermediate Care Facilities (ICF) for the Mentally Retarded and the Developmentally Disabled Facilities not Publicly Owned and not Publicly Operated Reimbursement Plan (the Plan) to address the following cost reporting issues:
1. Clarifying the definition of a late cost report and late cost report acceptance procedures.
2. Resubmissions of cost reports by providers.
3. Development of a sanction process (possibly a daily fine) for late cost reports including reimbursement at the lowest per diem by class or area.
4. Development of new policies and procedures regarding AHCA’s ability to recoup overpayments.
5. AHCA reserves the right to submit any provider found to be out of compliance with cost reporting policies and procedures to Medicaid Program Integrity for investigation of Medicaid fraud and abuse.

SUBJECT:

Florida Medicaid Title XIX Intermediate Care Facilities (ICF) for the Mentally Retarded and the Developmentally Disabled Facilities not publicly owned and not publicly operated cost reporting policies and procedures.

RULEMAKING AUTHORITY:

409.919 FS.

LAW:

409.908 FS.

PRINT PUBLISH DATE:

6/25/2010 Vol. 36/25

RELATED STATUTES
AND LAWS:

409.919 FS., 409.908 FS.

OVERSIGHT COMMITTEE:

Joint Administrative Procedures Committee
Florida Administrative Law Central Online Network (F.A.L.C.O.N.)

RELATED COURT CASES:

Division of Administrative Hearings

FEDERAL eRULEMAKING
WEB PORTAL:

Regulations.gov

HOW TO LINK TO
THIS NOTICE:

http://flrules.org/gateway/ruleno.asp?id=59G-6.045&PDate=6/25/2010&Section=1

REFERENCE MATERIALS:

No reference(s).

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