59G-1.060 : Provider Enrollment Policy - Florida Administrative Rules, Law, Code, Register

Florida Department of State and Division of Library and Information Services

Rule: 59G-1.060 Prev Up Next

Rule Title: Provider Enrollment Policy
Department:	AGENCY FOR HEALTH CARE ADMINISTRATION	Add to MyFLRules Favorites
Division:	Medicaid
Chapter:	GENERAL MEDICAID

Latest version of the final adopted rule presented in Florida Administrative Code (FAC):

	Effective Date:	2/9/2022
	History Notes:	Rulemaking Authority 409.919, 409.961 FS. Law Implemented 409.907, 409.973 FS. History–New 12-25-19, Amended 2-9-22.
	References in this version:	Ref-11332 Case Manager Certification, AHCA Form 5000-3537, May 2014 Ref-11333 Case Manager Supervisor Certification Targeted Case Management for Children at Risk of Abuse and Neglect, AHCA Form 5000-3536, May 2014 Ref-11334 Comprehensive Behavioral Health Assessment Agency and Practitioner Self-Certification, AHCA Form 5000-3512, May 2014 Ref-11335 Contractor Certification for Children’s Services Council, AHCA Form 5000-3535, May 2014 Ref-11336 County Health Department Agreement Provider Credentialing of Behavioral Health Providers and Social Workers, AHCA Form 5000-1066, June 2019 Ref-11337 Medical Foster Care Children’s Medical Services Local Medical Foster Care (MFC) Program Care Coordinator Attestation Checklist, AHCA Form 5000-1069, June 2019 Ref-11338 Physician Group Certificate of Ownership, AHCA Form 5000-1068, June 2019 Ref-11339 Practitioner Collaborative Agreement, AHCA Form 5000-1067, June 2019 Ref-11340 Provider Agency Certification for Children’s Services Council, AHCA Form 5000-3539, May 2014 Ref-11341 School District Assurance Agreement Provider Credentialing of Behavior Analysts, AHCA Form 5000-1162, June 2019 Ref-11342 School District Assurance Agreement Provider Credentialing of Behavioral Sciences Staff, AHCA Form 5000-1160, June 2019 Ref-11343 School District Assurance Agreement Provider Credentialing of Mental Health Counselors and Family Therapists, AHCA Form 5000-1161, June 2019 Ref-11344 School District Assurance Agreement Provider Credentialing of Psychologists, Behavior Analysts, and Social Workers, AHCA Form 5000-1163, June 2019 Ref-11345 School District Assurance Agreement Provider Credentialing of Registered Nurses and Licensed Practical Nurses, AHCA Form 5000-1164, June 2019 Ref-11346 School District Assurance Agreement Provider Credentialing of School Health Aides, AHCA Form 5000-1165, June 2019 Ref-11347 School District Assurance Agreement Provider Credentialing of Therapists and Therapy Assistants, AHCA Form 5000-1166, June 2019 Ref-11348 State of Florida Agency for Health Care Administration Florida Medicaid Provider Surety Bond, AHCA Form 5000-1064, June 2019 Ref-11349 Therapeutic Foster Care Provider Agency Self-Certification, AHCA Form 5000-3513, March 2014 Ref-11350 Electronic Data Interchange Agreement, AHCA Form 5000-1062, June 2019 Ref-13974 Florida Medicaid Provider Enrollment Policy, January 2022 Ref-13975 Florida Medicaid Provider Enrollment Application Out of State Fee for Service, AHCA Form 5000-1260, (JAN 2021) Ref-13976 Florida Medicaid Provider Enrollment Change of Ownership (CHOW) Disclosure Form-Hospital, Institutional Care (ICF) and Skilled Nursing Facility ONLY, AHCA Form 5000-1264, (JAN 2021) Ref-13977 Group Membership Authorization, AHCA Form 5000-1061, June 2019 Ref-13978 Non-profit Organization Certification-Fingerprinting Exemption, AHCA Form 5000-1261, (JAN 2021) Ref-13979 Special Exempt Entity Certification-Fingerprinting Exemption, AHCA Form 5000-1262, (JAN 2021)

History of this Rule since Jan. 6, 2006

Section	Description	ID	Publish Date

Final 59G-1.060	Provider Enrollment Policy	25495012	Effective: 02/09/2022
Change 59G-1.060	Provider Enrollment Policy	25340297	12/13/2021 Vol. 47/239
Proposed 59G-1.060	The purpose of the amendment to Rule 59G-1.060, Florida Administrative Code (F.A.C.), is to revise provider enrollment requirements and update the rule text.	25012437	9/15/2021 Vol. 47/179
Correction 59G-1.060	Provider Enrollment Policy	24551105	5/17/2021 Vol. 47/95
Public Meeting 59G-1.060	The Agency is scheduling the meeting for the purpose of discussing the draft Florida Medicaid Provider Enrollment Policy which is available .... May 27, 2021, 2:00 to 2:30 p.m. Remote Listeners: Attendees may register for the meeting at: ....	24551202	5/17/2021 Vol. 47/95
Public Meeting 59G-1.060	The Agency is scheduling the meeting for the purpose of discussing the draft Florida Medicaid Provider Enrollment Policy which is available .... May 14, 2021, 2:30-3:00 p.m. Remote Listeners: Attendees may register for the meeting at: ....	24540338	5/14/2021 Vol. 47/94
Public Meeting 59G-1.060	The Agency is rescheduling the original January 27, 2021 workshop published in Vol. 47, No. 8 on January 13, 2021, for the purpose of discussing .... February 5, 2021 from 2:30 p.m. – 3:00 p.m. Remote Listeners: Attendees may register for the workshop at: ....	24155248	1/29/2021 Vol. 47/19
Development 59G-1.060	The purpose of the amendment to Rule 59G-1.060, Florida Administrative Code (F.A.C.), is to revise provider enrollment requirements and update the rule text.	24093944	1/13/2021 Vol. 47/08
Final 59G-1.060	Provider Enrollment Policy	22691518	Effective: 12/25/2019
Correction 59G-1.060	Enrollment Policy	22584236	11/8/2019 Vol. 45/219
Change 59G-1.060	Enrollment Policy	22517694	10/23/2019 Vol. 45/207
Change 59G-1.060	Enrollment Policy	22414777	9/26/2019 Vol. 45/188
Public Hearing 59G-1.060	The Agency is scheduling a hearing for discussing the Florida Medicaid Provider Enrollment process and policy. August 14, 2019 from 1:30 p.m. to 2:30 p.m. Agency for Health Care Administration, 2727 Mahan Drive, Building ....	22212823	8/2/2019 Vol. 45/150
Proposed 59G-1.060	The purpose of Rule 59G-1.060, Florida Administrative Code, is to incorporate by reference the Florida Medicaid Provider Enrollment Policy, __________.	21815802	5/6/2019 Vol. 45/88
Public Meeting 59G-1.060	The Agency is holding a public meeting to discuss the Florida Medicaid Enrollment Policy. April 12, 2019; 10:00 a.m. - 11:00 a.m. Agency for Health Care Administration, 2727 Mahan Drive, Building ....	21703767	4/5/2019 Vol. 45/67
Development 59G-1.060	The purpose of rule 59G-1.060 is to incorporate by reference the Florida Medicaid Enrollment Policy, __________. The incorporated policy will specify enrollment requirements for individuals, groups, and entities seeking ....	17098110	2/2/2016 Vol. 42/21

Under Florida law, E-mail addresses are public records. If you do not want your E-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.