11763013, 59G-6.030 - Florida Administrative Rules, Law, Code, Register

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Notice: 11763013

Notice of Proposed Rule

Department:

AGENCY FOR HEALTH CARE ADMINISTRATION

Division:

Medicaid

Chapter:

REIMBURSEMENT TO PROVIDERS

Overview

RULE:

59G-6.030

Payment Methodology for Outpatient Hospital Services

PURPOSE:

: The purpose of this rule is to incorporate by reference the Florida Title XIX Outpatient Hospital Reimbursement Plan (the Plan), effective July 1, 2011. The Plan, effective July 1, 2011, includes the addition of a reference to Rule Number 59G-9.070, F.A.C., for the amount of late cost report sanctions; a reimbursement rate reduction (Medicaid trend adjustment); exemptions from reimbursement ceilings; the opportunity for certain hospitals to buy back their reimbursement rate reductions; a rate freeze on inpatient hospital reimbursement rates; the establishment of hospitals rates being set once a year every July 1; revisions to buy back descriptions; the addition of definitions for a hospital buy back, rate setting unit cost, legislative unit cost, and a base rate; and the addition of an appendix explaining Provider Preventable Conditions (PPC).

SUMMARY:

The proposed rule incorporates changes to the Florida Title XIX Inpatient Hospital Reimbursement Plan (the Plan) payment methodology, effective July 1, 2011 for a recurring reimbursement rate reduction (Medicaid trend adjustment), exemptions, buy backs, specification of the rule for the amount of cost report sanctions, a reimbursement rate freeze, an annual reimbursement rate calculation, and addition of definitions, and an appendix for PPCs.

RULEMAKING AUTHORITY:

409.919 FS.

LAW:

409.908 FS.

PRINT PUBLISH DATE:

7/20/2012 Vol. 38/29

COMMENTS:

From 7/20/2012 To 8/10/2012 (21 Days)
The public comment period for this notice has already expired.

REFERENCE MATERIALS:

No reference(s).

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