14985935, 59G-6.020 - Florida Administrative Rules, Law, Code, Register

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Florida Department of State and Division of Library and Information Services

Notice: 14985935

Notice of Proposed Rule

Department:

AGENCY FOR HEALTH CARE ADMINISTRATION

Division:

Medicaid

Chapter:

REIMBURSEMENT TO PROVIDERS

Overview

RULE:

59G-6.020

Payment Methodology for Inpatient Hospital Services

PURPOSE:

The purpose of the amendment to Rule 59G-6.020 is to incorporate by reference the Title XIX Inpatient Hospital Reimbursement Plan (the Plan), Version XL, effective July 1, 2013.

SUMMARY:

The amendment will update the Plan to reflect changes authorized in Senate Bill 1500, 2013-14 General Appropriations Act, Specific Appropriation 208, and Section 6, Senate Bill 1502, 2013-14 Implementing Bill. The changes include the criteria for certain hospitals to adjust their prior Medicaid inpatient trend adjustment, adjustments for inpatient reimbursement limitations, the methodology for a Diagnosis Related Group (DRG) based reimbursement system, the elimination of the methodology for cost based hospital reimbursement, special Medicaid payments to Winter Haven Hospital, a reconciliation of transitional DRG payments, the methodology of the upper payment limit (UPL) demonstration, a detailed description of the protocol used to determine certified public expenditures (CPEs) for state-owned psychiatric hospitals, the repeal of the Community Hospital Education Act as established in s. 381.0403, F.S., and the implementation of the Statewide Medicaid Residency Program as established in Senate Bill 1520, which creates s.409.909, Florida Statutes.

RULEMAKING AUTHORITY:

409.919 FS.

LAW:

409.905(5), 409.908, 409.909, 409.9113, 409.9115, 409.9116, 409.9118, 409.9119, and 409.913 F.S.

PRINT PUBLISH DATE:

8/27/2014 Vol. 40/167

COMMENTS:

From 8/27/2014 To 9/17/2014 (21 Days)
The public comment period for this notice has already expired.

REFERENCE MATERIALS:

No reference(s).

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