17362629, 59H-1.0035 - Florida Administrative Rules, Law, Code, Register

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Florida Department of State and Division of Library and Information Services

Notice: 17362629

Notice of Proposed Rule

Department:

AGENCY FOR HEALTH CARE ADMINISTRATION

Division:

Health Care Responsibility Program

Chapter:

FLORIDA HEALTH CARE INDIGENCY ELIGIBILITY CERTIFICATION STANDARDS

Overview

RULE:

59H-1.0035	Definitions
59H-1.0045	County Financial Responsibility
59H-1.0055	Hospital Participation
59H-1.0065	Covered Services
59H-1.008	Determination of a Qualified Indigent Patient
59H-1.010	Reimbursement Procedures
59H-1.015	Administrative Hearings, Applicant's Rights and Responsibilities

PURPOSE:

The Agency is amending the rules relating to HCRA to clarify definitions, remove outdated information, update the reimbursement rate notification reference, clarify timeliness of report submission requirements, implement standards for overpayment to hospitals and parties with rights to the appeal process.

SUMMARY:

Rule 59H-1.0035 is amended to change “individual” to “applicant” for clarification, remove outdated language, revise forms to be available on website, and update the name of the responsible Agency business unit.  Rule 59H-1.0045 is amended to change the term “per diem” to “reimbursement” to comply with the payment methodology for inpatient claims that are being revised to conform to legislative changes that became effective on July 1, 2013, to clarify submission timeliness, and update the name of the responsible Agency business unit.  Rule 59H-1.0055 is amended to update the name of the responsible Agency business unit, and add clarification that county is not responsible for payment until hospital has met its obligation.  Rule 59H-1.0065 is amended to remove outdated language.  Rule 59H-1.008 is amended to add that hospitals are responsible for assisting applicants in completing applications, to clarify submission timeliness, change notification requirements for certifying agencies, and make technical changes.  Rule 59H-1.010 is amended to clarify submission timeliness, and update name of form.  Rule 59H-1.015 is amended to clarify which parties have appeal rights and responsibility to repay any amount paid because of an inappropriate eligibility determination.

RULEMAKING AUTHORITY:

154.3105 FS.

LAW:

154.304, 154.306, 154.308, 154.309, 154.31, 154.312, 154.314 FS.

PRINT PUBLISH DATE:

3/31/2016 Vol. 42/63

COMMENTS:

From 3/31/2016 To 4/21/2016 (21 Days)
The public comment period for this notice has already expired.

REFERENCE MATERIALS:

No reference(s).

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