RULE NO.: RULE TITLE:
59G-4.160: Outpatient Hospital Services
PURPOSE AND EFFECT: The purpose of the amendment to Rule 59G-4.160, F.A.C., is to incorporate by reference the revised Florida Medicaid Hospital Services Coverage and Limitations Handbook, July 2011. The changes to the handbook will specify that the use of general classification codes 450 and 451 will be reimbursed based on a line item rate, the addition of Intrathecal Baclofen Therapy (ITB) information, and change from UB-92 to UB-04. The handbook has been revised to provide updated information on Appendix B with information on 0450 and 0451 revenue codes and includes Intrathecal Baclofen Therapy.
SUBJECT AREA TO BE ADDRESSED: Outpatient Hospital Services.
An additional area to be addressed during the workshop will be the potential regulatory impact Rule 59G-4.160, F.A.C., will have as provided for under Sections 120.54 and 120.541, F.S.
RULEMAKING AUTHORITY: 409.919 FS.
LAW IMPLEMENTED: 409.902, 409.905, 409.907, 409.908, 409.9081, 409.912, 409.913 FS.
IF REQUESTED IN WRITING AND NOT DEEMED UNNECESSARY BY THE AGENCY HEAD, A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
DATE AND TIME: Tuesday, August 2, 2011, 2:00 p.m. – 4:00 p.m.
PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room A, Tallahassee, Florida 32308-5407
Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 48 hours before the workshop/meeting by contacting: Pamela Kyllonen at the Bureau of Medicaid Services, (850)412-4211. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Pamela Kyllonen, Medicaid Services, 2727 Mahan Drive Mail Stop 20, Tallahassee, Florida 32308-5407, telephone: (850)412-4211, e-mail: pamela.kyllonen@ahca.myflorida.com

THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:

59G-4.160 Outpatient Hospital Services.

(1) No change.

(2) All hospital providers enrolled in the Medicaid program must comply with the provisions of the Florida Medicaid Hospital Services Coverage and Limitations Handbook, July 2011 June 2005, incorporated by reference, and the Florida Medicaid Provider Reimbursement Handbook, UB-04 incorporated by reference in Rule 59G-4.003, F.A.C. The Both handbooks is are available from the Medicaid fiscal agent’s Web site Portal at www. http://mymedicaid-florida.com. Select Click on Public Information for Providers, then on Provider Support, and then on Provider Handbooks. Paper copies of the handbooks may be obtained by calling the Provider Contact Center at (800)289-7799 and selecting Option 7.

Rulemaking Specific Authority 409.919 FS. Law Implemented 409.902, 409.905, 409.907, 409.908, 409.9081, 409.912, 409.913 FS. History–New 1-1-77, Revised 12-7-78, 1-18-82, Amended 7-1-83, 7-16-84, 7-1-85, 10-31-85, Formerly 10C-7.40, Amended 9-16-86, 2-28-89, 5-21-91, 5-13-92, 7-12-92, 1-5-93, 6-30-93, 7-20-93, 12-21-93, Formerly 10C-7.040, Amended 6-13-94, 12-27-94, 2-21-95, 9-11-95, 11-12-95, 2-20-96, 10-27-98, 5-12-99, 10-18-99, 3-22-01, 8-12-01, 2-25-03, 8-14-03, 11-28-04, 8-18-05, 1-10-06, 4-16-06, 2-25-09, __________.