59G-4.200: Nursing Facility Services
PURPOSE AND EFFECT: The purpose of this rule amendment is to incorporate by reference Update July 2007 to the Florida Medicaid Nursing Facility Services Coverage and Limitations Handbook and Update July 2007 to the Florida Medicaid Provider Reimbursement Handbook, Institutional 021. The handbooks were updated to revise Medicaid’s payment methodology for nursing facility Medicare Part A coinsurance. In accordance with the General Appropriations Act for 2007-2008, Medicaid will no longer pay the Medicare Part A coinsurance for nursing facility services if the Medicare payment equals or exceeds what Medicaid would have paid if it had been the sole payer.
The Florida Medicaid Provider Reimbursement Handbook, Institutional 021, update also includes a correction to third party liability policy and clarification of the patient responsibility policies.
The effect of the rule amendment to Rule 59G-4.200, F.A.C., will be to incorporate by reference in rule update July 2007 to the Florida Medicaid Nursing Facility Services Coverage and Limitations Handbook and update July 2007 to the Florida Medicaid Provider Reimbursement Handbook, Institutional 021.
SUBJECT AREA TO BE ADDRESSED: Nursing Facility Services.
SPECIFIC AUTHORITY: 409.919 FS.
LAW IMPLEMENTED: 409.902, 409.905, 409.908 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:
TIME AND DATE: Wednesday, July 25, 2007, 2:00 p.m.
PLACE: Agency for Health Care Administration, 2727 Fort Knox Boulevard, Building 3, Conference Room C, Tallahassee, Florida 32308
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Susan Rinaldi, Medicaid Services, 2727 Mahan Drive, Building 3, Mail Stop 20, Tallahassee, Florida 32308-5407, (850)487-3028, Rinaldis@ahca.myflorida.com
THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:
59G-4.200 Nursing Facility Services.
(1) No change.
(2) All participating nursing facility providers must comply with the provisions of the Florida Medicaid Nursing Facility Services Coverage and Limitations Handbook, October 2003, updated July 2004, erratum to the July 2004 update, and July 2007, and the corresponding Florida Medicaid Provider Reimbursement Handbook, Institutional 021, October 2003, updated July 2007, which are incorporated by reference. Both handbooks are available from the Medicaid fiscal agent’s website at http://floridamedicaid.acs-inc.com. Click on Provider Support, and then on Handbooks. Paper copies of the handbook may be obtained by calling the Medicaid fiscal agent at (800)377-8216.
(3) No change.
Specific Authority 409.919 FS. Law Implemented Chapter 400 Part II, 409.902, 409.905, 409.908 FS. History–New 1-1-77, Amended 6-13-77, 10-1-77, 1-1-78, 2-1-78, 12-28-78, 2-14-80, 4-5-83, 1-1-84, 8-29-84, 9-1-84, 9-5-84, 7-1-85, Formerly 10C-7.48, Amended 8-19-86, 6-1-89, 7-2-90, 6-4-92, 8-5-92, 11-2-92, 7-20-93, Formerly 10C-7.048, Amended 11-28-95, 5-9-99, 10-15-00, 10-4-01, 2-10-04, 9-28-04, 8-31-05, 7-23-06,_________.