59G-5.020: Provider Requirements
PURPOSE AND EFFECT: The purpose of this rule amendment is to incorporate by reference the revised Florida Medicaid Provider General Handbook, July 2008. The handbook revisions include the new Medicaid fiscal agent’s contact information, updated Medicaid provider enrollment procedures, and updated Medicare-Medicaid crossover policies. The revised handbook also includes the time standard for claim submission and special billing requirements. The effect of the rule amendment to Rule 59G-5.020, F.A.C., will be to incorporate by reference in rule the Florida Medicaid Provider General Handbook, July 2008.
SUBJECT AREA TO BE ADDRESSED: Provider Requirements.
SPECIFIC AUTHORITY: 409.919 FS.
LAW IMPLEMENTED: 409.902, 409.905, 409.906, 409.907, 409.908, 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:
TIME AND DATE: Tuesday, April 29, 2008, 1:30 p.m. – 2:30 p.m.
PLACE: Agency for Health Care Administration, 2728 Fort Knox Boulevard, Building 3, Conference Room D, Tallahassee, Florida 32308
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Karen Girard, Medicaid Services, 2727 Mahan Drive, Building 3, Mail Stop 20, Tallahassee, Florida 32308-5407, (850)488-9711, girardk@ahca.myflorida.com
THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:
59G-5.020 Provider Requirements.
(1) All Medicaid providers enrolled in the Medicaid program and billing agents who submit claims to Medicaid on behalf of an enrolled Medicaid provider must comply with the provisions of the Florida Medicaid Provider General Handbook, July 2008 January 2007, which is incorporated by reference and available from the fiscal agent’s website at http://mymedicaid-Florida.com floridamedicaid.acs-inc.com. Click on Provider Support, and then on Handbooks. A pPaper copy of the handbook may be obtained by calling the Medicaid fiscal agent Provider Enrollment at (800)289-7799 and selecting Option 4 377-8216.
(2) The following form is incorporated by reference: AHCA Form 2200-0004, March 2008 January 2007, Medicaid Provider Change Declaration of Service Address Request, one page. The form is available from the Medicaid fiscal agent’s website at http://mymedicaid-Florida.com floridamedicaid.acs-inc.com. Click on Provider Support, and then on Enrollment. The form may also be obtained from the Medicaid fiscal agent by calling Provider Enrollment at (800)289-7799 and selecting Option 7 377-8216.
(3) The following forms that are included in the Florida Medicaid Provider General Handbook are incorporated by reference. In Chapter 3, Temporary Emergency Medicaid Identification Card, January 2007; one page; CF-ES 2681, Feb 2003, Notice and Proof of Presumptive Eligibility for Medicaid for Pregnant Women, one page; CF-ES Form 2014, Feb 2003, Authorization for Medicaid/Medikids Eligibility, one page; AHCA Form 5240-006, Unborn Activation Form, January 2007, one page; CF-ES 2039, Sep 2002, Medical Assistance Referral, two pages.; In Chapter 3, and the CTEC-07, Revised March 2003, Crossover with TPL Claim and/or Adjustment Form, one page. In Chapter 6, Florida Medicaid Authorization Request, PA01 04/2002, one page; Medically Needy Billing Authorization, DF-ES 2902, June 2003, one page; State of Florida, Sterilization Consent Form, SCF 7/94, one page; State of Florida, Hysterectomy Acknowledgment Form, HAF 07/1999, one page; State of Florida, Exception to Hysterectomy Acknowledgment Requirement, ETA 07/2001, one page; State of Florida, Abortion Certification Form, AHCA-Med Serv Form 011, August 2001, one page and the Healthy Start Prenatal Risk Screening Instrument, DH 3134, 9/97, one page. The CF-ES forms are available from the Department of Children and Family Services. The Healthy Start Prenatal Risk Screening Instrument is available from the local County Health Department. The other forms are available from the Medicaid fiscal agent’s website at http://mymedicaid-Florida.com floridamedicaid.acs-inc.com. Click on Provider Support, and then on Handbooks. Paper copies of the forms may be obtained by calling the Medicaid fiscal agent Provider Enrollment at (800)289-7799 and selecting Option 7 377-8216.
Specific Authority 409.919 FS. Law Implemented 409.902, 409.905, 409.906, 409.907, 409.908, 409.912, 409.913 FS. History–New 9-22-93, Formerly 10P-5.020, Amended 7-8-97, 1-9-00, 4-24-01, 8-6-01, 10-8-03, 1-19-05, 5-24-07,_________.