59G-13.130: Traumatic Brain and Spinal Cord Injury Services
59G-13.132: Traumatic Brain and Spinal Cord Injury Waiver Disposable Incontinence Medical Supplies Procedure Codes and Fee Schedule
PURPOSE AND EFFECT: The purpose of the rule amendment to Rule 59G-13.130, F.A.C., is to incorporate by reference in rule the revised Florida Medicaid Traumatic Brain and Spinal Cord Injury Waiver Services Coverage and Limitations Handbook, January 2009. The handbook was updated to remove Appendix A, TBI/SCI Waiver Services Procedure Codes, Reimbursement and Maximum Limits. The procedure codes, reimbursement and maximum limits are being incorporated by reference in new Rule 59G-13.131, F.A.C. The revised handbook also includes a revised Prioritization Screening Instrument, AHCA-Med Serv Form 042; clarification that services cannot be reimbursed through the waiver if they are available through another funding source; and updated references for the new Medicaid fiscal agent. The rule was also amended to replace references to the Florida Medicaid Provider Reimbursement Handbook, Non-Institutional 081, with the Florida Medicaid Provider Reimbursement Handbook, CMS-1500. The effect will be to incorporate by reference in rule the Florida Medicaid Traumatic Brain and Spinal Cord Injury Waiver Services Coverage and Limitations Handbook, January 2009.
The purpose of the new Rule 59G-13.132, F.A.C., is to incorporate by reference in rule the Traumatic Brain and Spinal Cord Injury Waiver Services Disposable Incontinence Medical Supplies Procedure Codes and Fee Schedule and Quality Standards that are effective January 2009. The effect will be to incorporate by reference in rule the Traumatic Brain and Spinal Cord Injury Waiver Disposable Incontinence Medical Supplies Procedure Codes and Fee Schedule and Quality Standards, January 2009.
SUBJECT AREA TO BE ADDRESSED: Traumatic Brain and Spinal Cord Injury Waiver Services and Traumatic Brain and Spinal Cord Injury Waiver Disposable Incontinence Medical Supplies Procedure Codes and Fee Schedule.
SPECIFIC AUTHORITY: 409.919 FS.
LAW IMPLEMENTED: 409.906, 409.907, 409.908, 409.912 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: Thursday, December 11, 2008, 1:00 p.m.
PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room D, Tallahassee, Florida
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Arlene Walker, Bureau of Medicaid Services, 2727 Mahan Drive, MS #20, Tallahassee, Florida 32308-5403, (850)410-1570, walkerar@ahca.myflorida.com
THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:
59G-13.130 Traumatic Brain and Spinal Cord Injury Services
(1) No change.
(2) All traumatic brain and spinal cord injury waiver services providers enrolled in the Medicaid program must be in compliance with the Florida Medicaid Traumatic Brain and Spinal Cord Injury Waiver Services Coverage and Limitations Handbook, January 2009 April 2006, incorporated by reference, and the Florida Medicaid Provider Reimbursement Handbook, CMS-1500 Non-Institutional 081, which is incorporated by reference in Rule 59G-4.001 59G-13.001, F.A.C. Both handbooks are available from the Medicaid fiscal agent’s Web Portal at http://mymedicaid-florida.com. 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.
(3) The following forms that are included in the Florida Medicaid Traumatic Brain and Spinal Cord Injury Waiver Services Coverage and Limitations Handbook are incorporated by reference:
(a) Appendix B C contains the Home and Community-Based Waiver Referral Agreement, AHCA Med-Serv Form 039, April 2006, seven pages. The form is available by photocopying it from the handbook.;
(b) Appendix C D contains the Brain and Spinal Cord Injury Program Request for Level of Care, AHCA Med Serv Form 040, April 2006, two pages. The form is available by photocopying it from the handbook.;
(c) Appendix D E contains the Notification of Level of Care, DOEA-CARES Form 603 (Revised March 2003), which is incorporated by reference in Rule 59G-13.030, F.A.C. The form is mailed to the provider by the Department of Elder Affairs, CARES Unit.;
(d) Appendix E F contains the Brain and Spinal Cord Injury Program Waiting List Policy for the Traumatic Brain/ Spinal Cord Injury Medicaid Waiver Program, April 2006, five pages, and the Home and Community-Based Medicaid Waiver Referral Prioritization Screening Instrument, AHCA-Med Serv Form 042, January 2009 April 2006, four pages. The form is available by photocopying it from the handbook.;
(e) Appendix F G contains the Notice of Decision, AHCA-Med Serv Form 043, April 2006, two pages. The form is mailed to the recipient by the Medicaid Waiver Specialist.;
(f) Appendix G H contains the Brain and Spinal Cord Injury Program Medicaid Home and Community-Based Waiver Service Plan, AHCA-Med Serv Form 044, April 2006, one page. The form is available by photocopying it from the handbook.
Specific Authority 409.919 FS. Law Implemented 409.906, 409.907, 409.908, 409.912 FS. History–New 5-31-06, Amended________.
59G-13.032 Traumatic Brain and Spinal Cord Injury Waiver Disposable Incontinence Medical Supplies Procedure Codes and Fee Schedule.
(1) This rule applies to all traumatic brain and spinal cord injury waiver services providers enrolled in the Medicaid program.
(2) All traumatic brain and spinal cord injury waiver services providers enrolled in the Medicaid program must be in compliance with the Traumatic Brain and Spinal Cord Injury Waiver Disposable Incontinence Medical Supplies Procedure Codes and Fee Schedule, January 2009, and Quality Standards, January 2009, which are incorporated by reference. The Traumatic Brain and Spinal Cord Injury Waiver Disposable Incontinence Medical Supplies Procedure Codes and Fee Schedule and Quality Standards are available from the Medicaid fiscal agent’s Web Portal at http://mymedicaid-florida.com. Click on Public Information for Providers, then on Provider Support, and then on Fee Schedules. Paper copies may be obtained from the Agency for Health Care Administration, Bureau of Medicaid Services, 2727 Mahan Drive, M.S. 20, Tallahassee, Florida 32308.
Specific Authority 409.919 FS. Law Implemented 409.906, 409.908 FS. History–New_________.