Notice of Change/Withdrawal

59G-5.020: Provider Requirements
Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 33 No. 8, February 23, 2007 issue of the Florida Administrative Weekly.

        These changes are in response to comments received from the Joint Administrative Procedures Committee.

        The rule incorporates by reference the Florida Medicaid Provider General Handbook, January 2007. The handbook requires providers who render services at more than one service address under a single license or certification to submit an AHCA Form 2200-0004, Declaration of Service Address, January 2007, to identify each separate physical address where services are provided. We added the following first sentence to 59G-5.020(2), “The following form is incorporated by reference: AHCA Form 2200-0004, January 2007, Declaration of Service Address, one page. The form is available from the Medicaid fiscal agent’s website at Click on Provider Support, and then on Enrollment. The form may also be obtained from the Medicaid fiscal agent by calling Provider Enrollment at 800-377-8216.

        The following changes were made to the handbook.

        Page 1-6, Billing the Recipient, we corrected the third bullet to read, “The recipient is enrolled in a Medicaid managed care program and has been informed that the particular service has not been authorized by the recipient’s primary care provider.”

        Page 1-21, Emergency Services Under MediPass, we corrected the statute citation to section 409.9128, F.S.

        Page 2-8, Effective Date of Enrollment, was revised to read, “Effective July 1, 2006, upon approval of a fully completed application, the effective date for a new provider is the date the application was received. With respect to applicants who primarily provide emergency medical services transportation or emergency services and care, upon approval of the provider application, the effective date will be the date of service. With respect to providers who were recently granted a change of ownership, the effective date is either the date the application was received; the date the transfer of ownership was finalized; or the date the new owner’s license or any required certification became effective, whichever is later. With respect to providers who require Medicare certification, the effective date will be the Medicare certification date.”

        Page 2-15, Multiple Service Locations under a Single License or Certification, in the first and third paragraph, we added the form number and date for the Declaration of Service Address form.

        Page 4-19, How to File Paper Crossover Claims on the UB-92, sixth bullet, third sentence, we changed “reasonable facsimile” to “legible facsimile.”