Case Name: Annie Elizabeth KEARSE, Appellant, v. DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES, Appellee
Court: Florida District Court of Appeal
Jurisdiction: Florida
Decision Date: 1985-04-23
Citations: 474 So. 2d 819
Docket Number: No. BA-62
Parties: Annie Elizabeth KEARSE, Appellant, v. DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES, Appellee.
Judges: SMITH and ZEHMER, JJ., concur.
Reporter: Southern Reporter, Second Series
Volume: 474
Pages: 819–820

Head Matter:
Annie Elizabeth KEARSE, Appellant, v. DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES, Appellee.
No. BA-62.
District Court of Appeal of Florida, First District.
April 23, 1985.
On Rehearing Aug. 20, 1985.
Rehearing Denied Sept. 19, 1985.
Marilyn G. Rose and Mark H. Greenberg, and Amy E. Hirsch, Jacksonville, for appellant.
Theodore E. Mack, Asst. Gen. Counsel, Tallahassee, for appellee.

Opinion:
BARFIELD, Judge.
In this appeal Annie Elizabeth Kearse seeks review of the final order of the Division of Administrative Hearings upholding the validity of proposed Florida Administrative Code Rule IOC-7.65. Appellant attacks the rule as being invalid because of an inadequate economic impact statement; violative of the federal regulations regarding the cost effectiveness of Medicaid programs; violative of the federal regulations by leaving selection of participants to the unfettered discretion of the agency's employees; and violative of the federal regulations regarding access to necessary medical care.
We hold that the proposed rule is valid and the order of the Division of Administrative Hearings is affirmed. In so holding, we find it necessary to comment specifically on one aspect of the rule. The proposed rule provides that participants at Levels Three and Four of the program must obtain the prior approval of a case manager for reimbursement of non-emergency medical services. Proposed F.A.C. Rule 10C-7.65(8)(c) and (d). After the fact approval may be granted for emergency services. Id. "Emergency services" are defined in the rule as: "[Tjhose services . necessary to prevent death, serious impairment to the health of the recipient, or irreparable damage, or loss or serious impairment of a body function." Id. at (2)(1).
Appellant attacks the rule, contending that there are medically necessary services which do not qualify as emergency services and for which payment would be denied under the rule if a case manager were not available to authorize the services before they were performed. The concern of the appellant appears well-taken under the language of the rule; however, deference is given to the agency interpretation which differs from that of the appellant and which we find to be controlling in this case and binding on the agency. State Department of Health and Rehabilitative Services v. Framat Realty, Inc., 407 So.2d 238, 242 (Fla. 1st DCA 1981). That interpretation is that a provider of medically necessary services need only notify the case manager at a reasonable time following provision of such services when they were performed after hours, on the weekend, or such other time when the case manager was not available for "prior" approval.
AFFIRMED.
SMITH and ZEHMER, JJ., concur.