reglab/statecodes huggingface dataset:
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.120 - Statewide Inpatient Psychiatric Program

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule applies to all providers of the
				Statewide Inpatient Psychiatric Program who are enrolled in or registered with
				the Florida Medicaid program.
(2)
				All providers of the Statewide Inpatient Psychiatric Program must be in
				compliance with the provisions of the Florida Medicaid Statewide Inpatient
				Psychiatric Coverage Policy, December 2015, incorporated by reference. The
				policy is available on the Medicaid fiscal agent's website at
http://portal.flmmis.com/FLPublic
,
				and available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-06157
.
Rulemaking Authority 409.919 FS. Law Implemented 409.902,
					 409.906, 409.907, 409.908, 409.9081, 409.912, 409.913
					 FS.
New 1-3-16.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.125 - Behavior Analysis Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This
				rule applies to all providers rendering Florida Medicaid behavior analysis
				services to recipients.
(2) All
				providers must be in compliance with the provisions of the Florida Medicaid
				Behavior Analysis Services Coverage Policy, September 2023, incorporated by
				reference. The policy is available on the Agency for Health Care
				Administration's website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and at
https://www.flrules.org/Gateway/reference.asp?No=Ref-15896
.
(3) This rule is in effect for 5 years from
				its effective date.
Rulemaking Authority 409.919 FS. Law Implemented 409.906
					 FS.
New 2-19-17, Amended 10-29-17,
					 10-9-23.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.127 - Florida Assertive Community Treatment Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule applies to all providers
				rendering Florida Medicaid Florida Assertive Community Treatment Services to
				recipients.
(2) All providers must
				be in compliance with the provisions of the Florida Medicaid Florida Assertive
				Community Treatment Services Policy, December 2023, incorporated by reference.
				The policy is available on the Agency for Health Care Administration's website
				at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and at
http://www.flrules.org/Gateway/reference.asp?No=Ref-16146
.
(3) This rule is effective for five years
				after the effective date.
Rulemaking Authority 409.919 FS. Law Implemented 409.906
					 FS.
New 11-22-21, Amended
					 1-4-24.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.130 - Home Health Visit Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule
				applies to all providers rendering Florida Medicaid home health visit services
				to recipients.
(2) All providers
				must be in compliance with the provisions of the Florida Medicaid Home Health
				Visit Services Coverage Policy, November 2016, incorporated by reference. The
				policy is available on the Agency for Health Care Administration's (AHCA)
				website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and available at
https://www.flrules.org/Gateway/reference.asp?No=Ref-07500
.
(3) The following forms are incorporated by
				reference and are available on the AHCA website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and in the Florida Medicaid Home Health Visit Services Policy, November 2016.
(a) Parent or Legal Guardian Medical
				Limitations, AHCA Form 5000-3501, November 2016,
http://www.flrules.org/Gateway/reference.asp?No=Ref-07496
.
(b) Parent or Legal Guardian Work Schedule,
				AHCA Form 5000-3503, November 2016,
http://www.flrules.org/Gateway/reference.asp?No=Ref-07497
.
(c) Parent or Legal Guardian Statement of
				Work Schedule, AHCA Form 5000-3504, November 2016,
http://www.flrules.org/Gateway/reference.asp?No=Ref-07498
.
(d) Parent or Legal Guardian School Schedule,
				AHCA Form 5000-3505, November 2016,
http://www.flrules.org/Gateway/reference.asp?No=Ref-07499
.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.132 - Home Health Electronic Visit Verification Program

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule applies to providers enrolled
				directly in the Florida Medicaid program that furnish home health services
				(home health visits, private duty nursing, and personal care services) to
				recipients through the fee-for-service delivery system as specified on the
				Agency for Health Care Administration's (AHCA) website at
http://ahca.myflorida.com/Medicaid/home_health/dmv.shtml
in accordance with section
				409.9132, Florida Statutes
				(F.S.).
(2) Definition. Direct
				service provider - An individual who personally (face-to-face) provides
				services to recipients in accordance with rule
				59G-4.261,
				59G-4.215 or
				59G-4.130, Florida
				Administrative Code (F.A.C.).
(3)
				Home Health Electronic Visit Verification Program.
(a) All providers must comply with section
				409.9132, F.S.
(b) The Agency for Health Care Administration
				contracts with a vendor to electronically verify the delivery of home health
				services provided to recipients in their residence or other authorized setting.
1. Providers must document the home health
				service encounter for each recipient served (in accordance with the recipient's
				approved plan of care) and verify the delivery of the services rendered using
				AHCA's designated vendor's electronic visit verification (EVV)
				system.
2. Direct service providers
				must verify delivery of the service using the vendor's system at the beginning
				and end of each home health service encounter.
3. Providers must submit claims through
				AHCA's designated vendor's system to the Florida Medicaid fiscal agent for
				services rendered and verified in accordance with the prior authorization in
				the Florida Medicaid Management Information
				System.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.140 - Hospice Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule
				applies to all providers rendering Florida Medicaid hospice services to
				recipients.
(2) All providers must
				be in compliance with the provisions of the Florida Medicaid Hospice Services
				Coverage Policy, December 2021, incorporated by reference. The policy is
				available on the Agency for Health Care Administration's Web site at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and at
http://www.flrules.org/Gateway/reference.asp?No=Ref-13873
.
(3) This rule is in effect for five years
				from its effective date.
Rulemaking Authority 409.919, 409.961 FS. Law Implemented
					 409.906, 409.908, 409.973 FS.
New 1-1-87, Amended 10-9-90, 5-13-92, 10-8-92, Formerly
					 10C-7.0533, Amended 2-14-95, 12-27-95, 9-21-99, 8-4-04, 10-2-05, 8-27-06,
					 12-24-07, 6-2-16, 12-5-21.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.150 - Inpatient Hospital Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This
				rule applies to all providers rendering Florida Medicaid inpatient hospital
				services to recipients.
(2) All
				providers must be in compliance with the provisions of the Florida Medicaid
				Inpatient Hospital Services Coverage Policy, January 2024, incorporated by
				reference. The policy is available on the Agency for Health Care
				Administration's website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-16380
.
(3) The United States Department of Health
				and Human Services' Consent for Sterilization Form - HHS-687 (07/25), is
				incorporated by reference,
http://www.flrules.org/Gateway/reference.asp?No=Ref-16383
,
				and available at
https://opa.hhs.gov/grant-programs/title-x-service-grants/key-resources-title-x-grantees
.
(4) This rule is in effect for 5 years from
				its effective date.
Rulemaking Authority 409.919, 409.961 FS. Law Implemented
					 409.902, 409.905, 409.907, 409.908, 409.912, 409.913, 409.973
					 FS.
New 1-1-77, Amended 3-30-78, 1-2-79, 2-3-81, 7-28-81,
					 7-1-83, 3-1-84, 10-31-85, Formerly 10C-7.39, Amended 10-2-86, 2-28-89,
					 10-17-89, 10-14-90, 5-21-91, 11-14-91, 3-25-92, 5-13-92, 7-12-92, 8-9-93,
					 12-21-93, Formerly 10C-7.039, Amended 6-13-94, 12-27-94, 2-21-95, 9-11-95,
					 11-12-95, 2-20-96, 6-9-96, 5-12-99, 1-1-01, 2-25-09, 7-11-16,
					 4-3-24.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.160 - Outpatient Hospital Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This
				rule applies to all providers rendering Florida Medicaid outpatient hospital
				services to recipients.
(2) All
				providers must be in compliance with the provisions of the Florida Medicaid
				Outpatient Hospital Services Coverage Policy, August 2019, incorporated by
				reference. The policy is available on the Agency for Health Care
				Administration's website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
and available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-10811
.
(3) The United States Department of Health
				and Human Services' Consent for Sterilization Form - HHS-687 (10/12), is
				incorporated by reference,
http://www.flrules.org/Gateway/reference.asp?No=Ref-07025
,
				and available at
				http://www.hhs.gov/opa/pdfs/consent-for-sterilization-english-updated.pdf.
Rulemaking Authority 409.919, 409.961 FS. Law Implemented
					 409.902, 409.905, 409.907, 409.908, 409.912, 409.913, 409.973
					 FS.
New 1-1-77, Revised 12-7-78, 1-18-82, Amended 7-1-83,
					 7-16-84, 7-1-85, 10-31-85, Formerly 10C-7.40, Amended 9-16-86, 2-28-89,
					 5-21-91, 5-13-92, 7-12-92, 1-5-93, 6-30-93, 7-20-93, 12-21-93, Formerly
					 10C-7.040, Amended 6-13-94, 12-27-94, 2-21-95, 9-11-95, 11-12-95, 2-20-96,
					 10-27-98, 5-12-99, 10-18-99, 3-22-01, 8-12-01, 2-25-03, 8-14-03, 11-28-04,
					 8-18-05, 1-10-06, 4-16-06, 2-25-09, 6-25-12, 7-11-16,
					 9-8-19.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.165 - Inpatient Mental Health and Tuberculosis Hospital Services (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 409.919 FS. Law Implemented
					 409.905(5), 409.906(18), 409.908, 409.913(5)(e), (8)(h)
					 FS.
New 1-1-77, Amended 10-1-77, 3-10-83, Formerly 10C-7.46,
					 Amended 5-26-93, Formerly 10C-7.046, Repealed
					 7-2-06.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.170 - Intermediate Care Facility for Individuals with Intellectual Disabilities Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule
				applies to all providers rendering Florida Medicaid intermediate care facility
				for individuals with intellectual disabilities services to
				recipients.
(2) All providers must
				be in compliance with the provisions of the Florida Medicaid Intermediate Care
				Facility for Individuals with Intellectual Disabilities Services Coverage
				Policy, January 2023, incorporated by reference. The policy is available on the
				Agency for Health Care Administration's (AHCA) website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-14986
.
(3) The Intermediate Care Facility for
				Individuals with Intellectual Disabilities (ICF/IID) Utilization Review (UR)
				Plan, AHCA Form 5000-3009, July 2016, is incorporated by reference. The plan is
				available on the AHCA website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-07011
.
(4) This rule is in effect for five years
				from its effective date.
Rulemaking Authority 409.919 FS. Law Implemented 409.906,
					 409.908, 409.913 FS.
New 8-31-76, Amended 1-1-77, 10-16-77, 7-7-81, 4-12-83,
					 1-12-84, 7-2-84, 7-1-85, Formerly 10C-7.49, Amended 7-19-88, 6-4-92, 5-11-93,
					 Formerly 10C-7.049, Amended 11-27-95, 10-4-01, 1-23-05, 7-11-16,
					 1-11-23.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.171 - Intermediate Care Facilities for the Mentally Retarded/Developmentally Disabled; Recipient Eligibility Criteria (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 409.919 FS. Law Implemented
					 409.906(13), 409.908, 409.913(5)(e)
					 FS.
New 1-1-77, Amended 3-10-83, Formerly 10C-7.34, Amended
					 12-28-93, Formerly 10C-7.034, Repealed
					 7-11-16.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.180 - Intermediate Care Services

Current through Reg. 50, No. 138; July 16, 2024
(1) Purpose. This
				rule establishes the level of care criteria that must be met in order for
				nursing and rehabilitation services to qualify as intermediate care services
				and clarifies the criteria that must be met in order for such services to
				qualify as an intermediate level I or intermediate level II service under
				Medicaid.
(2) Definitions as used
				in this section.
(a) Intermediate care nursing
				home resident. A Medicaid nursing home applicant or recipient who requires
				intermediate care services including 24-hour observation and care and the
				constant availability of medical and nursing treatment and care, but not to the
				degree of care and treatment provided in a hospital or that which meets the
				criteria for skilled nursing services.
(b) Rehabilitation services. Individualized
				activities or exercises prescribed by health care professionals that are
				designed to restore the recipient to self-sufficiency or to maintain the
				recipient at the highest attainable functional level.
(c) Routine. The administration of
				medications, treatments, or services in accordance with an established or
				predetermined schedule and performed for individuals whose medical needs are
				stabilized or chronic.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.190 - Laboratory Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule
				applies to all providers rendering Florida Medicaid laboratory services to
				recipients.
(2) All providers must
				be in compliance with the provisions of the Florida Medicaid Laboratory
				Services Coverage Policy, January 2024, incorporated by reference. The policy
				is available on the Agency for Health Care Administration's website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-16381
.
(3) This rule is effective for 5 years after
				its effective date.
Rulemaking Authority 409.919, 409.961 FS. Law Implemented
					 409.905, 409.907, 409.908, 409.912, 409.913, 409.973
					 FS.
New 1-1-77, Amended 10-11-81, Formerly 10C-7.41, Amended
					 6-30-92, Formerly 10C-7.041, Amended 9-28-94, 1-9-96, 10-20-96, 9-14-97,
					 3-22-00, 5-16-01, 2-14-02, 8-25-03, 9-3-03, 10-27-03, 8-18-05, 5-7-07, 6-29-16,
					 4-3-24.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.192 - Statewide Medicaid Managed Care Long-term Care Program

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule applies to all providers
				rendering Florida Medicaid Statewide Medicaid Managed Care Long-term Care
				Program services to recipients.
(2)
				All providers must be in compliance with the provisions of the Florida Medicaid
				Statewide Medicaid Managed Care Long-term Care Program Coverage Policy, March
				2017, incorporated by reference. The policy is available on the Agency for
				Health Care Administration's website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and at
https://www.flrules.org/Gateway/reference.asp?No=Ref-07927
.
Rulemaking Authority 409.919, 409.961 FS. Law Implemented
					 409.978, 409.979 FS.
New 4-23-17.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.193 - Statewide Medicaid Managed Care Long-term Care Waiver Program Prioritization and Enrollment

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule
				applies to individuals living in their home, or a community setting, who are
				seeking Florida Medicaid coverage for home and community-based services (HCBS)
				through the Florida Medicaid Statewide Medicaid Managed Care Long-term Care
				(LTC) program.
(2) Definitions. The
				following definitions are applicable to this policy.
(a) Aging Out - When an individual who is
				enrolled in the Department of Children and Families' (DCF) Community Care for
				Disabled Adults or Home Care for Disabled Adults program reaches the maximum
				age for the program and is referred for screening and prioritization for the
				LTC program.
(b) Authorized
				Representative - As defined in Section
				409.962, Florida Statutes
				(F.S.).
(c) Enrollment - When the
				Agency for Health Care Administration (AHCA) places a recipient in a Florida
				Medicaid managed care plan.
(d)
				High Priority Rank -Number indicating an individual's assessed need for LTC
				services and placement on the wait list, based on priority ranks of 3 and above
				in accordance with paragraph (3)(b) of this rule.
(e) Imminent Risk - When individuals living
				in their home or a community setting meet all of the following:
1. Unable to perform self-care because of
				deteriorating mental or physical health condition(s).
2. There is no capable caregiver.
3. Placement in a nursing facility is likely
				within a month, or very likely within three months.
(f) Low Priority Rank - Number indicating an
				individual's assessed need for LTC services, based on priority ranks of 1 or
				2.
(g) Priority Rank -
				Automatically generated number indicating an individual's assessed need for LTC
				services and to determine placement on the wait list, based on the priority
				score.
(h) Priority Score -
				Automatically generated number based on a Department of Elder Affairs' (DOEA)
				screening completed in accordance with Rule
				58A-1.010, Florida
				Administrative Code (F.A.C.).
(i)
				Rescreening - As defined in Section
				409.962, F.S.
(j) Screening - As defined in Section
				409.962, F.S.
(k) Significant Change - As defined in
				Section 409.962, F.S.
(l) Wait List - A list maintained by DOEA of
				individuals who have been screened and assigned a high priority rank by an
				Aging and Disability Resource Center (ADRC).
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.195 - Licensed Midwife Services (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 409.919 FS. Law Implemented 409.906,
					 409.908, 409.9081 FS.
New 6-29-93, Formerly 10C-7.0520, Amended 3-10-96, 3-11-98,
					 10-13-98, Repealed 8-28-14.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.197 - Medical Foster Care Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This
				rule applies to all providers rendering Florida Medicaid medical foster care
				services to recipients.
(2) All
				providers must be in compliance with the provisions of the Florida Medicaid
				Medical Foster Care Services Coverage Policy, December 2019, incorporated by
				reference. The policy is available on the Agency for Health Care
				Administration's website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and at
http://www.flrules.org/Gateway/reference.asp?No=Ref-11402
.
Rulemaking Authority 409.919, 409.961 FS. Law Implemented
					 409.902, 409.903, 409.905, 409.908, 409.912, 409.913, 409.973
					 FS.
New 2-22-00, Amended 3-6-01, 3-1-04, 8-15-07, 12-18-17,
					 1-16-20.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.200 - Nursing Facility Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This
				rule applies to any person or entity prescribing or reviewing a request for
				nursing facility services and to all providers of nursing facility services who
				are enrolled in or registered with the Florida Medicaid program.
(2) All providers of nursing facility
				services must be in compliance with the provisions of the Florida Medicaid
				Nursing Facility Services Coverage Policy, May 2016, incorporated by reference.
				The policy is available on the Agency for Health Care Administration's website
				at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and at
http://www.flrules.org/Gateway/reference.asp?No=Ref-06634
.
Rulemaking Authority 409.919, 409.961 FS. Law Implemented
					 409.902, 409.905, 409.908, 409.912, 409.913, 409.973
					 FS.
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, 5-3-16.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.201 - Neurology Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule
				applies to all providers rendering Florida Medicaid neurology services to
				recipients.
(2) All providers must
				be in compliance with the provisions of the Florida Medicaid Neurology Services
				Coverage Policy, October 2018, incorporated by reference. The policy is
				available on the Agency for Health Care Administration's Web site at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-09873
.
Rulemaking Authority 409.919, 409.961 FS. Law Implemented
					 409.902, 409.905, 409.907, 409.908, 409.912, 409.913, 409.973
					 FS.
New 6-29-16, Amended
					 10-15-18.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.205 - Practitioner Services (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 409.919 FS. Law Implemented 409.902,
					 409.905, 409.906, 409.907, 409.908, 409.9081, 409.912, 409.913
					 FS.
New 6-11-13, Amended 4-1-14, Repealed
					 7-11-16.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.207 - Oral and Maxillofacial Surgery Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule applies to any person or entity
				prescribing or reviewing a request for oral and maxillofacial surgery services
				and to all providers of oral and maxillofacial surgery services who are
				enrolled in or registered with the Florida Medicaid program.
(2) All providers of oral and maxillofacial
				surgery services must be in compliance with the provisions of the Florida
				Medicaid Oral and Maxillofacial Surgery Services Coverage Policy, May 2016,
				incorporated by reference. The policy is available on the Agency for Health
				Care Administration's website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and at
http://www.flrules.org/Gateway/reference.asp?No=Ref-06594
.
Rulemaking Authority 409.919, 490.961 FS. Law Implemented
					 409.902, 409.905, 409.907, 409.908, 409.912, 409.913, 409.973
					 FS.
New 5-3-16.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.210 - Visual Care Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule
				applies to any person or entity prescribing or reviewing a request for visual
				care services and to all providers of visual care services who are enrolled in
				or registered with the Florida Medicaid program.
(2) All persons or entities described in
				subsection (1), must be in compliance with the provisions of the Florida
				Medicaid Visual Care Services Coverage Policy, June 2016, incorporated by
				reference. The policy is available on the Agency for Health Care
				Administration's website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and at
http://www.flrules.org/Gateway/reference.asp?No=Ref-06752
.
Rulemaking Authority 409.919, 409.961 FS. Law Implemented
					 409.902, 409.906, 409.907, 409.908, 409.9081, 409.912, 409.913, 409.973
					 FS.
New 4-13-93, Amended 7-1-93, Formerly 10C-7.069, Amended
					 12-21-97, 10-13-98, 5-24-99, 4-23-00, 7-5-01, 2-20-03, 8-5-03, 5-24-05,
					 8-18-05, 5-22-06, 4-4-07, 5-1-14,
					 6-29-16.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.211 - Orthopedic Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule
				applies to any person or entity prescribing or reviewing a request for
				orthopedic services and to all providers of orthopedic services who are
				enrolled in or registered with the Florida Medicaid program.
(2) All persons or entities described in
				subsection (1), must be in compliance with the provisions of the Florida
				Medicaid Orthopedic Services Coverage Policy, June 2016, incorporated by
				reference. The policy is available on the Agency for Health Care
				Administration's website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and at
http://www.flrules.org/Gateway/reference.asp?No=Ref-06788
.
Rulemaking Authority 409.919, 409.961 FS. Law Implemented
					 409.902, 409.905, 409.907, 409.908, 409.912, 409.913, 409.973
					 FS.
New 6-29-16.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.215 - Personal Care Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule
				applies to all providers rendering Florida Medicaid personal care services to
				recipients.
(2) All providers must
				be in compliance with the provisions of the Florida Medicaid Personal Care
				Services Coverage Policy, November 2016, incorporated by reference. The policy
				is available on the Agency for Health Care Administration's (AHCA) website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and available at
https://www.flrules.org/Gateway/reference.asp?No=Ref-07487
.
(3) The following forms are incorporated by
				reference and are available on the AHCA website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and in the Florida Medicaid Personal Care Services Coverage Policy, November
				2016.
(a) Parent or Legal Guardian Medical
				Limitations, AHCA Form 5000-3501, November 2016,
http://www.flrules.org/Gateway/reference.asp?No=Ref-07496
.
(b) Parent or Legal Guardian Work Schedule,
				AHCA Form 5000-3503, November 2016,
http://www.flrules.org/Gateway/reference.asp?No=Ref-07497
.
(c) Parent or Legal Guardian Statement of
				Work Schedule, AHCA Form 5000-3504, November 2016,
https://www.flrules.org/Gateway/reference.asp?No=Ref-07498
.
(d) Parent or Legal Guardian School Schedule,
				AHCA Form 5000-3505, November 2016,
http://www.flrules.org/Gateway/reference.asp?No=Ref-07499
.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.220 - Podiatry Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule
				applies to any person or entity prescribing or reviewing a request for podiatry
				services and to all providers of podiatry services who are enrolled in or
				registered with the Florida Medicaid program.
(2) All persons or entities described in
				subsection (1), must be in compliance with the provisions of the Florida
				Medicaid Podiatry Services Coverage Policy, June 2016, incorporated by
				reference. The policy is available from the Agency for Health Care
				Administration's website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and at
http://www.flrules.org/Gateway/reference.asp?No=Ref-06779
.
Rulemaking Authority 409.919, 409.961 FS. Law Implemented
					 409.902, 409.906, 409.907, 409.908, 409.912, 409.913, 409.973
					 FS.
New 1-23-84, Amended 10-25-84, Formerly 10C-7.529, Amended
					 4-21-92, 11-9-92, 7-1-93, Formerly 10C-7.0529, 10P-4.220, Amended 1-7-96,
					 3-11-98, 10-13-98, 5-24-99, 4-23-00, 7-5-01, 2-20-03, 8-5-03, 8-18-05, 4-13-10,
					 6-29-16.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.222 - Pain Management Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This
				rule applies to any person or entity prescribing or reviewing a request for
				pain management services and to all providers of pain management services who
				are enrolled in or registered with the Florida Medicaid program.
(2) All persons or entities described in
				subsection (1), must be in compliance with the provisions of the Florida
				Medicaid Pain Management Services Coverage Policy, June 2016, incorporated by
				reference. The policy is available on the Agency for Health Care
				Administration's website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and at
http://www.flrules.org/Gateway/reference.asp?No=Ref-06777
.
Rulemaking Authority 409.919, 409.961 FS. Law Implemented
					 409.902, 409.905, 409.907, 409.908, 409.912, 409.913, 409.973
					 FS.
New 6-29-16.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.230 - Physician Services (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 409.919 FS. Law Implemented 409.902,
					 409.905, 409.907, 409.908, 409.9081, 409.912, 409.913
					 FS.
New 1-1-77, Revised 2-1-78, 4-1-78, 1-2-79, 1-1-80, Amended
					 2-8-82, 3-11-84, Formerly 10C-7.38, Amended 1-10-91, 11-5-92, 1-7-93, Formerly
					 10C-7.038, Amended 6-29-93, 9-6-93, Formerly 10P-4.230, Amended 6-13-94,
					 2-9-95, 3-10-96, 5-28-96, 3-18-98, 9-22-98, 8-25-99, 4-23-00, 8-5-01, 2-20-03,
					 8-5-03, 8-3-04, 8-18-05, 8-31-05, 10-26-06, 2-11-07, 5-7-07, 7-2-07, 11-15-07,
					 10-21-10, Repealed 10-27-13.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.231 - Physician Assistant Services (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 409.919 FS. Law Implemented 409.906,
					 409.907, 409.908, 409.9081 FS.
New 8-21-95, Amended 5-28-96, 3-11-98, 10-13-98, 8-9-99,
					 4-23-00, 8-5-01, 2-20-03, 8-5-03, 8-3-04, 8-18-05, Repealed
					 10-27-13.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.235 - Respiratory System Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule
				applies to any person or entity prescribing or reviewing a request for
				respiratory system services and to all providers of respiratory system services
				who are enrolled in or registered with the Florida Medicaid program.
(2) All persons or entities described in
				subsection (1), must be in compliance with the provisions of the Florida
				Medicaid Respiratory System Services Coverage Policy, June 2016, incorporated
				by reference. The policy is available from the Agency for Health Care
				Administration's website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and at
http://www.flrules.org/Gateway/reference.asp?No=Ref-06792
.
Rulemaking Authority 409.919, 409.961 FS. Law Implemented
					 409.902, 409.905, 409.907, 409.908, 409.912, 409.913, 409.973
					 FS.
New 6-29-16.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.240 - Radiology and Nuclear Medicine Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule applies to all providers
				rendering Florida Medicaid radiology and nuclear medicine services to
				recipients.
(2) All providers must
				be in compliance with the provisions of the Florida Medicaid Radiology and
				Nuclear Medicine Services Coverage Policy, May 2019, incorporated by reference.
				The policy is available on the Agency for Health Care Administration Web Site
				at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and at
http://www.flrules.org/Gateway/reference.asp?No=Ref-10372
.
Rulemaking Authority 409.919, 409.961 FS. Law Implemented
					 409.902, 409.905, 409.908, 409.912, 409.913, 409.973
					 FS.
New 10-11-81, Formerly 10C-7.411, Amended 7-1-92, Formerly
					 10C-7.0411, Amended 5-16-94, 1-9-96, 10-20-96, 8-27-97, 3-22-00, 2-14-02,
					 6-1-03, 8-5-03, 3-15-04, 8-18-05, 6-29-16,
					 5-27-19.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.250 - Prescribed Drug Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule
				applies to all providers rendering Florida Medicaid prescribed drug services to
				recipients.
(2) All providers must
				be in compliance with the provisions of the Florida Medicaid Prescribed Drug
				Services Coverage Policy, December 2017, incorporated by reference. The policy
				available on the Agency for Health Care Administration's website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and at
https://www.flrules.org/Gateway/reference.asp?No=Ref-08824
.
Rulemaking Authority 409.919, 409.961 FS. Law Implemented
					 409.902, 409.906, 409.907, 409.908, 409.912, 409.913, 409.973
					 FS.
New 1-1-77, Amended 6-30-77, 10-1-77, 2-1-78, 4-1-78,
					 9-28-78, 6-1-79, 2-28-80, 11-11-81, 7-3-84, Formerly 10C-7.42, Amended 3-11-86,
					 12-5-88, 6-4-90, 10-29-90, 5-20-92, 4-11-93, Formerly 10C-7.042, Amended
					 12-28-95, 8-3-97, 2-11-98, 9-13-99, 7-20-00, 1-29-01, 4-24-01, 10-6-02,
					 12-7-06, 11-3-08, 6-19-12, 7-2-14,
					 12-24-17.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.251 - Prescribed Drugs Reimbursement Methodology

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule applies to all prescribed drug
				service providers enrolled in the Florida Medicaid program that provide
				services under the fee-for-service delivery system in accordance with Rule
				59G-4.250, Florida
				Administrative Code (F.A.C.).
(2)
				Definitions.
(a) Actual Acquisition Cost for
				Prescribed Drugs - (AAC) - The National Average Drug Acquisition Cost (NADAC)
				will be used for the AAC, when available. If the NADAC is unavailable, the AAC
				will be equal to the wholesaler acquisition cost.
(b) Average Sales Price - (ASP) - The average
				sales price as reported by prescribed drug manufacturers to the Centers for
				Medicare and Medicaid Services (CMS).
(c) State Maximum Allowable Cost - (SMAC) -
				The maximum allowable unit cost established by the state; SMAC may be manually
				set.
(d) Usual and Customary Charge
				- (U&C Charge) - The average charge to all other customers in any quarter
				for the same drug, quantity, and strength.
(e) Wholesaler Acquisition Cost - (WAC) - The
				cost wholesalers pay for a prescribed drug.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.255 - Prescription Drug Coverage Denials

Current through Reg. 50, No. 138; July 16, 2024
(1)
				Medicaid-participating pharmacies shall provide the pamphlet, Important
				Information About Your Florida Medicaid Prescription Drug Benefits, 10/03/05,
				or Información Importante A cerca de sus beneficios de medicamentos con
				receta del Medicaid de la Florida, 11/01/05, which are incorporated by
				reference, to Medicaid recipients whose prescription drug claims are denied by
				Medicaid if the pharmacy cannot resolve the denial during that day's pharmacy
				visit. The pharmacy must write on the pamphlet the date, the recipient's name,
				the drug name, and the reason for the denial or write on the pamphlet the date
				and recipient's name and attach a printout of the computer screen stating the
				drug name and the reason for the denial. The pamphlets are available from the
				Agency for Health Care Administration's website at
http://ahca.myflorida.com/Medicaid/Prescribed_Drug/multi_source.shtml
.
(2) Medicaid-participating pharmacies shall
				post two signs, Important Notice to Medicaid Recipients, 5/14/2004, and Aviso
				Importante a Recipientes de Medicaid, 5/14/2004, which are incorporated by
				reference, in a conspicuous location that is visible to recipients. The signs
				inform recipients of a toll-free number that can be called if the prescription
				is denied and the pharmacy failed to provide the denial information and an
				Important Information About Your Florida Medicaid Prescription Drug Benefits or
				Información Importante A cerca de sus beneficios de medicamentos con
				receta del Medicaid de la Florida pamphlet to the recipient. The signs are
				available from the Agency for Health Care Administration's website at
http://ahca.myflorida.com/Medicaid/Prescribed_Drug/multi_source.shtml
.
Rulemaking Authority 409.902, 409.919 FS. Law Implemented
					 409.902, 409.906, 409.919 FS.
New 3-2-06.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.260 - Prescribed Pediatric Extended Care Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule applies to all providers
				rendering Florida Medicaid prescribed pediatric extended care (PPEC) services
				to recipients.
(2) All providers
				must be in compliance with the provisions of the Florida Medicaid Prescribed
				Pediatric Extended Care Services Coverage Policy, February 2018, incorporated
				by reference. The policy is available on the Agency for Health Care
				Administration's Web site at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and at
http://www.flrules.org/Gateway/reference.asp?No=Ref-08568
.
Rulemaking Authority 409.919 FS. Law Implemented 409.902,
					 409.905, 409.907, 409.908, 409.912, 409.913
					 FS.
New 8-27-91, Amended 4-21-92, 3-9-93, Formerly 10C-7.0471,
					 Amended 2-11-96, 2-22-00, 5-11-04, 4-24-07, 9-4-13,
					 2-8-18.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.261 - Private Duty Nursing Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This
				rule applies to all providers rendering Florida Medicaid private duty nursing
				services to recipients.
(2) All
				providers must be in compliance with the provisions of the Florida Medicaid
				Private Duty Nursing Services Coverage Policy, November 2016, incorporated by
				reference. The policy is available on the Agency for Health Care
				Administration's website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and available at
https://www.flrules.org/Gateway/reference.asp?No=Ref-07495
.
(3) Florida Medicaid reimburses for medically
				necessary private duty nursing services provided to recipients under the age of
				21 years. Rule 59G-1.010, Florida
				Administrative Code (F.A.C.), defines "medically necessary" or "medical
				necessity" as follows:
"[T]he medical or allied care, goods, or services furnished
				  or ordered must:
(a) Meet the
				following conditions:
1. Be necessary to
				protect life, to prevent significant illness or significant disability, or to
				alleviate severe pain;
2. Be
				individualized, specific, and consistent with symptoms or confirmed diagnosis
				of the illness or injury under treatment, and not in excess of the patient's
				needs;
3. Be consistent with
				generally accepted professional medical standards as determined by the Medicaid
				program, and not experimental or investigational;
4. Be reflective of the level of service that
				can be safely furnished, and for which no equally effective and more
				conservative or less costly treatment is available statewide; and,
5. Be furnished in a manner not primarily
				intended for the convenience of the recipient, the recipient's caretaker, or
				the provider.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.264 - Regional Perinatal Intensive Care Center Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule applies to any person or entity
				prescribing or reviewing a request for obstetrical and neonatal services
				provided in a regional perinatal intensive care center (RPICC), and to all
				physicians providing services in a RPICC who are enrolled in the Florida
				Medicaid program and rendering services in the fee-for-service delivery
				system.
(2) Definitions.
(a) High-Risk Pregnancy - A pregnancy in
				which the woman whose medical history and diagnosis indicates, without
				consideration of a previous cesarean section, that a normal uncomplicated
				pregnancy and delivery are unlikely to occur.
(b) Recipient - For the purpose of this rule,
				the term used to describe an individual enrolled in Florida
				Medicaid.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.266 - Qualified Evaluator Network

Current through Reg. 50, No. 138; July 16, 2024
(1) Purpose.
				The Agency for Health Care Administration (AHCA), or its designee, will
				register qualified evaluators for the purpose of determining that a child in
				the legal custody of the Department of Children and Families (DCF) is suitable
				for residential treatment services (as defined in section
				39.407(6)(a),
				F.S.).
(2) Qualifications:
(a) A licensed psychiatrist or a psychologist
				meeting all of the following criteria may be registered as a qualified
				evaluator by AHCA, or its designee:
1. Be
				licensed in Florida in accordance with chapter 458, 459, or 490, F.S.
2. Have three or more years of clinical
				experience in the diagnosis and treatment of serious emotional disturbances in
				children and adolescents.
3. Have
				no actual or perceived conflict of interest with any inpatient facility or
				residential treatment center or program.
4. Have successfully passed background
				screening requirements of the Florida Department of Law Enforcement and Federal
				Bureau of Investigations.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.270 - Registered Nurse First Assistant Services (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 409.919 FS. Law Implemented 409.902
					 409.906, 409.908, 409.9081 FS.
New 3-11-98, Amended 10-13-98, 5-24-99, 4-23-00, 7-5-01,
					 2-20-03, 8-5-03, 8-4-04, 8-18-05, Repealed
					 10-27-13.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.280 - Rural Health Clinic

Current through Reg. 50, No. 138; July 16, 2024
(1) This rule
				applies to all rural health clinic (RHC) providers that are enrolled in or
				registered with the Florida Medicaid program.
(2) All RHC providers must comply with Title
				42, Code of Federal Regulations, Parts 440 and 491.
(3) Florida Medicaid reimburses for services
				provided through the fee-for-service delivery system at one encounter rate per
				day, per recipient. For rates, see
http://ahca.myflorida.com/Medicaid/Finance/finance/institutional/index.shtml
.
Rulemaking Authority 409.919 FS. Law Implemented 409.905,
					 409.908, 409.9081 FS.
New 4-14-80, Amended 12-28-80, Formerly 10C-7.51, Amended
					 8-11-91, 1-19-93, Formerly 10C-7.051, Amended 6-29-94, 6-10-96, 6-24-98,
					 12-4-00, 5-31-04, 5-7-07, 6-29-16.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.290 - Skilled Services

Current through Reg. 50, No. 138; July 16, 2024
(1) Purpose. This
				rule establishes the level of care criteria that must be met in order for
				nursing and rehabilitative services to qualify as skilled services under
				Medicaid.
(2) Definitions as used
				in this section.
(a) Continuous. The need for
				24-hour care in a skilled nursing facility with professional nursing services
				available.
(b) Direct supervision.
				Performance of a procedure in the presence of professional personnel or their
				presence in the facility during the time in which the procedure is being
				performed.
(c) Licensed nursing
				personnel. Registered professional or licensed practical nurses, currently
				licensed by the State of Florida to practice as a registered nurse or licensed
				practical nurse respectively.
(d)
				Professional personnel. Florida licensed or certified physicians, registered
				nurses, respiratory care practitioners/therapists, audiologists, physical,
				occupational or speech therapists.
(e) Rehabilitative services. Individualized
				services prescribed by a health care professional that are designed to restore
				a recipient to self-sufficiency or to the highest attainable functional level
				in the shortest possible time following an illness or injury.
(f) Skilled care recipient. A Medicaid
				applicant or recipient who requires skilled nursing or skilled rehabilitative
				services.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59G - Medicaid › Chapter 59G-4 - MEDICAID POLICY › Section 59G-4.295 - Therapeutic Group Care Services

Current through Reg. 50, No. 138; July 16, 2024
(1) This
				rule applies to all providers rendering Florida Medicaid therapeutic group care
				services to recipients.
(2) All
				providers must be in compliance with the provisions of the Florida Medicaid
				Therapeutic Group Care Services Coverage Policy, July 2017, incorporated by
				reference. The policy is available on the Agency for Health Care
				Administration's website at
http://ahca.myflorida.com/Medicaid/review/index.shtml
,
				and at
http://www.flrules.org/Gateway/reference.asp?No=Ref-08487
.
Rulemaking Authority 409.919, 409.961 FS. Law Implemented
					 409.902, 409.906, 409.907, 409.908, 409.912, 409.913, 409.973
					 FS.
New 3-13-14, Amended
					 8-6-17.