Florida Administrative Code

(1) Definitions. (a) Generally accepted professional medical standards - Standards based on reliable scientific evidence published in peer-reviewed scientific literature generally recognized by the relevant medical community or practitioner specialty associations' recommendations…

(1) This rule applies to any person or entity prescribing or reviewing a request for Florida Medicaid covered services and to all providers of Florida Medicaid covered services who are enrolled in or registered with the Florida Medicaid program. (2) Definitions. Clinical Trials -…

(1) Purpose. This rule applies to all Florida Medicaid-certified nursing facilities (NF), regardless of payer source; all providers rendering NF services to Florida Medicaid recipients; and all entities that perform a function in the Preadmission Screening and Resident Review (PA…

The following forms are incorporated by reference and are used either by other state agencies or providers rendering Florida Medicaid services to recipients. The forms are available from the Agency for Health Care Administration's Web site at http://ahca.myflorida.com/Medicaid/re…

(1) Purpose. This rule specifies requirements that apply to all providers rendering Florida Medicaid services to recipients. (2) Billing the Recipient. Providers must inform a recipient of his or her responsibility to pay for services that are not covered by Florida Medicaid, and…

(1) This policy applies to all persons who are required to notify Florida Medicaid of any third-party benefits a recipient may have and to providers rendering Florida Medicaid services to recipients. (2) Purpose. Third-party liability (TPL) refers to the legal obligation of third…

(1) This rule applies to providers rendering Florida Medicaid services to recipients. (2) All providers must comply with the provisions of the Florida Medicaid Authorization Requirements Policy, June 2016, incorporated by reference. The policy is available on the Agency for Healt…

(1) This rule applies to providers rendering Florida Medicaid services to recipients. (2) Documentation Requirements. (a) All Florida Medicaid providers must: 1. Ensure medical records establish the medical necessity for and the extent of services provided. 2. Sign and date each …

(1) This rule applies to providers rendering Florida Medicaid services to recipients. (2) Requirement. Recipients are responsible for paying all applicable copayment and coinsurance amounts directly to the provider who furnished Florida Medicaid covered services. (3) Amounts. The…

(1) This rule applies to any person or entity prescribing or reviewing a request for Florida Medicaid services and to all providers of Florida Medicaid services that are enrolled in or registered with the Florida Medicaid program. (2) Definition. Telemedicine - The practice of he…

(1) Purpose. This rule specifies recipient eligibility requirements for Florida Medicaid covered services and applies to all providers rendering Florida Medicaid covered services to recipients. (2) Eligibility Determination. The Department of Children and Families (DCF) and the S…

(1) This rule applies to all individuals, groups, and entities that are seeking to enroll, renew, or maintain enrollment as an authorized provider for the Florida Medicaid program. (2) All providers must be in compliance with the provisions of the Florida Medicaid Provider Enroll…

(1) Purpose. This rule establishes procedures applicable to Fair Hearings conducted by the Agency for Health Care Administration (Agency) pursuant to Section 409.285(2), Florida Statutes (F.S.). (2) Definitions. The following definitions are applicable to this rule: (a) Action - …

Rulemaking Authority 408.918 FS. Law Implemented 408.918 FS. History-New 4-24-03, Repealed 9-23-10.

Rulemaking Authority 408.918 FS. Law Implemented 408.918 FS. History-New 4-24-03, Repealed 9-23-10.

Rulemaking Authority 408.918 FS. Law Implemented 408.918 FS. History-New 4-24-03, Repealed 9-23-10.

Rulemaking Authority 408.918 FS. Law Implemented 408.918 FS. History-New 4-24-03, Repealed 9-23-10.

Rulemaking Authority 409.9065(4)(b) FS. Law Implemented 409.906(20), 409.9065(4)(b), 409.908, 409.912 FS. History-New 1-9-03, Repealed 5-9-10.

Rulemaking Authority 409.9065(4)(b) FS. Law Implemented 409.906(20), 409.9065(4)(b), 409.908, 409.912 FS. History-New 1-9-03, Repealed 5-9-10.

Rulemaking Authority 409.9065(4)(b) FS. Law Implemented 409.906(20), 409.9065(4)(b), 409.908, 409.912 FS. History-New 1-9-03, Repealed 5-9-10.

Rulemaking Authority 409.9065(4)(b) FS. Law Implemented 409.906(20), 409.9065(4)(b), 409.908, 409.912 FS. History-New 1-9-03, Repealed 5-9-10.

Rulemaking Authority 409.9065(4)(b) FS. Law Implemented 409.906(20), 409.9065(4)(b), 409.908, 409.912 FS. History-New 1-9-03, Repealed 5-9-10.

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.906, 409.907, 409.908, 409.912 FS. History-New 2-3-05, Repealed 1-26-10.

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.906, 409.907, 409.908, 409.912, 409.913 FS. History-New 9-21-11, Amended 11-1-13, Repealed 3-21-18.

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.906, 409.907, 409.908, 409.912, 409.913 FS. History-New 6-1-05, Amended 4-17-06, 7-8-10, Repealed 8-28-14.

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.906, 409.908, 409.912, 409.913 FS. History-New 7-8-10, Repealed 8-28-14.

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.906, 409.907, 409.908, 409.912, 409.913 FS. History-New 6-7-12, Repealed 8-28-14.

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.906, 409.907, 409.908, 409.912, 409.913 FS. History-New 5-28-12, Repealed 8-28-14.

Rulemaking Authority 409.919 FS. Law Implemented 409.906, 409.908, 409.912 FS. History-New 5-31-10, Repealed 8-28-14.

Rulemaking Authority 409.919 FS. Law Implemented 409,902, 409.906, 409,907, 409.908, 409.912, 409.913 FS. History-New 6-7-12, Repealed 8-28-14.

(1) This rule applies to all providers rendering Florida Medicaid Developmental Disabilities Individual Budgeting Waiver services to recipients. (2) All providers must be in compliance with the provisions of the Florida Medicaid Developmental Disabilities Individual Budgeting Wai…

(1) This rule applies to all settings where Florida Medicaid waiver services are rendered to individuals enrolled in home and community-based service (HCBS) waiver programs authorized under sections 1915(c), 1915(i), and 1915(k) of the Social Security Act. (2) All settings must b…

(1) Purpose. Under authority of section 2176 of Public Law 97-35, Florida obtained waivers of federal Medicaid requirements to enable the provision of specified home and community-based (HCB) services to persons at risk of institutionalization. Through the administration of sever…

(1) This rule applies to all providers that render Florida Medicaid Developmental Disabilities Individual Budgeting Waiver services to recipients. (2) Florida Medicaid reimburses providers in accordance with the Florida Medicaid Developmental Disabilities Individual Budgeting Wai…

Rulemaking Authority 409.919 FS. Law Implemented 409.906, 409.908 FS. History-New 11-22-06, Amended 12-3-08, Repealed 10-27-13.

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.906, 409.907, 409.908, 409.912, 409.913 FS. History-New 12-3-08, Amended 7-8-10, 5-3-12, Repealed 10-19-15.

Rulemaking Authority 409.919 FS. Law Implemented 393.0661, 409.906, 409.908 FS. History-New 10-13-08, Repealed 10-27-13.

(1) Developmental Disabilities Waiver disposable incontinence medical supplies are reimbursed according to the Florida Medicaid Developmental Disabilities Individual Budgeting Waiver Disposable Incontinence Medical Supplies Fee Schedule, October 2015, incorporated by reference, a…

(1) Recipients enrolled in the Individual Budgeting (iBudget) Waiver receiving Consumer-Directed Care Plus program services, along with all program representatives, consultants, employees, vendors, and Agency for Persons with Disabilities staff must be in compliance with the prov…

Rulemaking Authority 409.919 FS. Law Implemented 409.906, 409.908 FS. History-New 10-18-07, Amended 7-29-08, Repealed 10-27-13.

Rulemaking Authority 409.919 FS. Law Implemented 409.906, 409.908 FS. History-New 10-18-07, Repealed 10-27-13.

(1) This rule applies to all Familial Dysautonomia waiver services providers enrolled in the Medicaid program. (2) All Familial Dysautonomia waiver services providers enrolled in the Medicaid program must be in compliance with the Familial Dysautonomia Waiver Disposable Incontine…

Rulemaking Authority 409.919 FS. Law Implemented 409.906, 409.908, 409.912 FS. History-New 2-3-05, Amended 5-31-06, Repealed 3-21-18.

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.906, 409,907, 409.908, 409.912, 409.913 FS. History-New 6-7-12, Repealed 3-21-18.

Rulemaking Authority 409.919 FS. Law Implemented 409.906, 409.907, 409.908, 409.912 FS. History-New 5-31-06, Repealed 3-21-18.

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.906, 409.907, 409.908, 409.912, 409.913 FS. History-New 8-5-09, Amended 9-21-11, 11-1-13, Repealed 3-21-18.

Rulemaking Authority 409.919 FS. Law Implemented 409.902, 409.906, 409.907, 409.908, 409.912, 409.913 FS. History-New 6-7-12, Amended 5-17-15, Repealed 3-21-18.