Fla. Admin. Code Ann. R. 59G-6.020 - Payment Methodology for Inpatient Hospital Services

(1) Reimbursement to participating inpatient hospitals for services provided shall be in accordance with the Florida Title XIX Inpatient Hospital Reimbursement Plan (the Plan), Version XLIV, effective July 1, 2017, http://www.flrules.org/Gateway/reference.asp?No=Ref-09420, incorporated by reference. The Plan is applicable to the fee-for-service delivery system.

(2) A copy of the Plan as revised may be obtained by writing to the Bureau of Medicaid Program Finance, Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Mail Stop 8, Tallahassee, Florida 32308.

(3) The Provider Reimbursement Manual CMS PUB. 15-1, is incorporated by reference, http://www.flrules.org/Gateway/reference.asp?No=Ref-08256, and available at https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Paper-Based-Manuals-Items/CMS021929.html. The following cost reports are included in the Plan and are incorporated by reference: CMS-2552-96, June 2003, http://www.flrules.org/Gateway/reference.asp?No=Ref-07058; and CMS-2552-10, October 2012, http://www.flrules.org/Gateway/reference.asp?No=Ref-07059. These cost reports are available on the Centers for Medicare and Medicaid Services website at http://www.cms.gov/Research-Statistics-Data-and-Systems/Files-for-Order/CostReports/Hospital-1996-form.html and http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3P240f.pdf, respectively.

Notes

Fla. Admin. Code Ann. R. 59G-6.020

Rulemaking Authority 409.919 FS. Law Implemented 409.905, 409.908, 409.909, 409.913, 409.9113, 409.9115, 409.9116, 409.9118, 409.9119 FS.

New 10-31-85, Formerly 10C-7.391, Amended 10-1-86, 1-10-89, 11-19-89, 3-26-90, 8-14-90, 9-30-90, 9-16-91, 4-6-92, 11-30-92, 6-30-93, Formerly 10C-7.0391, Amended 4-10-94, 8-15-94, 1-11-95, 5-13-96, 7-1-96, 12-2-96, 11-30-97, 9-16-98, 11-10-99, 9-20-00, 3-31-02, 1-8-03, 7-3-03, 2-1-04, 2-16-04, 2-17-04, 8-10-04, 10-12-04, 1-10-06, 4-19-06, 12-11-06, 3-4-08, 6-10-08, 1-11-09, 3-24-10, 7-5-10, 7-15-10, 2-23-11, 10-30-12, 4-23-14, Amended by Florida Register Volume 41, Number 003, January 6, effective 1/19/2015, Amended by Florida Register Volume 41, Number 106, June 2, 2015 effective 6/15/2015, Amended by Florida Register Volume 42, Number 125, June 28, 2016 effective 7/11/2016, Amended by Florida Register Volume 43, Number 124, June 27, 2017 effective 7/10/2017, Amended by Florida Register Volume 44, Number 124, June 26, 2018 effective 7/12/2018.

New 10-31-85, Formerly 10C-7.391, Amended 10-1-86, 1-10-89, 11-19-89, 3-26-90, 8-14-90, 9-30-90, 9-16-91, 4-6-92, 11-30-92, 6-30-93, Formerly 10C-7.0391, Amended 4-10-94, 8-15-94, 1-11-95, 5-13-96, 7-1-96, 12-2-96, 11-30-97, 9-16-98, 11-10-99, 9-20-00, 3-31-02, 1-8-03, 7-3-03, 2-1-04, 2-16-04, 2-17-04, 8-10-04, 10-12-04, 1-10-06, 4-19-06, 12-11-06, 3-4-08, 6-10-08, 1-11-09, 3-24-10, 7-5-10, 7-15-10, 2-23-11, 10-30-12, 4-23-14, 1-19-15, 6-15-15, 7-11-16, 7-10-17, 7-12-18.