59G-4.192 LTC Program Policy FINAL VERSION W NOC

Florida Medicaid Statewide Medicaid Managed Care Long-term Care Program Coverage Policy Agency for Health Care Administration March 2017. Florida Medicaid Statewide Medicaid Managed Care Long-term Care Program Coverage Policy Table of Contents Introduction .. 1 Description and Program Goal .. 1 Legal Authority .. 1 Definitions .. 1 Eligible Recipient .. 3 General Criteria .. 3 Who Can Receive .. 3 Patient Responsibility .. 3 Eligible Provider .. 4 General Criteria .. 4 Who Can Provide .. 4 Coverage Information .. 4 General Criteria .. 4 Specific Criteria .. 4 Exclusion .. 8 Documentation .. 8 General Criteria .. 8 Specific Criteria .. 8 Authorization .. 9 Appendix .. 10 Statewide Medicaid Managed Care Long-term Care Provider Qualifications .. 10 Statewide Medicaid Managed Care Long-term Care Program Procedure Codes for Home and Community-Based Supportive Services.

Statewide Medicaid Managed Care Long-term Care Program Coverage Policy 2 March 2017 plan, to determine eligibility for the LTC program based on the need for a nursing facility level of care. 1.3.6 Coverage and Limitations Handbook or Coverage Policy A policy document found in Rule Division 59G, F.A.C. that contains coverage

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