Fla. Admin. Code R. 59G-4.215 – Personal Care Services

(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, October 2024, 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 HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-17129"https://www.flrules.org/Gateway/reference.asp?No=Ref-17129.
(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, October 2024.
1. (a) Parent or Legal Guardian Medical Limitations, AHCA Form 5000-3501, November 2016, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-07496" http://www.flrules.org/Gateway/reference.asp?No=Ref-07496.
2. (b) Parent or Legal Guardian Work Schedule, AHCA Form 5000-3503, November 2016, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-07497" http://www.flrules.org/Gateway/reference.asp?No=Ref-07497.
3. (c) Parent or Legal Guardian Statement of Work Schedule, AHCA Form 5000-3504, November 2016, HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-07498" https://www.flrules.org/Gateway/reference.asp?No=Ref-07498.
4. (d) Parent or Legal Guardian School Schedule, AHCA Form 5000-3505, November 2016, HYPERLINK "http://www.flrules.org/Gateway/reference.asp?No=Ref-07499" http://www.flrules.org/Gateway/reference.asp?No=Ref-07499.

Rulemaking Authority 409.919, 409.961 FS. Law Implemented 400.4765, 409.902, 409.905, 409.907, 409.908, 409.9081, 409.912, 409.913, 409.973 FS. History–New 11-17-16, Amended 12-22-24.