Section 65E-14.019 - Methods of Paying for Services(1) When purchasing substance abuse and mental health services pursuant to Rule 65E-14.021, F.A.C., the department or a Managing Entity shall use one or a combination of the payment methodologies provided for in subsection 65E-14.019(2), F.A.C. Each contract or subcontract shall specify the payment methodology or methodologies to be used.(2) Pursuant to Section 394.74(2)(b), F.S., the following payment methodologies may be negotiated for use in a contract or subcontract:(a) Fee-for-service rate: a method of making payment for services, based on a negotiated schedule of fees set by contract or subcontract.(b) Case rate: a negotiated payment for a clinically-defined episode of care for an individual served, based on a contractually defined for package of services to be delivered within a defined period of time.(c) Capitation rate: a negotiated monthly fee that is paid for an enrolled individual, whether or not the individual receives the services in that time period.(d) Cost reimbursement: This payment methodology may be used to reimburse for operational start-up costs for new services; for specific service contracts when required by statute, grant or funding source; or for specific fixed capital outlay projects appropriated by the legislature.(3) All supporting documentation shall comply with the Department of Financial Services Reference Guide for State Expenditures, February 2011, https://www.flrules.org/Gateway/reference.asp?No=Ref-04201, which is hereby incorporated by reference, a copy of which may be obtained from the Office of Substance Abuse and Mental Health, 1317 Winewood Blvd., Building 6, Tallahassee, Florida 32399-0700.(4) All contracts and subcontracts, regardless of payment methodology, shall comply with any requirements which are conditions of the receipt of state or federal grant funds as specified in the contract or subcontract.Fla. Admin. Code Ann. R. 65E-14.019
Rulemaking Authority 394.74(2), 394.78(1), (5), 394.9082(3) FS. Law Implemented 394.74(2), 394.76(4), 394.78(1), (5), 394.9082 FS.
New 7-1-03, Amended 12-14-03, Amended by Florida Register Volume 40, Number 136, July 15, 2014 effective 7/27/2014.New 7-1-03, Amended 12-14-03, 7-27-14.