Assistive Care Services and Assisted Living for the Elderly Waiver

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Assistive Care Services and Assisted Living for the Elderly Waiver Services Coverage and Limitations Handbook APPENDIX A ASSISTIVE CARE SERVICES PROCEDURE CODE TABLE AND FEES CODE DESCRIPTION OF SERVICE UNIT PER DIEM RATE W9659 ACS for Non-waiver recipients Daily $9.28 *Note for ALE Waiver providers use only. Procedure Code W-9657 must be used to bill for ACS services provided to ALE waiver recipients. For more information, ALE waiver providers can consult Chapter 6 of this handbook. July 2001 A-1
Assistive Care Services and Assisted Living for the Elderly Waiver Services Coverage and Limitations Handbook PART I APPENDIX B APPEAL RIGHTS AND FAIR HEARING PROCESS Fair Hearing Process Right to a Fair Hearing An ACS recipient or applicant has the right to appeal any action taken by the Agency for Health Care Administration (AHCA), Department of Children and Families (DCF) or service providers that adversely affects the recipient’s receipt of services. ACS recipients must be given at least 10 calendar days advance written notice of any suspension, reduction, or termination of services or program participation. The advance notice must inform the ACS recipient of the right to a fair hearing. Where to Apply for a Hearing Hearing requests must be sent to the DCF, Office of Hearing Appeals (OSIH), 1317 Winewood Boulevard, Building 5, Room 203, Tallahassee, Florida 32399-0700. The telephone number is (850) 488-1429. How to Request a Hearing The ACS applicant, recipient, or authorized representative must request a hearing within 90 days of the receipt of the written notification of the adverse decision. ACS providers must offer assistance to recipients or applicants with the fair hearing process. Continuation of Benefits If the ACS applicant, recipient, or authorized representative requests a fair hearing within 10 calendar days of the receipt of the notice of case action or denial of service, ACS services must be reinstated at the level prior to the adverse action. If an ACS applicant or recipient requests a fair hearing and services are reinstated to the prior level, the recipient might be requested to repay that portion of the benefits that the hearing decision determines to be invalid. The recipient must be given written notice of this responsibility. July 2001 B-1
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Assistive Care Services and Assisted Living for the Elderly Waiver

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