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ATTN: Florida Facilities: Form AHCA 5000-3008 has been revised

The Medical Certification for Nursing Facility/Home and Community-Based Services form (AHCA MedServ-3008 form, May 2009), commonly known as the 3008, has been revised and incorporated into Rule 59G-1.045, Florida Administrative Code. In addition to extensive updates to the form itself, the 3008 has a new name and a new form number. The revised 3008 is called the Medical Certification for Medicaid Long-Term Care Services and Patient Transfer Form (AHCA Form 5000-3008, October 2015). Use of the AHCA MedServ-3008 should have been discontinued on October 1. Effective October 1, the AHCA Form 5000-3008 replaces the AHCA MedServ-3008. The revised 3008 is available on the Department of Elder Affairs’ web page (http://elderaffairs.state. fl.us/doea/cares_3008ppp.php) and on the Florida Medicaid Web Portal Provider Forms (http://portal.flmmis.com/FLPublic/Provider_ProviderServices/Provider_ProviderSupport/Provider_ ProviderSupport_Forms/tabId/52/Default.aspx) webpage.

 

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