Florida Senate - 2015                          SENATOR AMENDMENT
       Bill No. CS for CS for SB 2-A
       
       
       
       
       
       
                                Ì121532sÎ121532                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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                Floor: 1/AD/2R         .                                
             06/03/2015 02:09 PM       .                                
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       Senator Bean moved the following:
       
    1         Senate Amendment 
    2  
    3         Delete lines 250 - 279
    4  and insert:
    5         (5) COST SHARING.—
    6         (a) Except for enrollees eligible under paragraph (1)(c),
    7  enrollees are assessed monthly premiums based on their modified
    8  adjusted gross income. The maximum monthly premium payments are
    9  set at the following income levels:
   10         1. At or below 22 percent of the federal poverty level: $3.
   11         2. Greater than 22 percent, but at or below 50 percent, of
   12  the federal poverty level: $8.
   13         3. Greater than 50 percent, but at or below 75 percent, of
   14  the federal poverty level: $15.
   15         4. Greater than 75 percent, but at or below 100 percent, of
   16  the federal poverty level: $20.
   17         5. Greater than 100 percent of the federal poverty level:
   18  $25.
   19         (b) Depending on the products and services selected by the
   20  enrollee, the enrollee may also incur additional cost sharing,
   21  such as copayments, deductibles, or other out-of-pocket costs.
   22         (c) An enrollee may be subject to charges for an
   23  inappropriate emergency room visit of up to $8 for the first
   24  visit and up to $25 for any subsequent visit, based on the
   25  enrollee’s benefit plan, to discourage inappropriate use of the
   26  emergency room.
   27         (d) Cumulative annual cost sharing per enrollee may not
   28  exceed 5 percent of an enrollee’s annual modified adjusted gross
   29  income.
   30         (e) If, after a 30-day grace period, a full premium payment
   31  has not been received, the enrollee shall be transitioned from
   32  coverage to inactive status and may not reenroll for a minimum
   33  of 6 months, unless a hardship exception has been granted.
   34  Enrollees may seek a hardship exception under the Medicaid Fair
   35  Hearing Process.
   36         (f) Enrollees eligible under paragraph (1)(c) must pay
   37  premiums according to the Title XXI state plan amendment and
   38  follow disenrollment criteria for noncompliance in accordance
   39  with s. 624.91.