The Florida Senate

154.308  Determination of patient's eligibility; spend-down program.--

(1)  The department, pursuant to s. 154.3105, shall adopt rules which provide statewide eligibility determination procedures, forms, and criteria which shall be used by all counties for determining whether a person financially qualifies as indigent for the purposes of this act.

(a)  The criteria used to determine eligibility shall be uniform statewide and shall include, at a minimum, which assets, if any, may be included in the determination, which verification of income shall be required, which categories of persons shall be eligible, and any other criteria which may be determined as necessary.

(b)  The methodology by which to determine financial eligibility shall also be uniform statewide such that any county or the state could determine whether a person would be a qualified indigent under this act.

(2)  Determination of financial eligibility as a qualified indigent may occur either prior to a person's admission to a participating hospital or a regional referral hospital or subsequent to such admission.

(3)  Determination of whether a hospital patient not already determined eligible meets or does not meet eligibility standards to financially qualify as indigent for the purpose of this act shall be made within 60 days following notification by the hospital requesting a determination of indigency, by certified letter, to the county known or believed to be the county of residence or to the department. If for any reason, the county or department is unable to determine a patient's eligibility within the allotted timeframe, the hospital shall be notified in writing of the reason or reasons.

(4)  A patient determined eligible as a qualified indigent for the purpose of this act subsequent to his or her admission to a participating hospital or a regional referral hospital shall be considered to have been qualified upon admission. Such determination shall be made by a person designated by the governing board of the county to make such a determination or by the department.

(5)  Notwithstanding any other provision within this act, any county may establish thresholds of financial eligibility to qualify indigents under this act which are less restrictive than 100 percent of the federal poverty line. However, no county may establish eligibility thresholds which are more restrictive than 100 percent of the federal poverty line.

(6)  Notwithstanding any other provision of this act, there is hereby established a spend-down program for persons who would otherwise qualify as qualified indigent persons, but whose average family income, for the 12 months preceding the determination, is between 100 percent and 150 percent of the federal poverty level. The department shall adopt, by rule, procedures for the spend-down program. The rule shall require that in order to qualify for the spend-down program, a person must have incurred bills for hospital care which would otherwise have qualified for payment under this part. This subsection does not apply to persons who are residents of counties that are at their 10-mill cap on October 1, 1991.

History.--s. 6, ch. 77-455; s. 10, ch. 88-294; s. 6, ch. 90-295; s. 4, ch. 91-173; s. 874, ch. 95-147.