Florida Senate - 2006                      COMMITTEE AMENDMENT
    Bill No. SB 2050
                        Barcode 422358
                            CHAMBER ACTION
              Senate                               House
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 1           Comm: FAV             .                    
       03/22/2006 11:50 AM         .                    
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11  The Committee on Banking and Insurance (Garcia) recommended
12  the following amendment:
13  
14         Senate Amendment (with title amendment) 
15         On page 5, line 30, through
16            page 6, line 25, delete those lines
17  
18  and insert:  
19         Section 2.  Subsection (28) is added to section
20  409.811, Florida Statutes, to read:
21         409.811  Definitions relating to Florida KidCare
22  Act.--As used in ss. 409.810-409.820, the term:
23         (28)  "Maximum income threshold" means a percentage of
24  the current federal poverty level used to determine
25  eligibility for certain program components, as approved by
26  federal waiver or state plan amendment. The agency shall seek
27  federal approval of the highest maximum income threshold
28  allowed by the Federal Government up to 300 percent of the
29  current federal poverty level. Until such federal approval is
30  granted, the threshold shall be 200 percent of the current
31  federal poverty level or the highest threshold allowed under
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    Florida Senate - 2006                      COMMITTEE AMENDMENT
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 1  current federal waiver authority.
 2         Section 3.  Paragraph (a) of subsection (6) of section
 3  409.8132, Florida Statutes, is amended to read:
 4         409.8132  Medikids program component.--
 5         (6)  ELIGIBILITY.--
 6         (a)  A child who has attained the age of 1 year but who
 7  is under the age of 5 years is eligible to enroll in the
 8  Medikids program component of the Florida KidCare program, if
 9  the child is a member of a family that has a family income
10  which exceeds the Medicaid applicable income level as
11  specified in s. 409.903, but which is equal to or below the
12  maximum income threshold 200 percent of the current federal
13  poverty level.  In determining the eligibility of such a
14  child, an assets test is not required. A child who is eligible
15  for Medikids may elect to enroll in Florida Healthy Kids
16  coverage or employer-sponsored group coverage. However, a
17  child who is eligible for Medikids may participate in the
18  Florida Healthy Kids program only if the child has a sibling
19  participating in the Florida Healthy Kids program and the
20  child's county of residence permits such enrollment.
21         Section 4.  Subsection (2) of section 409.8134, Florida
22  Statutes, is amended to read:
23         409.8134  Program enrollment and expenditure
24  ceilings.--
25         (2)  The Florida KidCare program may conduct enrollment
26  at any time throughout the year for the purpose of enrolling
27  children eligible for all program components listed in s.
28  409.813 except Medicaid. The four Florida KidCare
29  administrators shall work together to ensure that the
30  year-round enrollment period is announced statewide. Eligible
31  children shall be enrolled on a first-come, first-served basis
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    Florida Senate - 2006                      COMMITTEE AMENDMENT
    Bill No. SB 2050
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 1  using the date the enrollment application is received.
 2  Enrollment shall immediately cease when the enrollment ceiling
 3  is reached. Year-round enrollment shall only be held if the
 4  Social Services Estimating Conference determines that
 5  sufficient federal and state funds will be available to
 6  finance the increased enrollment for as long as federal
 7  funding is available through federal fiscal year 2007. Any
 8  individual who is not enrolled must reapply by submitting a
 9  new application. The application for the Florida KidCare
10  program shall be valid for a period of 120 days after the date
11  it was received. At the end of the 120-day period, if the
12  applicant has not been enrolled in the program, the
13  application shall be invalid and the applicant shall be
14  notified of the action. The applicant may resubmit the
15  application after notification of the action taken by the
16  program. Except for the Medicaid program, whenever the Social
17  Services Estimating Conference determines that there are
18  presently, or will be by the end of the current fiscal year,
19  insufficient funds to finance the current or projected
20  enrollment in the Florida KidCare program, all additional
21  enrollment must cease and additional enrollment may not resume
22  until sufficient funds are available to finance such
23  enrollment.
24         Section 5.  Section 409.814, Florida Statutes, is
25  amended to read:
26         409.814  Eligibility.--A child who has not reached 19
27  years of age whose family income is equal to or below the
28  maximum income threshold 200 percent of the federal poverty
29  level is eligible for the Florida KidCare program as provided
30  in this section. For enrollment in the Children's Medical
31  Services Network, a complete application includes the medical
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    Florida Senate - 2006                      COMMITTEE AMENDMENT
    Bill No. SB 2050
                        Barcode 422358
 1  or behavioral health screening. If, subsequently, an
 2  individual is determined to be ineligible for coverage, he or
 3  she must immediately be disenrolled from the respective
 4  Florida KidCare program component.
 5         (1)  A child who is eligible for Medicaid coverage
 6  under s. 409.903 or s. 409.904 must be enrolled in Medicaid
 7  and is not eligible to receive health benefits under any other
 8  health benefits coverage authorized under the Florida KidCare
 9  program.
10         (2)  A child who is not eligible for Medicaid, but who
11  is eligible for the Florida KidCare program, may obtain health
12  benefits coverage under any of the other components listed in
13  s. 409.813 if such coverage is approved and available in the
14  county in which the child resides. However, a child who is
15  eligible for Medikids may participate in the Florida Healthy
16  Kids program only if the child has a sibling participating in
17  the Florida Healthy Kids program and the child's county of
18  residence permits such enrollment.
19         (3)  A child who is eligible for the Florida KidCare
20  program who is a child with special health care needs, as
21  determined through a medical or behavioral screening
22  instrument, is eligible for health benefits coverage from and
23  shall be referred to the Children's Medical Services Network.
24         (4)  The following children are not eligible to receive
25  premium assistance for health benefits coverage under the
26  Florida KidCare program, except under Medicaid if the child
27  would have been eligible for Medicaid under s. 409.903 or s.
28  409.904 as of June 1, 1997:
29         (a)  A child who is eligible for coverage under a state
30  health benefit plan on the basis of a family member's
31  employment with a public agency in the state.
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    Florida Senate - 2006                      COMMITTEE AMENDMENT
    Bill No. SB 2050
                        Barcode 422358
 1         (b)  A child who is currently eligible for or covered
 2  under a family member's group health benefit plan or under
 3  other employer health insurance coverage, excluding coverage
 4  provided under the Florida Healthy Kids Corporation as
 5  established under s. 624.91, provided that the cost of the
 6  child's participation is not greater than 5 percent of the
 7  family's income. This provision shall be applied during
 8  redetermination for children who were enrolled prior to July
 9  1, 2004. These enrollees shall have 6 months of eligibility
10  following redetermination to allow for a transition to the
11  other health benefit plan.
12         (c)  A child who is seeking premium assistance for the
13  Florida KidCare program through employer-sponsored group
14  coverage, if the child has been covered by the same employer's
15  group coverage during the 6 months prior to the family's
16  submitting an application for determination of eligibility
17  under the program.
18         (d)  A child who is an alien, but who does not meet the
19  definition of qualified alien, in the United States.
20         (e)  A child who is an inmate of a public institution
21  or a patient in an institution for mental diseases.
22         (f)  A child who has had his or her coverage in an
23  employer-sponsored health benefit plan voluntarily canceled in
24  the last 6 months, except those children who were on the
25  waiting list prior to March 12, 2004.
26         (g)  A child who is otherwise eligible for KidCare and
27  who has a preexisting condition that prevents coverage under
28  another insurance plan as described in paragraph (b) which
29  would have disqualified the child for KidCare if the child
30  were able to enroll in the plan shall be eligible for KidCare
31  coverage when enrollment is possible.
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    Florida Senate - 2006                      COMMITTEE AMENDMENT
    Bill No. SB 2050
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 1         (5)  A child whose family income is above the maximum
 2  income threshold 200 percent of the federal poverty level or a
 3  child who is excluded under the provisions of subsection (4)
 4  may participate in the Florida KidCare program, excluding the
 5  Medicaid program, but is subject to the following provisions:
 6         (a)  The family is not eligible for premium assistance
 7  payments and must pay the full cost of the premium, including
 8  any administrative costs.
 9         (b)  The agency is authorized to place limits on
10  enrollment in Medikids by these children in order to avoid
11  adverse selection. The number of children participating in
12  Medikids whose family income exceeds the maximum income
13  threshold 200 percent of the federal poverty level must not
14  exceed 10 percent of total enrollees in the Medikids program.
15         (c)  The board of directors of the Florida Healthy Kids
16  Corporation is authorized to place limits on enrollment of
17  these children in order to avoid adverse selection. In
18  addition, the board is authorized to offer a reduced benefit
19  package to these children in order to limit program costs for
20  such families. The number of children participating in the
21  Florida Healthy Kids program whose family income exceeds the
22  maximum income threshold 200 percent of the federal poverty
23  level must not exceed 10 percent of total enrollees in the
24  Florida Healthy Kids program.
25         (d)  Children described in this subsection are not
26  counted in the annual enrollment ceiling for the Florida
27  KidCare program.
28         (6)  Once a child is enrolled in the Florida KidCare
29  program, the child is eligible for coverage under the program
30  for 12 months without a redetermination or reverification of
31  eligibility, if the family continues to pay the applicable
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    Florida Senate - 2006                      COMMITTEE AMENDMENT
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 1  premium. Eligibility for program components funded through
 2  Title XXI of the Social Security Act shall terminate when a
 3  child attains the age of 19. Effective January 1, 1999, a
 4  child who has not attained the age of 5 and who has been
 5  determined eligible for the Medicaid program is eligible for
 6  coverage for 12 months without a redetermination or
 7  reverification of eligibility.
 8         (7)  When determining or reviewing a child's
 9  eligibility under the Florida KidCare program, the applicant
10  shall be provided with reasonable notice of changes in
11  eligibility which may affect enrollment in one or more of the
12  program components. When a transition from one program
13  component to another is authorized, there shall be cooperation
14  between the program components and the affected family which
15  promotes continuity of health care coverage. Any authorized
16  transfers must be managed within the program's overall
17  appropriated or authorized levels of funding. Each component
18  of the program shall establish a reserve to ensure that
19  transfers between components will be accomplished within
20  current year appropriations. These reserves shall be reviewed
21  by each convening of the Social Services Estimating Conference
22  to determine the adequacy of such reserves to meet actual
23  experience.
24         (8)  In determining the eligibility of a child, an
25  assets test is not required. Each applicant shall provide
26  written documentation during the application process and the
27  redetermination process, including, but not limited to, the
28  following:
29         (a)  Proof of family income, which must include a copy
30  of the applicant's most recent federal income tax return. In
31  the absence of a federal income tax return, an applicant may
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    Florida Senate - 2006                      COMMITTEE AMENDMENT
    Bill No. SB 2050
                        Barcode 422358
 1  submit wages and earnings statements (pay stubs), W-2 forms,
 2  or other appropriate documents.
 3         (b)  A statement from all family members that:
 4         1.  Their employer does not sponsor a health benefit
 5  plan for employees; or
 6         2.  The potential enrollee is not covered by the
 7  employer-sponsored health benefit plan because the potential
 8  enrollee is not eligible for coverage, or, if the potential
 9  enrollee is eligible but not covered, a statement of the cost
10  to enroll the potential enrollee in the employer-sponsored
11  health benefit plan.
12         (9)  Subject to paragraph (4)(b) and s. 624.91(3), the
13  Florida KidCare program shall withhold benefits from an
14  enrollee if the program obtains evidence that the enrollee is
15  no longer eligible, submitted incorrect or fraudulent
16  information in order to establish eligibility, or failed to
17  provide verification of eligibility. The applicant or enrollee
18  shall be notified that because of such evidence program
19  benefits will be withheld unless the applicant or enrollee
20  contacts a designated representative of the program by a
21  specified date, which must be within 10 days after the date of
22  notice, to discuss and resolve the matter. The program shall
23  make every effort to resolve the matter within a timeframe
24  that will not cause benefits to be withheld from an eligible
25  enrollee.
26         (10)  The following individuals may be subject to
27  prosecution in accordance with s. 414.39:
28         (a)  An applicant obtaining or attempting to obtain
29  benefits for a potential enrollee under the Florida KidCare
30  program when the applicant knows or should have known the
31  potential enrollee does not qualify for the Florida KidCare
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    Florida Senate - 2006                      COMMITTEE AMENDMENT
    Bill No. SB 2050
                        Barcode 422358
 1  program.
 2         (b)  An individual who assists an applicant in
 3  obtaining or attempting to obtain benefits for a potential
 4  enrollee under the Florida KidCare program when the individual
 5  knows or should have known the potential enrollee does not
 6  qualify for the Florida KidCare program.
 7         Section 6.  Paragraph (a) of subsection (1) of section
 8  409.818, Florida Statutes, is amended to read:
 9         409.818  Administration.--In order to implement ss.
10  409.810-409.820, the following agencies shall have the
11  following duties:
12         (1)  The Department of Children and Family Services
13  shall:
14         (a)  Develop a simplified eligibility application
15  system, including the use of mail-in forms and electronic
16  information intake methods, mail-in form to be used for
17  determining the eligibility of children for coverage under the
18  Florida KidCare program, in consultation with the agency, the
19  Department of Health, and the Florida Healthy Kids
20  Corporation. The simplified eligibility application system
21  form must include an item that provides an opportunity for the
22  applicant to indicate whether coverage is being sought for a
23  child with special health care needs. Families applying for
24  children's Medicaid coverage must also be able to use the
25  simplified application form without having to pay a premium.
26         1.  The department shall forward the family's
27  application information, together with accompanying
28  documentation, if any, to the Florida Healthy Kids
29  Corporation, and such application information and documents
30  shall be processed for KidCare program enrollment by the
31  Florida Healthy Kids Corporation in accordance with
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                        Barcode 422358
 1  eligibility criteria then in effect, without requiring the
 2  applicant to submit a separate application for the KidCare
 3  program.
 4         2.  A child shall be enrolled in the KidCare program if
 5  the child is determined to be eligible for KidCare enrollment
 6  and the family agrees to pay the KidCare program premiums, as
 7  applicable.
 8         Section 7.  Section 409.8195, Florida Statutes, is
 9  created to read:
10         409.8195  Marketing.--
11         (1)  Participating health insurance plans may develop
12  advertising and outreach materials and participate in outreach
13  activities such as health fairs and other public events, as
14  approved by the entity responsible for outreach, for the
15  purpose of educating families about the benefits of the
16  Florida KidCare program and contacting families when they are
17  disenrolled from or found ineligible for the Medicaid program
18  and at the time of redeterminations for both Medicaid and
19  KidCare programs.
20         (2)  In all counties where there is more than one
21  Healthy Kids health insurance plan available, families shall
22  have a choice of health insurance plans. If a family does not
23  choose a health insurance plan, the corporation will assign
24  children to a health insurance plan.
25         Section 8.  This act shall take effect upon becoming a
26  law.
27  
28  
29  ================ T I T L E   A M E N D M E N T ===============
30  And the title is amended as follows:
31         On page 1, lines 11-13, delete those lines
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    Florida Senate - 2006                      COMMITTEE AMENDMENT
    Bill No. SB 2050
                        Barcode 422358
 1  and insert:
 2         contribution; amending s. 409.811, F.S.;
 3         defining the term "maximum income threshold";
 4         amending s. 409.8132, F.S.; revising
 5         eligibility requirements for the Medikids
 6         program component of the Florida KidCare
 7         program; amending s. 409.8134, F.S.; revising
 8         restrictions on enrollment in the Florida
 9         KidCare program; amending s. 409.814, F.S.;
10         revising eligibility requirements for the
11         Florida KidCare program which relate to maximum
12         income levels; conforming a cross-reference;
13         amending s. 409.818, F.S.; revising duties of
14         the Department of Children and Family Services
15         relating to administration of the Florida
16         KidCare Act; creating s. 409.8195, F.S.;
17         allowing participating health insurance plans
18         to develop advertising and conduct outreach to
19         educate families about the Florida KidCare
20         program; requiring families to have a choice of
21         Healthy Kids health insurance plans if more
22         than one such plan is available in the county;
23         providing an effective date.
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