Florida Senate - 2007                      COMMITTEE AMENDMENT
    Bill No. CS for CS for SB 930
                        Barcode 064092
                            CHAMBER ACTION
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11  The Committee on Health and Human Services Appropriations
12  (Peaden) recommended the following amendment:
13  
14         Senate Amendment (with title amendment) 
15         Delete everything after the enacting clause
16  
17  and insert:  
18         Section 1.  Section 409.811, Florida Statutes, is
19  amended to read:
20         409.811  Definitions relating to Florida Kidcare
21  Act.--As used in ss. 409.810-409.830 ss. 409.810-409.820, the
22  term:
23         (1)  "Actuarially equivalent" means that:
24         (a)  The aggregate value of the benefits included in
25  health benefits coverage is equal to the value of the benefits
26  in the benchmark benefit plan; and
27         (b)  The benefits included in health benefits coverage
28  are substantially similar to the benefits included in the
29  benchmark benefit plan, except that preventive health services
30  must be the same as in the benchmark benefit plan.
31         (2)  "Agency" means the Agency for Health Care
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Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 Administration. 2 (3) "Applicant" means a parent or guardian of a child 3 or a child whose disability of nonage has been removed under 4 chapter 743, who applies for determination of eligibility for 5 health benefits coverage under ss. 409.810-409.830 ss. 6 409.810-409.820. 7 (4) "Benchmark benefit plan" means the form and level 8 of health benefits coverage established in s. 409.815. 9 (5) "Child" means any person under 19 years of age. 10 (6) "Child with special health care needs" means a 11 child who has a chronic physical, developmental, behavioral, 12 or emotional condition and who also required health care and 13 related services of a type or amount beyond that which is 14 generally required by children. whose serious or chronic 15 physical or developmental condition requires extensive 16 preventive and maintenance care beyond that required by 17 typically healthy children. Health care utilization by such a 18 child exceeds the statistically expected usage of the normal 19 child adjusted for chronological age, and such a child often 20 needs complex care requiring multiple providers, 21 rehabilitation services, and specialized equipment in a number 22 of different settings. 23 (7) "Children's Medical Services Network" or "network" 24 means a statewide managed care service system as defined in s. 25 391.021(1). 26 (8) "Community rate" means a method used to develop 27 premiums for a health insurance plan that spreads financial 28 risk across a large population and allows adjustments only for 29 age, gender, family composition, and geographic area. 30 (9) "Department" means the Department of Health. 31 (10) "Enrollee" means a child who has been determined 2 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 eligible for and is receiving coverage under ss. 2 409.810-409.820. 3 (11) "Family" means the group or the individuals whose 4 income is considered in determining eligibility for the 5 Florida Kidcare program. The family includes a child with a 6 custodial parent or caretaker relative who resides in the same 7 house or living unit or, in the case of a child whose 8 disability of nonage has been removed under chapter 743, the 9 child. The family may also include other individuals whose 10 income and resources are considered in whole or in part in 11 determining eligibility of the child. 12 (12) "Family income" means cash received at periodic 13 intervals from any source, such as wages, benefits, 14 contributions, or rental property. Income also may include any 15 money that would have been counted as income under the Aid to 16 Families with Dependent Children (AFDC) state plan in effect 17 prior to August 22, 1996. 18 (13) "Florida Kidcare Plus" means health benefits 19 coverage for children with special health care needs which 20 benefits are delivered through the Children's Medical Services 21 Network established in chapter 391. 22 (14)(13) "Florida Kidcare program," "Kidcare program," 23 or "program" means the health benefits program for children 24 administered through ss. 409.810-409.830 ss. 409.810-409.820. 25 (15)(14) "Guarantee issue" means that health benefits 26 coverage must be offered to an individual regardless of the 27 individual's health status, preexisting condition, or claims 28 history. 29 (16)(15) "Health benefits coverage" means protection 30 that provides payment of benefits for covered health care 31 services or that otherwise provides, either directly or 3 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 through arrangements with other persons, covered health care 2 services on a prepaid per capita basis or on a prepaid 3 aggregate fixed-sum basis. 4 (17)(16) "Health insurance plan" means health benefits 5 coverage under the following: 6 (a) A health plan offered by any certified health 7 maintenance organization or authorized health insurer, except 8 a plan that is limited to the following: a limited benefit, 9 specified disease, or specified accident; hospital indemnity; 10 accident only; limited benefit convalescent care; Medicare 11 supplement; credit disability; dental; vision; long-term care; 12 disability income; coverage issued as a supplement to another 13 health plan; workers' compensation liability or other 14 insurance; or motor vehicle medical payment only; or 15 (b) An employee welfare benefit plan that includes 16 health benefits established under the Employee Retirement 17 Income Security Act of 1974, as amended. 18 (18) "Healthy Kids" means a component of the Florida 19 Kidcare program of medical assistance for children who are 5 20 through 18 years of age and whose family or household incomes 21 are above the Title XIX-income-eligibility threshold. 22 (19)(17) "Medicaid" means the medical assistance 23 program authorized by Title XIX of the Social Security Act, 24 and regulations thereunder, and ss. 409.901-409.920, as 25 administered in this state by the agency. 26 (20)(18) "Medically necessary" means the use of any 27 medical treatment, service, equipment, or supply necessary to 28 palliate the effects of a terminal condition, or to prevent, 29 diagnose, correct, cure, alleviate, or preclude deterioration 30 of a condition that threatens life, causes pain or suffering, 31 or results in illness or infirmity and which is: 4 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 (a) Consistent with the symptom, diagnosis, and 2 treatment of the enrollee's condition; 3 (b) Provided in accordance with generally accepted 4 standards of medical practice; 5 (c) Not primarily intended for the convenience of the 6 enrollee, the enrollee's family, or the health care provider; 7 (d) The most appropriate level of supply or service 8 for the diagnosis and treatment of the enrollee's condition; 9 and 10 (e) Approved by the appropriate medical body or health 11 care specialty involved as effective, appropriate, and 12 essential for the care and treatment of the enrollee's 13 condition. 14 (21)(19) "Medikids" means a component of the Florida 15 Kidcare program of medical assistance authorized by Title XXI 16 of the Social Security Act, and regulations thereunder, and s. 17 409.8132, as administered in the state by the agency. 18 (22)(20) "Preexisting condition exclusion" means, with 19 respect to coverage, a limitation or exclusion of benefits 20 relating to a condition based on the fact that the condition 21 was present before the date of enrollment for such coverage, 22 whether or not any medical advice, diagnosis, care, or 23 treatment was recommended or received before such date. 24 (23)(21) "Premium" means the entire cost of a health 25 insurance plan, including the administration fee or the risk 26 assumption charge. 27 (24)(22) "Premium assistance payment" means the 28 monthly consideration paid by the agency per enrollee in the 29 Florida Kidcare program towards health insurance premiums. 30 (25)(23) "Qualified alien" means an alien as defined 31 in s. 431 of the Personal Responsibility and Work Opportunity 5 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 Reconciliation Act of 1996, as amended, Pub. L. No. 104-193. 2 (26)(24) "Resident" means a United States citizen, or 3 qualified alien, who is domiciled in this state. 4 (27)(25) "Rural county" means a county having a 5 population density of fewer less than 100 persons per square 6 mile, or a county defined by the most recent United States 7 Census as rural, in which there is no prepaid health plan 8 participating in the Medicaid program as of July 1, 1998. 9 (28)(26) "Substantially similar" means that, with 10 respect to additional services as defined in s. 2103(c)(2) of 11 Title XXI of the Social Security Act, these services must have 12 an actuarial value equal to at least 75 percent of the 13 actuarial value of the coverage for that service in the 14 benchmark benefit plan and, with respect to the basic services 15 as defined in s. 2103(c)(1) of Title XXI of the Social 16 Security Act, these services must be the same as the services 17 in the benchmark benefit plan. 18 Section 2. Section 409.812, Florida Statutes, is 19 amended to read: 20 409.812 Program created; purpose.--The Florida Kidcare 21 program is created to provide a defined set of health benefits 22 to previously uninsured, low-income children through the 23 establishment of a variety of affordable health benefits 24 coverage options from which families may select coverage and 25 through which families may contribute financially to the 26 health care of their children. 27 Section 3. Section 409.813, Florida Statutes, is 28 amended to read: 29 409.813 Program components; entitlement and 30 nonentitlement.--The Florida Kidcare program includes health 31 benefits coverage provided to children through the following 6 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 funding sources, which shall be marketed as the Florida 2 Kidcare program: 3 (1) Title XIX of the Social Security Act Medicaid; 4 (2) Title XXI of the Social Security Act Medikids as 5 created in s. 409.8132; 6 (3) The Title V Program of the Social Security Act, as 7 it relates to children with special health care needs The 8 Florida Healthy Kids Corporation as created in s. 624.91; 9 (4) Employer-sponsored group health insurance plans 10 approved under ss. 409.810-409.830 ss. 409.810-409.820; and 11 (5) Full pay premiums for children with family incomes 12 above the maximum income threshold or children who are not 13 Title XXI-eligible pursuant to s. 409.8141; and The Children's 14 Medical Services network established in chapter 391. 15 (6) General revenue or local contributions. 16 17 Except for Title XIX-funded Florida Kidcare coverage under the 18 Medicaid program, coverage under the Florida Kidcare program 19 is not an entitlement. No cause of action shall arise against 20 the state, the Department of Health, the Department of 21 Children and Family Services, or the Florida Healthy Kids 22 Corporation, or the Agency for Health Care Administration 23 agency for failure to make health services available to any 24 person under ss. 409.810-409.830 ss. 409.810-409.820. 25 Section 4. Section 409.8132, Florida Statutes, is 26 amended to read: 27 409.8132 Medikids program component.-- 28 (1) PROGRAM COMPONENT CREATED; PURPOSE.--The Medikids 29 program component is created in the Agency for Health Care 30 Administration to provide health care services under the 31 Florida Kidcare program to eligible children using the 7 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 administrative structure and provider network of the Medicaid 2 program. 3 (2) ADMINISTRATION.--The secretary of the agency shall 4 appoint an administrator of the Medikids program component. 5 The Agency for Health Care Administration is designated as the 6 state agency authorized to make payments for medical 7 assistance and related services for the Medikids program 8 component of the Florida Kidcare program. Payments shall be 9 made, subject to any limitations or directions in the General 10 Appropriations Act, only for covered services provided to 11 eligible children by qualified health care providers under the 12 Florida Kidcare program. 13 (3) INSURANCE LICENSURE NOT REQUIRED.--The Medikids 14 program component shall not be subject to the licensing 15 requirements of the Florida Insurance Code or rules adopted 16 thereunder. 17 (4) APPLICABILITY OF LAWS RELATING TO MEDICAID.--The 18 provisions of ss. 409.902, 409.905, 409.906, 409.907, 409.908, 19 409.912, 409.9121, 409.9122, 409.9123, 409.9124, 409.9127, 20 409.9128, 409.913, 409.916, 409.919, 409.920, and 409.9205 21 apply to the administration of the Medikids program component 22 of the Florida Kidcare program, except that s. 409.9122 23 applies to Medikids as modified by the provisions of 24 subsection (7). 25 (5) BENEFITS.--Benefits provided under the Medikids 26 program component shall be the same benefits provided to 27 children as specified in ss. 409.905 and 409.906. 28 (6) ELIGIBILITY.-- 29 (a) A child who has attained the age of 1 year but who 30 is under the age of 5 years is eligible to enroll in the 31 Medikids program component of the Florida Kidcare program, if 8 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 the child is a member of a family that has a family income 2 which exceeds the Medicaid applicable income level as 3 specified in s. 409.903, but which is equal to or below 200 4 percent of the current federal poverty level. In determining 5 the eligibility of such a child, an assets test is not 6 required. A child who is eligible for Medikids may elect to 7 enroll in Florida Healthy Kids coverage or employer-sponsored 8 group coverage. However, a child who is eligible for Medikids 9 may participate in the Florida Healthy Kids program only if 10 the child has a sibling participating in the Florida Healthy 11 Kids program and the child's county of residence permits such 12 enrollment. 13 (b) The provisions of ss. 409.814, 409.8141, 409.8142, 14 and 409.8149 s. 409.814(3), (4), and (5) shall be applicable 15 to the Medikids program. 16 (7) ENROLLMENT.--Enrollment in the Medikids program 17 component may occur at any time throughout the year. A child 18 may not receive services under the Medikids program until the 19 child is enrolled in a managed care plan or MediPass. Once 20 determined eligible, an applicant may receive choice 21 counseling and select a managed care plan or MediPass. The 22 agency may initiate mandatory assignment for a Medikids 23 applicant who has not chosen a managed care plan or MediPass 24 provider after the applicant's voluntary choice period ends. 25 An applicant may select MediPass under the Medikids program 26 component only in counties that have fewer than two managed 27 care plans available to serve Medicaid recipients and only if 28 the federal Health Care Financing Administration determines 29 that MediPass constitutes "health insurance coverage" as 30 defined in Title XXI of the Social Security Act. 31 (8) PENALTIES FOR VOLUNTARY CANCELLATION.--The agency 9 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 shall establish enrollment criteria that must include 2 penalties or waiting periods of not fewer than 60 days for 3 reinstatement of coverage upon voluntary cancellation for 4 nonpayment of premiums. 5 Section 5. Section 409.8134, Florida Statutes, is 6 amended to read: 7 409.8134 Program expenditure ceiling.-- 8 (1) Except for the Medicaid program, a ceiling shall 9 be placed on annual federal and state expenditures for the 10 Florida Kidcare program as provided each year in the General 11 Appropriations Act. 12 (2) The Florida Kidcare program may conduct enrollment 13 at any time throughout the year for the purpose of enrolling 14 children eligible for all program components listed in s. 15 409.813 except Medicaid. The four Florida Kidcare 16 administrators shall work together to ensure that the 17 year-round enrollment period is announced statewide. Eligible 18 children shall be enrolled on a first-come, first-served basis 19 using the date the enrollment application is received. 20 Enrollment shall immediately cease when the expenditure 21 ceiling is reached. Year-round enrollment shall only be held 22 if the Social Services Estimating Conference determines that 23 sufficient federal and state funds will be available to 24 finance the increased enrollment through federal fiscal year 25 2007. Any individual who is not enrolled must reapply by 26 submitting a new application. The application for the Florida 27 Kidcare program shall be valid for a period of 120 days after 28 the date it was received. At the end of the 120-day period, if 29 the applicant has not been enrolled in the program, the 30 application shall be invalid and the applicant shall be 31 notified of the action. The applicant may resubmit the 10 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 application after notification of the action taken by the 2 program. Except for the Medicaid program, whenever the Social 3 Services Estimating Conference determines that there are 4 presently, or will be by the end of the current fiscal year, 5 insufficient funds to finance the current or projected 6 enrollment in the Florida Kidcare program, all additional 7 enrollment must cease and additional enrollment may not resume 8 until sufficient funds are available to finance such 9 enrollment. 10 (3) Upon determination by the Social Services 11 Estimating Conference that there are insufficient funds to 12 finance the current enrollment in the Florida Kidcare program 13 within current appropriations, the program shall initiate 14 disenrollment procedures to remove enrollees, except those 15 children who receive Florida Kidcare Plus benefits enrolled in 16 the Children's Medical Services Network, on a last-in, 17 first-out basis until the expenditure and appropriation levels 18 are balanced. 19 (4) The agencies that administer the Florida Kidcare 20 program components shall collect and analyze the data needed 21 to project program enrollment costs, including price level 22 adjustments, participation and attrition rates, current and 23 projected caseloads, utilization, and current and projected 24 expenditures for the next 3 years. The agencies shall report 25 caseload and expenditure trends to the Social Services 26 Estimating Conference in accordance with chapter 216. 27 Section 6. Section 409.814, Florida Statutes, is 28 amended to read: 29 (Substantial rewording of section. See 30 s. 409.814, F.S., for present text.) 31 409.814 Eligibility.-- 11 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 (1) ELIGIBILITY FOR THE FLORIDA KIDCARE PROGRAM.--To 2 be eligible for the Florida Kidcare program, a child must be: 3 (a) A resident of the state. 4 (b) Under 19 years of age. 5 (c) Uninsured at the time of application, except for 6 children eligible for Medicaid. 7 (2) ELIGIBILITY FOR FLORIDA KIDCARE PLUS.--To be 8 eligible for the Florida Kidcare Plus benefit delivered by the 9 Children's Medical Services Network in the Florida Kidcare 10 program, a child must meet the requirements of subsection (1) 11 and must be a child with special health care needs as 12 determined through a clinical-eligibility screening instrument 13 administered by the Department of Health pursuant to s. 14 409.818(2). 15 Section 7. Section 409.8141, Florida Statutes, is 16 created to read: 17 409.8141 Premium assistance.-- 18 (1) The Florida Kidcare program may provide premium 19 assistance to certain children enrolled in the program. To be 20 eligible for premium assistance, the child must meet the 21 requirements of s. 409.814 and must: 22 (a) Reside in a household where the family income is 23 equal to or less than 200 percent of the federal poverty 24 level; 25 (b) Be a United States citizen or a qualified alien as 26 defined in s. 409.811(24); 27 (c) Not be an inmate of a public institution or a 28 patient in an institution for mental diseases; 29 (d) Not be eligible for coverage under a state health 30 benefit plan on the basis of a family member's employment with 31 a public agency in the state; and 12 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 (e) Not be currently eligible for or covered under a 2 family member's group health benefit plan or under other 3 employer health insurance coverage, excluding full-pay Florida 4 Kidcare health benefits coverage, if the cost of the child's 5 participation is not greater than 5 percent of the family's 6 income. 7 (2) A child seeking premium assistance for the Florida 8 Kidcare program is not eligible for premium assistance if the 9 child was covered through an employer-sponsored group coverage 10 6 months prior to the family submitting an application for 11 determination of eligibility under the program, unless the 12 employer-sponsored health coverage was discontinued for 13 good-cause reasons. Good-cause reasons for discontinued 14 employer-sponsored health coverage include: 15 (a) The cost of participation in an employer-sponsored 16 health benefit plan is greater than 5 percent of the family's 17 income; 18 (b) The parent lost a job that provided an 19 employer-sponsored health benefit plan for children; 20 (c) The parent who had health benefits coverage for 21 the child is deceased; 22 (d) The child has a medical condition that, without 23 medical care, would cause serious disability, loss of 24 function, or death; 25 (e) The employer of the parent canceled health 26 benefits coverage for children; 27 (f) The child's health benefits coverage ended because 28 the child reached the maximum lifetime coverage amount; 29 (g) The child has exhausted coverage under a COBRA 30 continuation provision; 31 (h) The health benefits coverage does not cover the 13 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 child's health care needs; or 2 (i) Domestic violence led to loss of coverage. 3 (3) Eligibility for premium assistance shall be 4 verified for each applicant and enrollee during the 5 application and reverification processes based on: 6 (a) Family income documented with a copy of the 7 applicant's most recent federal income tax return. In the 8 absence of a federal income tax return, an applicant's wages 9 and earnings statements, W-2 forms, or other appropriate 10 documentation obtained from other government sources, 11 including electronic records, may be considered. An assets 12 test is not required. 13 (b) A statement from the applicant or enrollee that 14 the child is not currently insured by an employer-sponsored or 15 other benefit plan. 16 (4) Enrollees not meeting the eligibility requirements 17 of subsection (1) shall pay the full cost of the premium and 18 are not required to document income. The number of children 19 participating in the non-Title XIX-funded Florida Kidcare 20 program under this subsection whose family income exceeds 200 21 percent of the federal poverty level must not exceed 10 22 percent of total enrollees in the non-title XIX-funded Florida 23 Kidcare program. 24 (5)(a) A Title XIX-funded child enrolled in the 25 Florida Kidcare program is eligible for coverage for 6 months 26 without redetermination or reverification of eligibility. 27 (b) A child found eligible for premium assistance in 28 the Florida Kidcare program shall receive premium assistance 29 for 12 months without reverification of eligibility if the 30 family continues to participate in any applicable cost-sharing 31 pursuant to s. 409.816. The Florida Kidcare program shall 14 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 conduct an annual eligibility reverification for each enrollee 2 eligible for premium assistance. 3 (6) If a child loses eligibility for Florida Kidcare 4 health benefits coverage, the child's managed health care 5 provider shall be notified at the same time the family is 6 notified in order to facilitate necessary action to maintain 7 continuous health care coverage. 8 Section 8. Section 409.8142, Florida Statutes, is 9 created to read: 10 409.8142 Penalties.-- 11 (1) Subject to s. 624.91(4), the Florida Kidcare 12 program shall withhold benefits from an enrollee if the 13 program obtains evidence that the enrollee is no longer 14 eligible, submitted incorrect or fraudulent information in 15 order to establish eligibility, or failed to provide 16 verification of eligibility. The applicant or enrollee shall 17 be notified that, because of such evidence, program benefits 18 will be withheld unless the applicant or enrollee contacts a 19 designated representative of the program by a specified date, 20 which must be within 10 business days after the date of 21 notice, to discuss and resolve the matter. The program shall 22 make every effort to resolve the matter within a timeframe 23 that will not cause benefits to be withheld from an eligible 24 enrollee. 25 (2) If, subsequent to any eligibility determination, 26 an individual is determined to be ineligible for coverage, he 27 or she must immediately be disenrolled from the Florida 28 Kidcare program. 29 (3) Waiting periods of not less than 60 days for 30 reinstatement of coverage upon voluntary cancellation for 31 nonpayment of premiums when applicable shall be established by 15 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 the agency. 2 Section 9. Section 409.8149, Florida Statutes, is 3 created to read: 4 409.8149 Enrollment; plan choice.-- 5 (1) ENROLLMENT.--The Florida Kidcare program may 6 conduct enrollment at any time throughout the year for the 7 purpose of enrolling children eligible for all coverage funded 8 pursuant to s. 409.813, except Medicaid. Eligible children 9 shall be enrolled on a first-come, first-served basis, based 10 upon the date the enrollment application is received. The 11 application for the Florida Kidcare program is valid for a 12 period of 120 days after the date the application is received. 13 At the end of the 120-day period, if the applicant has not 14 been enrolled in the program, the application is invalid and 15 the applicant shall be notified of the action. The applicant 16 may resubmit the application after notification of the action 17 taken by the program. 18 (2) PLAN CHOICE.-- 19 (a) Enrollees who do not voluntarily choose a benefit 20 plan shall be assigned to a managed care plan by the Florida 21 Kidcare program. The program shall assign enrollees eligible 22 for Medicaid to a Medicaid managed care plan or to the 23 Medicaid fee-for-service program if a Medicaid managed care 24 plan does not exist in the geographical area in which the 25 enrollee resides. The program shall assign all other enrollees 26 to plans selected pursuant to s. 624.91 in the geographical 27 area in which each enrollee resides. 28 (b) Upon selection or assignment, an enrollee shall 29 have 90 days during which to voluntarily disenroll from a 30 benefit plan and select another. 31 (c) Upon the anniversary of enrollment, each enrollee 16 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 may voluntarily select another benefit plan. The Florida 2 Kidcare program shall notify enrollees of their options with 3 respect to the annual open enrollment 60 days prior to the 4 anniversary of initial enrollment. 5 Section 10. Section 409.815, Florida Statutes, is 6 amended to read: 7 409.815 Health benefits coverage; limitations.-- 8 (1) MEDICAID BENEFITS.--For purposes of the Florida 9 Kidcare program, benefits available under Medicaid and 10 Medikids include those goods and services provided under the 11 medical assistance program authorized by Title XIX of the 12 Social Security Act, and regulations thereunder, as 13 administered in this state by the agency. This includes those 14 mandatory Medicaid services authorized under s. 409.905, and 15 optional Medicaid services authorized under s. 409.906, and 16 emergency services provided under s. 409.9128. Effective July 17 1, 2008, health benefits available under the Florida Kidcare 18 program shall include the same mandatory and optional Medicaid 19 services as specified in s. 409.830(2)., rendered on behalf of 20 eligible individuals by qualified providers, in accordance 21 with federal requirements for Title XIX, subject to any 22 limitations or directions provided for in the General 23 Appropriations Act or chapter 216, and according to 24 methodologies and limitations set forth in agency rules and 25 policy manuals and handbooks incorporated by reference 26 thereto. 27 (2) BENCHMARK BENEFITS.--In order for health benefits 28 coverage to qualify for premium assistance payments for an 29 eligible child under ss. 409.810-409.830 ss. 409.810-409.820, 30 the health benefits coverage, except for coverage under 31 Medicaid and Medikids, must include the following minimum 17 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 benefits, as medically necessary. 2 (a) Preventive health services.--Covered services 3 include: 4 1. Well-child care, including services recommended in 5 the Guidelines for Health Supervision of Children and Youth as 6 developed by the American Academy of Pediatrics; 7 2. Immunizations and injections; 8 3. Health education counseling and clinical services; 9 4. Vision screening; and 10 5. Hearing screening. 11 (b) Inpatient hospital services.--All covered services 12 provided for the medical care and treatment of an enrollee who 13 is admitted as an inpatient to a hospital licensed under part 14 I of chapter 395, with the following exceptions: 15 1. All admissions must be authorized by the enrollee's 16 health benefits coverage provider. 17 2. The length of the patient stay shall be determined 18 based on the medical condition of the enrollee in relation to 19 the necessary and appropriate level of care. 20 3. Room and board may be limited to semiprivate 21 accommodations, unless a private room is considered medically 22 necessary or semiprivate accommodations are not available. 23 4. Admissions for rehabilitation and physical therapy 24 are limited to 15 days per contract year. 25 (c) Emergency services.--Covered services include 26 visits to an emergency room or other licensed facility if 27 needed immediately due to an injury or illness and delay means 28 risk of permanent damage to the enrollee's health. Health 29 maintenance organizations shall comply with the provisions of 30 s. 641.513. 31 (d) Maternity services.--Covered services include 18 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 maternity and newborn care, including prenatal and postnatal 2 care, with the following limitations: 3 1. Coverage may be limited to the fee for vaginal 4 deliveries; and 5 2. Initial inpatient care for newborn infants of 6 enrolled adolescents shall be covered, including normal 7 newborn care, nursery charges, and the initial pediatric or 8 neonatal examination, and the infant may be covered for up to 9 3 days following birth. 10 (e) Organ transplantation services.--Covered services 11 include pretransplant, transplant, and postdischarge services 12 and treatment of complications after transplantation for 13 transplants deemed necessary and appropriate within the 14 guidelines set by the Organ Transplant Advisory Council under 15 s. 765.53 or the Bone Marrow Transplant Advisory Panel under 16 s. 627.4236. 17 (f) Outpatient services.--Covered services include 18 preventive, diagnostic, therapeutic, palliative care, and 19 other services provided to an enrollee in the outpatient 20 portion of a health facility licensed under chapter 395, 21 except for the following limitations: 22 1. Services must be authorized by the enrollee's 23 health benefits coverage provider; and 24 2. Treatment for temporomandibular joint disease (TMJ) 25 is specifically excluded. 26 (g) Behavioral health services.-- 27 1. Mental health benefits include: 28 a. Inpatient services, limited to not more than 30 29 inpatient days per contract year for psychiatric admissions, 30 or residential services in facilities licensed under s. 31 394.875(8) or s. 395.003 in lieu of inpatient psychiatric 19 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 admissions; however, a minimum of 10 of the 30 days shall be 2 available only for inpatient psychiatric services when 3 authorized by a physician; and 4 b. Outpatient services, including outpatient visits 5 for psychological or psychiatric evaluation, diagnosis, and 6 treatment by a licensed mental health professional, limited to 7 a maximum of 40 outpatient visits each contract year. 8 2. Substance abuse services include: 9 a. Inpatient services, limited to not more than 7 10 inpatient days per contract year for medical detoxification 11 only and 30 days of residential services; and 12 b. Outpatient services, including evaluation, 13 diagnosis, and treatment by a licensed practitioner, limited 14 to a maximum of 40 outpatient visits per contract year. 15 (h) Durable medical equipment.--Covered services 16 include equipment and devices that are medically indicated to 17 assist in the treatment of a medical condition and 18 specifically prescribed as medically necessary, with the 19 following limitations: 20 1. Low-vision and telescopic aides are not included. 21 2. Corrective lenses and frames may be limited to one 22 pair every 2 years, unless the prescription or head size of 23 the enrollee changes. 24 3. Hearing aids shall be covered only when medically 25 indicated to assist in the treatment of a medical condition. 26 4. Covered prosthetic devices include artificial eyes 27 and limbs, braces, and other artificial aids. 28 (i) Health practitioner services.--Covered services 29 include services and procedures rendered to an enrollee when 30 performed to diagnose and treat diseases, injuries, or other 31 conditions, including care rendered by health practitioners 20 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 acting within the scope of their practice, with the following 2 exceptions: 3 1. Chiropractic services shall be provided in the same 4 manner as in the Florida Medicaid program. 5 2. Podiatric services may be limited to one visit per 6 day totaling two visits per month for specific foot disorders. 7 (j) Home health services.--Covered services include 8 prescribed home visits by both registered and licensed 9 practical nurses to provide skilled nursing services on a 10 part-time intermittent basis, subject to the following 11 limitations: 12 1. Coverage may be limited to include skilled nursing 13 services only; 14 2. Meals, housekeeping, and personal comfort items may 15 be excluded; and 16 3. Private duty nursing is limited to circumstances 17 where such care is medically necessary. 18 (k) Hospice services.--Covered services include 19 reasonable and necessary services for palliation or management 20 of an enrollee's terminal illness, with the following 21 exceptions: 22 1. Once a family elects to receive hospice care for an 23 enrollee, other services that treat the terminal condition 24 will not be covered; and 25 2. Services required for conditions totally unrelated 26 to the terminal condition are covered to the extent that the 27 services are included in this section. 28 (l) Laboratory and X-ray services.--Covered services 29 include diagnostic testing, including clinical radiologic, 30 laboratory, and other diagnostic tests. 31 (m) Nursing facility services.--Covered services 21 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 include regular nursing services, rehabilitation services, 2 drugs and biologicals, medical supplies, and the use of 3 appliances and equipment furnished by the facility, with the 4 following limitations: 5 1. All admissions must be authorized by the health 6 benefits coverage provider. 7 2. The length of the patient stay shall be determined 8 based on the medical condition of the enrollee in relation to 9 the necessary and appropriate level of care, but is limited to 10 not more than 100 days per contract year. 11 3. Room and board may be limited to semiprivate 12 accommodations, unless a private room is considered medically 13 necessary or semiprivate accommodations are not available. 14 4. Specialized treatment centers and independent 15 kidney disease treatment centers are excluded. 16 5. Private duty nurses, television, and custodial care 17 are excluded. 18 6. Admissions for rehabilitation and physical therapy 19 are limited to 15 days per contract year. 20 (n) Prescribed drugs.-- 21 1. Coverage shall include drugs prescribed for the 22 treatment of illness or injury when prescribed by a licensed 23 health practitioner acting within the scope of his or her 24 practice. 25 2. Prescribed drugs may be limited to generics if 26 available and brand name products if a generic substitution is 27 not available, unless the prescribing licensed health 28 practitioner indicates that a brand name is medically 29 necessary. 30 3. Prescribed drugs covered under this section shall 31 include all prescribed drugs covered under the Florida 22 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 Medicaid program. 2 (o) Therapy services.--Covered services include 3 rehabilitative services, including occupational, physical, 4 respiratory, and speech therapies, with the following 5 limitations: 6 1. Services must be for short-term rehabilitation 7 where significant improvement in the enrollee's condition will 8 result; and 9 2. Services shall be limited to not more than 24 10 treatment sessions within a 60-day period per episode or 11 injury, with the 60-day period beginning with the first 12 treatment. 13 (p) Transportation services.--Covered services include 14 emergency transportation required in response to an emergency 15 situation. 16 (q) Dental services.--Dental services shall be covered 17 and may include those dental benefits provided to children by 18 the Florida Medicaid program under s. 409.906(6). 19 (r) Lifetime maximum.--Health benefits coverage 20 obtained under ss. 409.810-409.820 shall pay an enrollee's 21 covered expenses at a lifetime maximum of $1 million per 22 covered child. 23 (s) Cost-sharing.--Cost-sharing provisions must comply 24 with s. 409.816. 25 (t) Exclusions.-- 26 1. Experimental or investigational procedures that 27 have not been clinically proven by reliable evidence are 28 excluded; 29 2. Services performed for cosmetic purposes only or 30 for the convenience of the enrollee are excluded; and 31 3. Abortion may be covered only if necessary to save 23 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 the life of the mother or if the pregnancy is the result of an 2 act of rape or incest. 3 (u) Enhancements to minimum requirements.-- 4 1. This section sets the minimum benefits that must be 5 included in any health benefits coverage, other than Medicaid 6 or Medikids coverage, offered under ss. 409.810-409.820. 7 Health benefits coverage may include additional benefits not 8 included under this subsection, but may not include benefits 9 excluded under paragraph (s). 10 2. Health benefits coverage may extend any limitations 11 beyond the minimum benefits described in this section. 12 13 Except for the Children's Medical Services Network, the agency 14 may not increase the premium assistance payment for either 15 additional benefits provided beyond the minimum benefits 16 described in this section or the imposition of less 17 restrictive service limitations. 18 (v) Applicability of other state laws.--Health 19 insurers, health maintenance organizations, and their agents 20 are subject to the provisions of the Florida Insurance Code, 21 except for any such provisions waived in this section. 22 1. Except as expressly provided in this section, a law 23 requiring coverage for a specific health care service or 24 benefit, or a law requiring reimbursement, utilization, or 25 consideration of a specific category of licensed health care 26 practitioner, does not apply to a health insurance plan policy 27 or contract offered or delivered under ss. 409.810-409.820 28 unless that law is made expressly applicable to such policies 29 or contracts. 30 2. Notwithstanding chapter 641, a health maintenance 31 organization may issue contracts providing benefits equal to, 24 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 exceeding, or actuarially equivalent to the benchmark benefit 2 plan authorized by this section and may pay providers located 3 in a rural county negotiated fees or Medicaid reimbursement 4 rates for services provided to enrollees who are residents of 5 the rural county. 6 Section 11. Section 409.816, Florida Statutes, is 7 amended to read: 8 409.816 Limitations on premiums and cost-sharing; 9 penalties for nonpayment of premiums.--The following 10 limitations on premiums and cost-sharing are established for 11 the program. 12 (1) Enrollees who receive coverage under Title XIX of 13 the Social Security Act the Medicaid program may not be 14 required to pay: 15 (a) Enrollment fees, premiums, or similar charges; or 16 (b) Copayments, deductibles, coinsurance, or similar 17 charges. 18 (2) Enrollees in families with a family income equal 19 to or below 150 percent of the federal poverty level, who are 20 not receiving coverage under the Medicaid program, may not be 21 required to pay: 22 (a) Enrollment fees, premiums, or similar charges that 23 exceed the maximum monthly charge permitted under s. 24 1916(b)(1) of the Social Security Act; or 25 (b) Copayments, deductibles, coinsurance, or similar 26 charges that exceed a nominal amount, as determined consistent 27 with regulations referred to in s. 1916(a)(3) of the Social 28 Security Act. However, such charges may not be imposed for 29 preventive services, including well-baby and well-child care, 30 age-appropriate immunizations, and routine hearing and vision 31 screenings. 25 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 (3) Enrollees in families with a family income above 2 150 percent of the federal poverty level, who are not 3 receiving coverage under Title XIX of the Social Security Act 4 the Medicaid program or who are not eligible under s. 409.814 5 s. 409.814(5), may be required to pay enrollment fees, 6 premiums, copayments, deductibles, coinsurance, or similar 7 charges on a sliding scale related to income, except that the 8 total annual aggregate cost-sharing with respect to all 9 children in a family may not exceed 5 percent of the family's 10 income. However, copayments, deductibles, coinsurance, or 11 similar charges may not be imposed for preventive services, 12 including well-baby and well-child care, age-appropriate 13 immunizations, and routine hearing and vision screenings. 14 Section 12. Section 409.817, Florida Statutes, is 15 amended to read: 16 409.817 Approval of health benefits coverage; 17 financial assistance.--In order for health insurance coverage 18 to qualify for premium assistance payments for an eligible 19 child under ss. 409.810-409.830 ss. 409.810-409.820, the 20 health benefits coverage must: 21 (1) Be certified by the Office of Insurance Regulation 22 of the Financial Services Commission under s. 409.818 as 23 meeting, exceeding, or being actuarially equivalent to the 24 benchmark benefit plan; 25 (1)(2) Be guarantee issued; 26 (2)(3) Be community rated; 27 (3)(4) Not impose any preexisting condition exclusion 28 for covered benefits; however, group health insurance plans 29 may permit the imposition of a preexisting condition 30 exclusion, but only insofar as it is permitted under s. 31 627.6561; 26 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 (4)(5) Comply with the applicable limitations on 2 premiums and cost-sharing in s. 409.816; 3 (5)(6) Comply with the quality assurance and access 4 standards developed under s. 409.818 s. 409.820; and 5 (6)(7) Establish periodic open enrollment periods, 6 which may not occur more frequently than quarterly. 7 Section 13. Section 409.818, Florida Statutes, is 8 amended to read: 9 409.818 Administration.--In order to implement ss. 10 409.810-409.830 ss. 409.810-409.820, the following agencies 11 shall have the following duties: 12 (1) The Department of Children and Family Services 13 shall: 14 (a) Develop a standardized intake process for all 15 Community Access Network partners which informs applicants 16 about coverage and services available through the Florida 17 Kidcare program and collects all information necessary to 18 assess eligibility for any premium assistance. 19 (b)(a) Develop a standardized simplified eligibility 20 application process mail-in form to be used for determining 21 the eligibility of children for coverage for all funding 22 sources through under the Florida Kidcare program, in 23 consultation with the agency, the Department of Health, and 24 the Florida Healthy Kids Corporation. The department shall 25 collect all information necessary to determine eligibility for 26 premium assistance and provide simplified eligibility 27 application form must include an item that provides an 28 opportunity for the applicant to indicate whether coverage is 29 being sought for a child with special health care needs. 30 Families applying for children's Medicaid coverage must also 31 be able to use the standardized simplified application process 27 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 form without having to pay a premium. 2 (c)(b) Establish and maintain the eligibility 3 determination process under the program except as specified in 4 subsection (5). No later than July 1, 2008, the department 5 shall directly, or through the services of a contracted 6 third-party administrator, establish and maintain a process 7 for determining eligibility of children for coverage under the 8 entire Florida Kidcare program. The eligibility determination 9 process must be used solely for determining eligibility of 10 applicants for health benefits coverage under the program. The 11 eligibility determination process must include an initial 12 determination of eligibility for any coverage offered under 13 the program, as well as a redetermination or reverification of 14 eligibility each subsequent 6 months. Effective January 1, 15 1999, A child who has not attained the age of 5 and who has 16 been determined eligible for the Medicaid program is eligible 17 for coverage for 12 months without a redetermination or 18 reverification of eligibility. In conducting an eligibility 19 determination, the department shall determine if the child has 20 special health care needs. The department, in consultation 21 with the Agency for Health Care Administration and the Florida 22 Healthy Kids Corporation, shall develop procedures for 23 redetermining eligibility which enable a family to easily 24 update any change in circumstances which could affect 25 eligibility. The department may accept changes in a family's 26 status as reported to the department by the Florida Healthy 27 Kids Corporation without requiring a new application from the 28 family. Redetermination of a child's eligibility for Medicaid 29 may not be linked to a child's eligibility determination for 30 other programs. 31 (d)(c) Inform program applicants about eligibility 28 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 determinations and ensure appropriate followup procedures for 2 plan enrollment provide information about eligibility of 3 applicants to Medicaid, Medikids, the Children's Medical 4 Services Network, and the Florida Healthy Kids Corporation, 5 and to insurers and their agents, through a centralized 6 coordinating office. 7 (e) No later than, July 1, 2008, in consultation with 8 the Agency for Health Care Administration, establish a single 9 toll-free telephone line to assist families that have 10 questions about the Florida Kidcare program. The single 11 toll-free line shall also connect the applicant or enrollee 12 with customer service for account information established 13 under s. 409.830(1)(b). 14 (f)(d) Adopt such rules as may be necessary for 15 conducting program eligibility functions. 16 (2) The Department of Health shall: 17 (a) In consultation with the agency, develop a minimum 18 set of pediatric quality assurance and access standards, 19 including reporting requirements, for the Florida Kidcare 20 program. The standards must include a process for granting 21 exceptions to specific requirements for quality assurance and 22 access. Compliance with the standards shall be a condition of 23 program participation by health benefits coverage providers. 24 These standards shall comply with the provisions of this 25 chapter and chapter 641 and Title XXI of the Social Security 26 Act. 27 (b) Determine clinical eligibility for and administer 28 the Florida Kidcare Plus health benefits coverage. Design an 29 eligibility intake process for the program, in coordination 30 with the Department of Children and Family Services, the 31 agency, and the Florida Healthy Kids Corporation. The 29 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 eligibility intake process may include local intake points 2 that are determined by the Department of Health in 3 coordination with the Department of Children and Family 4 Services. 5 (b) Chair a state-level coordinating council to review 6 and make recommendations concerning the implementation and 7 operation of the program. The coordinating council shall 8 include representatives from the department, the Department of 9 Children and Family Services, the agency, the Florida Healthy 10 Kids Corporation, the Office of Insurance Regulation of the 11 Financial Services Commission, local government, health 12 insurers, health maintenance organizations, health care 13 providers, families participating in the program, and 14 organizations representing low-income families. 15 (c) In consultation with the Florida Healthy Kids 16 Corporation and the Department of Children and Family 17 Services, establish a toll-free telephone line to assist 18 families with questions about the program. 19 (c)(d) Adopt such rules as may be necessary to 20 implement this subsection outreach activities. 21 (3) The Agency for Health Care Administration, under 22 the authority granted in s. 409.914(1), shall: 23 (a) Calculate the premium assistance payment necessary 24 to comply with the premium and cost-sharing limitations 25 specified in s. 409.816. The premium assistance payment for 26 each enrollee in a health insurance plan participating in the 27 Florida Healthy Kids Corporation shall equal the premium 28 approved by the Florida Healthy Kids Corporation and the 29 Office of Insurance Regulation of the Financial Services 30 Commission pursuant to ss. 627.410 and 641.31, less any 31 enrollee's share of the premium established within the 30 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 limitations specified in s. 409.816. The premium assistance 2 payment for each enrollee in an employer-sponsored health 3 insurance plan approved under ss. 409.810-409.820 shall equal 4 the premium for the plan adjusted for any benchmark benefit 5 plan actuarial equivalent benefit rider approved by the Office 6 of Insurance Regulation pursuant to ss. 627.410 and 641.31, 7 less any enrollee's share of the premium established within 8 the limitations specified in s. 409.816. In calculating the 9 premium assistance payment levels for children with family 10 coverage, the agency shall set the premium assistance payment 11 levels for each child proportionately to the total cost of 12 family coverage. 13 (b) Provide fiscal management for Title XIX and Title 14 XXI funding for the Florida Kidcare program, distributing 15 funds among Florida Healthy Kids, the Department of Children 16 and Family Services, and the Department of Health based on 17 costs and the participation of children in the plans and 18 programs available to Florida Kidcare program participants. 19 (c)(b) Make premium assistance payments to health 20 insurance plans on a periodic basis. The agency may use its 21 Medicaid fiscal agent or a contracted third-party 22 administrator in making these payments. The agency may 23 require health insurance plans that participate in the 24 Medikids program or employer-sponsored group health insurance 25 to collect premium payments from an enrollee's family. 26 Participating health insurance plans shall report premium 27 payments collected on behalf of enrollees in the program to 28 the agency in accordance with a schedule established by the 29 agency. 30 (d)(c) Monitor compliance with quality assurance and 31 access standards developed under paragraph (2)(a) s. 409.820. 31 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 (e)(d) Establish a mechanism for investigating and 2 resolving complaints and grievances from program applicants, 3 enrollees, and health benefits coverage providers, and 4 maintain a record of complaints and confirmed problems. In the 5 case of a child who is enrolled in a health maintenance 6 organization, the agency must use the provisions of s. 641.511 7 to address grievance reporting and resolution requirements. 8 (e) Approve health benefits coverage for participation 9 in the program, following certification by the Office of 10 Insurance Regulation under subsection (4). 11 (f) Adopt rules necessary for calculating premium 12 assistance payment levels, making premium assistance payments, 13 monitoring access and quality assurance standards, 14 investigating and resolving complaints and grievances, 15 administering the Medikids program, and approving health 16 benefits coverage. The agency is designated the lead state 17 agency for Title XXI of the Social Security Act for purposes 18 of receipt of federal funds, for reporting purposes, and for 19 ensuring compliance with federal and state regulations and 20 rules. 21 (g) Develop and implement an outreach and marketing 22 program that educates the public about the Florida Kidcare 23 program, explains procedures for enrolling in Florida Kidcare, 24 and maintains public awareness of the program. 25 (h) Seek and implement federal waivers or state plan 26 amendments necessary to implement this section and ss. 27 409.810-409.830. 28 (4) The Office of Insurance Regulation shall certify 29 that health benefits coverage plans that seek to provide 30 services under the Florida Kidcare program, except those 31 offered through the Florida Healthy Kids Corporation or the 32 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 Children's Medical Services Network, meet, exceed, or are 2 actuarially equivalent to the benchmark benefit plan and that 3 health insurance plans will be offered at an approved rate. In 4 determining actuarial equivalence of benefits coverage, the 5 Office of Insurance Regulation and health insurance plans must 6 comply with the requirements of s. 2103 of Title XXI of the 7 Social Security Act. The department shall adopt rules 8 necessary for certifying health benefits coverage plans. 9 (5) The Florida Healthy Kids Corporation shall retain 10 its functions as authorized in s. 624.91, including 11 eligibility determination for participation in the Healthy 12 Kids program. 13 (4)(6) The agency, in consultation with the Department 14 of Health, the Department of Children and Family Services, the 15 Florida Healthy Kids Corporation, and the Office of Insurance 16 Regulation, after consultation with and approval of the 17 Speaker of the House of Representatives and the President of 18 the Senate, is are authorized to make program modifications 19 that are necessary to overcome any objections of the United 20 States Department of Health and Human Services to obtain 21 approval of the state's child health insurance plan under 22 Title XXI of the Social Security Act. 23 Section 14. Section 409.820, Florida Statutes, is 24 repealed. 25 Section 15. Section 409.821, Florida Statutes, is 26 amended to read: 27 409.821 Florida Kidcare program public records 28 exemption.--Notwithstanding any other law to the contrary, Any 29 information identifying a Florida Kidcare program applicant or 30 enrollee, as defined in s. 409.811, held by the Agency for 31 Health Care Administration, the Department of Children and 33 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 Family Services, the Department of Health, or the Florida 2 Healthy Kids Corporation is confidential and exempt from s. 3 119.07(1) and s. 24(a), Art. I of the State Constitution. Such 4 information may be disclosed to another governmental entity 5 only if disclosure is necessary for the entity to perform its 6 duties and responsibilities under the Florida Kidcare program 7 and shall be disclosed to the Department of Revenue for 8 purposes of administering the state Title IV-D program. The 9 receiving governmental entity must maintain the confidential 10 and exempt status of such information. Furthermore, such 11 information may not be released to any person without the 12 written consent of the program enrollee or the parent or 13 guardian of the enrollee applicant. This exemption applies to 14 any information identifying a Florida Kidcare program 15 applicant or enrollee held by the Agency for Health Care 16 Administration, the Department of Children and Family 17 Services, the Department of Health, or the Florida Healthy 18 Kids Corporation before, on, or after the effective date of 19 this exemption. A violation of this section is a misdemeanor 20 of the second degree, punishable as provided in s. 775.082 or 21 s. 775.083. This section does not prohibit an enrollee's 22 parent or legal guardian from obtaining confirmation of 23 coverage, dates of coverage, name of the enrollee's health 24 plan, and amount of premium being paid. 25 Section 16. Section 409.830, Florida Statutes, is 26 created to read: 27 409.830 Florida Kidcare Program Consolidation 28 Initiative.--The Florida Kidcare Program Consolidation 29 Initiative is created to provide a seamless delivery system of 30 health benefits to uninsured, low-income children. The 31 initiative shall consolidate the administration of the Florida 34 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 Kidcare program under the fewest entities necessary for the 2 purpose of conducting marketing and outreach, eligibility 3 determination, premium collection, contract management of 4 health plans and fiscal agents, quality assurance and 5 grievance resolution, and fiscal management of all the 6 components of the Florida Kidcare program. The initiative 7 shall consolidate the Florida Kidcare program's administrative 8 structure and align polices by no later than July 1, 2009. The 9 Agency for Health Care Administration shall manage the 10 consolidation of the Florida Kidcare program. A deputy 11 secretary of Florida Kidcare is created within the agency to 12 represent the interest of children in obtaining necessary 13 health care services and health care coverage. The deputy 14 secretary of Florida Kidcare shall develop policies and 15 strategies for issues related to children's lack of access to 16 high-quality and affordable health care services and coverage. 17 The deputy secretary shall identify and provide 18 recommendations for ways to improve the delivery of services 19 for children through the Florida Kidcare program. 20 (1) ADMINISTRATION.-- 21 (a) The Agency for Health Care Administration is 22 designated as the single state agency authorized to make 23 payments for medical assistance and related services; to 24 conduct contract management of health plans, providers, and 25 fiscal agents; to collect premiums; to develop and implement 26 quality assurance and grievance-resolution processes; to 27 conduct marketing and outreach programs; and to conduct other 28 fiscal-management activities relating to all the components of 29 the Florida Kidcare program no later than July 1, 2008. 30 1. The agency, in consultation with the Department of 31 Children and Family Services, shall adopt a standardized 35 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 application form for the purpose of collecting all information 2 necessary to determine eligibility for all components of the 3 Florida Kidcare program. All eligibility information shall be 4 electronically verified to the extent possible. Each applicant 5 shall supply written documentation of any eligibility 6 information that cannot be electronically verified. 7 2. The agency may contract with capitated managed care 8 plans and other providers to deliver health benefits as 9 necessary under this section and to begin providing services 10 by July 1, 2008. 11 3. No later than July 1, 2008, the agency is 12 responsible for developing and distributing marketing and 13 outreach materials that educate families about the Florida 14 Kidcare program as a whole, including eligibility 15 requirements, application procedures, benefit design, and 16 other information considered necessary to assist families in 17 applying for and remaining in the Florida Kidcare program. 18 Marketing and outreach materials shall present the Florida 19 Kidcare program as a single program and explain that the 20 family's information is collected in order to determine if the 21 family is eligible for a premium discount or for no premium 22 requirement. 23 4. The agency may adopt rules as necessary to 24 administer the Florida Kidcare program, except as specified in 25 s. 409.818. 26 (b) The Department of Children and Family Services is 27 responsible for conducting eligibility determination for all 28 components of the Florida Kidcare program no later than July 29 1, 2008. 30 1. No later than July 1, 2008, the Department of 31 Children and Family Services, in coordination with the agency, 36 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 shall be responsible for eligibility determination, including 2 receiving and processing applications for all program 3 components, determining eligibility for all program 4 components, receiving electronic verification, and 5 transmitting and receiving all correspondence related to the 6 eligibility-determination process. All correspondence shall be 7 identified solely with the Florida Kidcare program as a whole. 8 2. No later than July 1, 2008, the Department of 9 Children and family Services is responsible to provide a 10 single toll-free line for a customer service call center to 11 access account information and provide general information 12 concerning the Florida Kidcare program. 13 (c) The Florida Healthy Kids Corporation's remaining 14 roles and responsibilities as defined in s. 624.91 shall be 15 transferred to the agency no later than July 1, 2009. 16 (2) BENEFITS.--No later than July 1, 2008, health 17 benefits, as specified in paragraphs (a) and (b), shall be 18 provided to eligible children under the Florida Kidcare 19 program, except those children with special health care needs 20 who shall be provided benefits under the Florida Kidcare Plus 21 Plan. 22 (a) No later than July 1, 2008, the Florida Kidcare 23 program shall contain the same benefits as specified in ss. 24 409.905 and 409.906 and emergency services provided under s. 25 409.9128. 26 (b) The Florida Kidcare Plus Plan as defined in s. 27 409.811(13) shall contain the same benefits as specified in 28 ss. 409.905 and 409.906 and emergency services provided under 29 s. 409.9128. 30 (3) SERVICE DELIVERY SYSTEMS.--No later than July 1, 31 2008, health care services under the Florida Kidcare program 37 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 shall be delivered through managed care plans, primary care 2 case management providers, and fee-for-service providers under 3 contract or other arrangement with the agency. Title XXI 4 enrollees, excluding those enrolled in the Florida Kidcare 5 Plus Plan, shall enroll in a managed care plan if two or more 6 plans are available. Florida Healthy Kids Corporation shall 7 extend health plan contracts through June 30, 2009, for 8 children enrolled in the Florida Healthy Kids program as of 9 July 1, 2008. 10 (4) ELIGIBILITY.--Effective July 1, 2008, children 11 eligible to participate in the Florida Kidcare program are 12 those qualified under the eligibility standards specified in 13 ss. 409.8132, 409.814, 409.8141, 409.903, and 409.904. 14 (5) ENROLLMENT.--Effective July 1, 2008, the parents, 15 guardians or persons applying on behalf of children determined 16 eligible after June 30, 2008, shall choose a Florida Kidcare 17 Plan providing the benefits as described in s. 409.830(2)(a) 18 and (b). Children enrolled in Florida Healthy Kids plans on 19 June 30, 2008, shall transfer to a Florida Kidcare Plan 20 providing the benefits as described in s. 409.830(2)(a) and 21 (b) no later than June 30, 2009. 22 (6) CAPITATION RATES.--No later than July 1, 2008, any 23 managed care plan that participates in the Florida Kidcare 24 program shall be compensated in accordance with s. 409.9124, 25 except in counties compensated in accordance with s. 26 409.91211. 27 (7) WAIVER AUTHORITY.--The agency shall seek federal 28 waiver approval or amendments to the Medicaid state plan and 29 Title XXI state plan which are necessary to implement the 30 initiative as specified in this section. 31 Section 17. Section 624.91, Florida Statutes, is 38 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 amended to read: 2 624.91 The Florida Healthy Kids Corporation Act.-- 3 (1) SHORT TITLE.--This section may be cited as the 4 "William G. 'Doc' Myers Healthy Kids Corporation Act." 5 (2) LEGISLATIVE INTENT.-- 6 (a) The Legislature finds that increased access to 7 health care services could improve children's health and 8 reduce the incidence and costs of childhood illness and 9 disabilities among children in this state. Many children do 10 not have comprehensive, affordable health care services 11 available. It is the intent of the Legislature that the 12 Florida Healthy Kids Corporation provide comprehensive health 13 insurance coverage to such children. The corporation is 14 encouraged to cooperate with any existing health service 15 programs funded by the public or the private sector. 16 (b) It is the intent of the Legislature that the 17 Florida Healthy Kids Corporation serve as one of several 18 providers of services to children eligible for medical 19 assistance under Title XXI of the Social Security Act. 20 Although the corporation may serve other children, the 21 Legislature intends the primary recipients of services 22 provided through the corporation be school-age children with a 23 family income below 200 percent of the federal poverty level, 24 who do not qualify for Medicaid. It is also the intent of the 25 Legislature that state and local government Florida Healthy 26 Kids funds be used to continue coverage, subject to specific 27 appropriations in the General Appropriations Act, to children 28 not eligible for federal matching funds under Title XXI. 29 (3) ELIGIBILITY FOR STATE-FUNDED ASSISTANCE.--Only the 30 following individuals are eligible for state-funded assistance 31 in paying Florida Healthy Kids premiums: 39 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 (a) Residents of this state who are eligible for the 2 Florida Kidcare program pursuant to s. 409.814. 3 (b) Notwithstanding s. 409.814, legal aliens who are 4 enrolled in the Florida Healthy Kids program as of January 31, 5 2004, who do not qualify for Title XXI federal funds because 6 they are not qualified aliens as defined in s. 409.811. 7 (3)(4) NONENTITLEMENT.--Nothing in this section shall 8 be construed as providing an individual with an entitlement to 9 health care services. No cause of action shall arise against 10 the state, the Florida Healthy Kids Corporation, or a unit of 11 local government for failure to make health services available 12 under this section. 13 (4)(5) CORPORATION AUTHORIZATION, DUTIES, POWERS.-- 14 (a) There is created the Florida Healthy Kids 15 Corporation, a not-for-profit corporation. 16 (b) The Florida Healthy Kids Corporation shall: 17 1. Arrange for the collection of any family, local 18 contributions, or employer payment or premium, in an amount to 19 be determined by the board of directors, to provide for 20 payment of premiums for health benefits comprehensive 21 insurance coverage and for the actual or estimated 22 administrative expenses. No later than July 1, 2009, the 23 collection of family premiums shall be transferred to the 24 Agency for Health Care Administration. 25 2. Arrange for the collection of any voluntary 26 contributions to provide for payment of Florida Kidcare 27 premiums for children who are not eligible for medical 28 assistance under Title XXI of the Social Security Act. No 29 later than July 1, 2009, this function shall be transferred to 30 the Agency for Health Care Administration. 31 3. Subject to the provisions of s. 409.8134, accept 40 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 voluntary supplemental local match contributions that comply 2 with the requirements of Title XXI of the Social Security Act 3 for the purpose of providing additional Florida Kidcare 4 coverage in contributing counties under Title XXI. No later 5 than July 1, 2009, this function shall be transferred to the 6 Agency for Health Care Administration. 7 4. Establish the administrative and accounting 8 procedures for the operation of the corporation. 9 5. Establish, with consultation from appropriate 10 professional organizations, standards for preventive health 11 services and providers and comprehensive insurance benefits 12 appropriate to children, provided that the such standards for 13 rural areas do shall not limit primary care providers to 14 board-certified pediatricians. 15 6. Determine eligibility for children seeking to 16 participate in the Title XXI-funded components of the Florida 17 Kidcare program consistent with the requirements specified in 18 s. 409.814, as well as the non-Title-XXI-eligible children as 19 provided in subsection (3). No later than July 1, 2008, this 20 function shall be transferred to the Department of Children 21 and Family Services. 22 7. Establish procedures under which providers of local 23 match to, applicants to and participants in the program may 24 have grievances reviewed by an impartial body and reported to 25 the board of directors of the corporation. No later than July 26 1, 2009, this function shall be transferred to the Agency for 27 Health Care Administration. 28 8. Establish participation criteria and, if 29 appropriate, contract with an authorized insurer, health 30 maintenance organization, or third-party administrator to 31 provide administrative services to the corporation. 41 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 9. Establish enrollment criteria which shall include 2 penalties or waiting periods of not fewer than 60 days for 3 reinstatement of coverage upon voluntary cancellation for 4 nonpayment of family premiums. 5 10. Contract with authorized insurers or any provider 6 of health care services, meeting standards established by the 7 corporation, for the provision of comprehensive insurance 8 coverage to participants. Such standards shall include 9 criteria under which the corporation may contract with more 10 than one provider of health care services in program sites. 11 Health plans shall be selected through a competitive bid 12 process. The Florida Healthy Kids Corporation shall purchase 13 goods and services in the most cost-effective manner 14 consistent with the delivery of quality medical care. The 15 maximum administrative cost for a Florida Healthy Kids 16 Corporation contract shall be 15 percent. For health care 17 contracts, the minimum medical loss ratio for a Florida 18 Healthy Kids Corporation contract shall be 85 percent. For 19 dental contracts, the remaining compensation to be paid to the 20 authorized insurer or provider under a Florida Healthy Kids 21 Corporation contract shall be no less than an amount which is 22 85 percent of premium; to the extent any contract provision 23 does not provide for this minimum compensation, this section 24 shall prevail. The health plan selection criteria and scoring 25 system, and the scoring results, shall be available upon 26 request for inspection after the bids have been awarded. 27 11. Establish disenrollment criteria in the event 28 local matching funds are insufficient to cover enrollments. 29 12. Health and dental plans participating in the 30 Florida Healthy Kids program may develop and distribute 31 marketing and other promotional materials and participate in 42 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 activities, such as health fairs and public events, as 2 approved by the corporation. The health and dental plans may 3 also contact their current and former enrollees to encourage 4 continued participation in the program and to assist the 5 enrollee in transferring from a Title XIX-financed plan to a 6 Title XXI-financed plan. No later than July 1, 2008, this 7 function shall be transferred to the Department of Children 8 and Family Services. Develop and implement a plan to publicize 9 the Florida Healthy Kids Corporation, the eligibility 10 requirements of the program, and the procedures for enrollment 11 in the program and to maintain public awareness of the 12 corporation and the program. 13 13. Secure staff necessary to properly administer the 14 corporation. Staff costs shall be funded from state and local 15 matching funds and such other private or public funds as 16 become available. The board of directors shall determine the 17 number of staff members necessary to administer the 18 corporation. 19 14. Provide a report annually to the Governor, Chief 20 Financial Officer, Commissioner of Education, Senate 21 President, Speaker of the House of Representatives, and 22 Minority Leaders of the Senate and the House of 23 Representatives. 24 15. Establish benefit packages which conform to the 25 provisions of the Florida Kidcare program, as created in ss. 26 409.810-409.830 ss. 409.810-409.820. 27 (c) Coverage under the corporation's program is 28 secondary to any other available private coverage held by, or 29 applicable to, the participant child or family member. 30 Insurers under contract with the corporation are the payors of 31 last resort and must coordinate benefits with any other 43 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 third-party payor that may be liable for the participant's 2 medical care. 3 (d) The Florida Healthy Kids Corporation shall be a 4 private corporation not for profit, organized under pursuant 5 to chapter 617, and shall have all powers necessary to carry 6 out the purposes of this act, including, but not limited to, 7 the power to receive and accept grants, loans, or advances of 8 funds from any public or private agency and to receive and 9 accept from any source contributions of money, property, 10 labor, or any other thing of value, to be held, used, and 11 applied for the purposes of this section act. 12 (5)(6) BOARD OF DIRECTORS.-- 13 (a) The Florida Healthy Kids Corporation shall operate 14 subject to the supervision and approval of a board of 15 directors chaired by the Chief Financial Officer or her or his 16 designee, and composed of 10 other members selected for 3-year 17 terms of office as follows: 18 1. The Secretary of Health Care Administration, or his 19 or her designee; 20 2. One member appointed by the Commissioner of 21 Education from the Office of School Health Programs of the 22 Florida Department of Education; 23 3. One member appointed by the Chief Financial Officer 24 from among three members nominated by the Florida Pediatric 25 Society; 26 4. One member, appointed by the Governor, who 27 represents the Children's Medical Services Program; 28 5. One member appointed by the Chief Financial Officer 29 from among three members nominated by the Florida Hospital 30 Association; 31 6. One member, appointed by the Governor, who is an 44 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 expert on child health policy; 2 7. One member, appointed by the Chief Financial 3 Officer, from among three members nominated by the Florida 4 Academy of Family Physicians; 5 8. One member, appointed by the Governor, who 6 represents the state Medicaid program; 7 9. One member, appointed by the Chief Financial 8 Officer, from among three members nominated by the Florida 9 Association of Counties; and 10 10. The State Health Officer or her or his designee. 11 (b) A member of the board of directors may be removed 12 by the official who appointed that member. The board shall 13 appoint an executive director, who is responsible for other 14 staff authorized by the board. 15 (c) Board members are entitled to receive, from funds 16 of the corporation, reimbursement for per diem and travel 17 expenses as provided by s. 112.061. 18 (d) There shall be no liability on the part of, and no 19 cause of action shall arise against, any member of the board 20 of directors, or its employees or agents, for any action they 21 take in the performance of their powers and duties under this 22 act. 23 (6)(7) LICENSING NOT REQUIRED; FISCAL OPERATION.-- 24 (a) The corporation shall not be deemed an insurer. 25 The officers, directors, and employees of the corporation 26 shall not be deemed to be agents of an insurer. Neither the 27 corporation nor any officer, director, or employee of the 28 corporation is subject to the licensing requirements of the 29 insurance code or the rules of the Department of Financial 30 Services. However, any marketing representative utilized and 31 compensated by the corporation must be appointed as a 45 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 representative of the insurers or health services providers 2 with which the corporation contracts. 3 (b) The board has complete fiscal control over the 4 corporation and is responsible for all corporate operations. 5 (c) The Department of Financial Services shall 6 supervise any liquidation or dissolution of the corporation 7 and shall have, with respect to such liquidation or 8 dissolution, all power granted to it pursuant to the insurance 9 code. 10 (7)(8) ACCESS TO RECORDS; CONFIDENTIALITY; 11 PENALTIES.--Notwithstanding any other laws to the contrary, 12 the Florida Healthy Kids Corporation shall have access to the 13 medical records of a student upon receipt of permission from a 14 parent or guardian of the student. Such medical records may be 15 maintained by state and local agencies. Any identifying 16 information, including medical records and family financial 17 information, obtained by the corporation pursuant to this 18 subsection is confidential and is exempt from the provisions 19 of s. 119.07(1). Neither the corporation nor the staff or 20 agents of the corporation may release, without the written 21 consent of the participant or the parent or guardian of the 22 participant, to any state or federal agency, to any private 23 business or person, or to any other entity, any confidential 24 information received pursuant to this subsection. A violation 25 of this subsection is a misdemeanor of the second degree, 26 punishable as provided in s. 775.082 or s. 775.083. 27 (8) The venue for all civil and administrative actions 28 against the Florida Healthy Kids Corporation shall be in Leon 29 County. 30 Section 18. Effective July 1, 2009, section 624.91, 31 Florida Statutes, as amended by this act, is repealed. 46 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 Section 19. The Agency for Health Care Administration 2 shall provide a consolidation transition plan that identifies 3 budget, statutory, and administrative issues that need to be 4 addressed in order to implement the provisions of s. 409.830, 5 Florida Statutes. The transition plan shall be provided to the 6 Governor, the President of the Senate, and the Speaker of the 7 House of Representatives by January 1, 2008. 8 Section 20. The sum of $333,049 in nonrecurring funds 9 from the General Revenue Fund and $780,082 in nonrecurring 10 funds from the Administrative Trust Fund are appropriated to 11 the Agency for Health Care Administration, and 10 full time 12 equivalent positions and associated salary rate of 519,766 is 13 authorized to implement the provisions of this act during the 14 2007-2008 fiscal year. 15 Section 21. The sum of $1,233,995 in nonrecurring 16 funds from the General Revenue Fund and $2,890,319 in 17 nonrecurring funds from the Federal Grants Trust Fund are 18 appropriated to the Department of Children and Family Services 19 and 115 full-time equivalent positions and associated salary 20 rate of 948,602 is authorized to implement the provisions of 21 this act during the 2007-2008 fiscal year. 22 Section 22. Except as otherwise expressly provided in 23 this act, this act shall take effect July 1, 2007. 24 25 26 ================ T I T L E A M E N D M E N T =============== 27 And the title is amended as follows: 28 Delete everything before the enacting clause 29 30 and insert: 31 A bill to be entitled 47 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 An act relating to medical assistance; amending 2 s. 409.811, F.S.; revising and providing 3 definitions relating to the Florida Kidcare 4 Act; amending s. 409.812, F.S.; revising the 5 purpose of the Florida Kidcare program; 6 amending s. 409.813, F.S.; revising the funding 7 sources for the health benefits coverage 8 provided to children under the program; 9 amending s. 409.8132, F.S.; revising the 10 eligibility and enrollment requirements in the 11 Medikids program component; amending s. 12 409.8134, F.S.; revising enrollment procedures; 13 amending s. 409.814, F.S.; revising eligibility 14 requirements for the program; creating s. 15 409.8141, F.S.; specifying requirements for 16 premium assistance eligibility; creating s. 17 409.8142, F.S.; specifying penalties for 18 fraudulent actions, failure to verify 19 eligibility, and nonpayment of premiums; 20 creating s. 409.8149, F.S.; specifying 21 enrollment procedures and requirements for plan 22 choice; amending s. 409.815, F.S.; revising the 23 health benefits coverage of the Florida Kidcare 24 program; amending s. 409.816, F.S.; revising 25 the limitations on premiums and cost-sharing; 26 amending s. 409.817, F.S.; revising the 27 qualifications for health insurance plans 28 serving the program; amending s. 409.818, F.S.; 29 specifying the duties and responsibilities of 30 the Department of Children and Family Services, 31 the Department of Health, the Agency for Health 48 11:36 AM 04/17/07 s0930.ha02.t01
Florida Senate - 2007 COMMITTEE AMENDMENT Bill No. CS for CS for SB 930 Barcode 064092 1 Care Administration, the Florida Healthy Kids 2 Corporation, and the Office of Insurance 3 Regulation pertaining to the administration of 4 the Florida Kidcare program; repealing s. 5 409.820, F.S., relating to quality assurance 6 and access standards; amending s. 409.821, 7 F.S.; clarifying that provisions exempting 8 certain records from public-records 9 requirements does not prevent an enrollee's 10 parent or guardian from obtaining records and 11 information concerning the enrollee; creating 12 s. 409.830, F.S.; establishing the Florida 13 Kidcare Program Consolidation Initiative, which 14 shall combine the administration of the 15 program; creating a deputy secretary of Florida 16 Kidcare within the Agency for Health Care 17 Administration; amending s. 624.91, F.S.; 18 revising provisions of the Florida Healthy Kids 19 Corporation Act; deleting certain eligibility 20 requirements; providing for the transfer of 21 functions to the Agency for Health Care 22 Administration and the Department of Children 23 and Family Services; repealing s. 624.91, F.S., 24 relating to the Florida Healthy Kids 25 Corporation; requiring a consolidation 26 transition plan; providing an appropriation and 27 authorizing additional positions; providing 28 effective dates. 29 30 31 49 11:36 AM 04/17/07 s0930.ha02.t01