Florida Senate - 2011                        COMMITTEE AMENDMENT
       Bill No. CS for SB 1736
       
       
       
       
       
       
                                Barcode 701714                          
       
                              LEGISLATIVE ACTION                        
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       The Committee on Budget (Bogdanoff) recommended the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Between lines 2601 and 2602
    4  insert:
    5         Section 71. Section 409.9021, Florida Statutes, is amended
    6  to read:
    7         409.9021 Conditions for Medicaid Forfeiture of eligibility
    8  agreement.—
    9         (1) As a condition of Medicaid eligibility, subject to
   10  federal approval, a Medicaid applicant shall agree in writing to
   11  forfeit all entitlements to any goods or services provided
   12  through the Medicaid program if he or she has been found to have
   13  committed fraud, through judicial or administrative
   14  determination, two times in a period of 5 years. This provision
   15  applies only to the Medicaid recipient found to have committed
   16  or participated in the fraud and does not apply to any family
   17  member of the recipient who was not involved in the fraud.
   18         (2) A person who is eligible for Medicaid services and who
   19  has access to health care coverage through an employer-sponsored
   20  health plan may not receive Medicaid services reimbursed under
   21  s. 409.908, s. 409.912, or s. 409.986, but may use Medicaid
   22  financial assistance to pay the cost of premiums for the
   23  employer-sponsored health plan for the eligible person and his
   24  or her Medicaid-eligible family members.
   25         (3) A Medicaid recipient who has access to other insurance
   26  or coverage created pursuant to state or federal law may opt out
   27  of the Medicaid services provided under s. 409.908, s. 409.912,
   28  or s. 409.986 and use Medicaid financial assistance to pay the
   29  cost of premiums for the recipient and the recipient’s Medicaid
   30  eligible family members.
   31         (4) Subsections (2) and (3) shall be administered by the
   32  agency in accordance with s. 409.964(1)(j). The maximum amount
   33  available for the Medicaid financial assistance shall be
   34  calculated based on the Medicaid capitated rate as if the
   35  Medicaid recipient and the recipient’s eligible family members
   36  participated in a qualified plan for Medicaid managed care under
   37  this chapter.
   38  
   39  
   40  ================= T I T L E  A M E N D M E N T ================
   41         And the title is amended as follows:
   42         Delete line 230
   43  and insert:
   44         certain circumstances; amending s. 409.9021, F.S.;
   45         revising provisions relating to conditions for
   46         Medicaid eligibility; prohibiting a recipient who has
   47         access to employer-sponsored health care from
   48         obtaining services reimbursed through the Medicaid
   49         fee-for-service system; requiring the agency to
   50         develop a process to allow the Medicaid premium that
   51         would have been received to be used to pay employer
   52         premiums; requiring that the agency allow opt-out
   53         opportunities for certain recipients; amending s.
   54         409.91196, F.S.;