CODING: Words stricken are deletions; words underlined are additions.





                                                   HOUSE AMENDMENT

                      Bill No. CS for SB's 1414 and 2520, 1st Eng.

    Amendment No.     (for drafter's use only)

                            CHAMBER ACTION
              Senate                               House
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 4                                                                

 5                                           ORIGINAL STAMP BELOW

 6

 7

 8

 9

10                                                                

11  Representative(s) Peaden and Albright offered the following:

12

13         Amendment (with title amendment) 

14  Remove from the bill:  Everything after the enacting clause

15

16  and insert in lieu thereof:

17         Section 1.  Subsections (4) and (7) of section

18  409.8132, Florida Statutes, 1998 Supplement, are amended to

19  read:

20         409.8132  Medikids program component.--

21         (4)  APPLICABILITY OF LAWS RELATING TO MEDICAID.--The

22  provisions of ss. 409.902, 409.905, 409.906, 409.907, 409.908,

23  409.910, 409.912, 409.9121, 409.9122, 409.9123, 409.9124,

24  409.9127, 409.9128, 409.913, 409.916, 409.919, 409.920, and

25  409.9205 apply to the administration of the Medikids program

26  component of the Florida Kidcare program, except that s.

27  409.9122 applies to Medikids as modified by the provisions of

28  subsection (7).

29         (7)  ENROLLMENT.--Enrollment in the Medikids program

30  component may only occur during periodic open enrollment

31  periods as specified by the agency. During the first 12 months

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                                                   HOUSE AMENDMENT

                      Bill No. CS for SB's 1414 and 2520, 1st Eng.

    Amendment No.     (for drafter's use only)





 1  of the program, there shall be at least one, but no more than

 2  three, open enrollment periods. The initial open enrollment

 3  period shall be for 90 days, and subsequent open enrollment

 4  periods during the first year of operation of the program

 5  shall be for 30 days. After the first year of the program, the

 6  agency shall determine the frequency and duration of open

 7  enrollment periods. An applicant may apply for enrollment in

 8  the Medikids program component and proceed through the

 9  eligibility determination process at any time throughout the

10  year. However, enrollment in Medikids shall not begin until

11  the next open enrollment period; and a child may not receive

12  services under the Medikids program until the child is

13  enrolled in a managed care plan or MediPass. In addition, once

14  determined eligible, an applicant may receive choice

15  counseling and select a managed care plan or MediPass. An

16  applicant may select MediPass under the Medikids program

17  component only in counties that have fewer than two managed

18  care plans available to serve Medicaid recipients and only if

19  the federal Health Care Financing Administration determines

20  that MediPass constitutes "health insurance coverage" as

21  defined in Title XXI of the Social Security Act. The agency

22  may implement procedures for the mandatory assignment of

23  Medikids applicants who do not make a voluntary choice of a

24  managed care plan or MediPass. In counties with two or more

25  managed care plans, assignment shall be made among managed

26  care plans. In counties with fewer than two managed care

27  plans, assignment shall be made based on existing Medicaid

28  assignment procedures.

29         Section 2.  Subsection (3) is added to section 409.815,

30  Florida Statutes, 1998 Supplement, to read:

31         409.815  Health benefits coverage; limitations.--

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                                                   HOUSE AMENDMENT

                      Bill No. CS for SB's 1414 and 2520, 1st Eng.

    Amendment No.     (for drafter's use only)





 1         (3)  KIDCARE DENTAL PROGRAM.--A Kidcare dental program

 2  is created for children eligible for the Florida Kidcare

 3  program as created under ss. 409.810-409.820, except for those

 4  children eligible under Medicaid and Medikids. The agency

 5  shall develop and administer the Kidcare dental program. Under

 6  the Kidcare dental program:

 7         (a)  Dental benefits must include the same services

 8  specified in s. 409.906(6), excluding orthodontics.

 9         (b)  Dental providers must be enrolled in the Medicaid

10  program and are to be reimbursed using Medicaid

11  fee-for-service rates.

12         (c)  The agency shall designate a limited number of

13  sites and a limited number of children to participate in the

14  dental program, using the following criteria:

15         1.  Sites selected for the program must comply with the

16  quality assurance and access standards developed under s.

17  409.820 and selection as a site must be a condition of program

18  participation. No more than three counties may be selected as

19  sites for the implementation of the program; and

20         2.  Enrollment for the entire program may not exceed

21  1,000 children.

22

23  Implementation of the Kidcare dental program is subject to an

24  annual appropriation for that specific purpose and may not

25  result in a decrease in the total number of children served

26  under the program from the previous fiscal year. The agency

27  shall include in the report required under s. 409.8177 an

28  evaluation of the Kidcare dental program. This subsection

29  expires December 31, 2001.

30         Section 3.  Subsection (8) is added to section 409.904,

31  Florida Statutes, 1998 Supplement, to read:

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                                                   HOUSE AMENDMENT

                      Bill No. CS for SB's 1414 and 2520, 1st Eng.

    Amendment No.     (for drafter's use only)





 1         409.904  Optional payments for eligible persons.--The

 2  agency may make payments for medical assistance and related

 3  services on behalf of the following persons who are determined

 4  to be eligible subject to the income, assets, and categorical

 5  eligibility tests set forth in federal and state law.  Payment

 6  on behalf of these Medicaid eligible persons is subject to the

 7  availability of moneys and any limitations established by the

 8  General Appropriations Act or chapter 216.

 9         (8)  A child who has not attained the age of 19 years

10  who applies for eligibility for the Medicaid program through a

11  qualified Medicaid provider must be offered the opportunity,

12  subject to federal regulations, to be made presumptively

13  eligible for the Medicaid program.

14         Section 4.  Paragraph (b) of subsection (4) of section

15  624.91, Florida Statutes, 1998 Supplement, is amended to read:

16         624.91  The Florida Healthy Kids Corporation Act.--

17         (4)  CORPORATION AUTHORIZATION, DUTIES, POWERS.--

18         (b)  The Florida Healthy Kids Corporation shall phase

19  in a program to:

20         1.  Organize school children groups to facilitate the

21  provision of comprehensive health insurance coverage to

22  children;

23         2.  Arrange for the collection of any family, local

24  contributions, or employer payment or premium, in an amount to

25  be determined by the board of directors, to provide for

26  payment of premiums for comprehensive insurance coverage and

27  for the actual or estimated administrative expenses;

28         3.  Establish the administrative and accounting

29  procedures for the operation of the corporation;

30         4.  Establish, with consultation from appropriate

31  professional organizations, standards for preventive health

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                                                   HOUSE AMENDMENT

                      Bill No. CS for SB's 1414 and 2520, 1st Eng.

    Amendment No.     (for drafter's use only)





 1  services and providers and comprehensive insurance benefits

 2  appropriate to children; provided that such standards for

 3  rural areas shall not limit primary care providers to

 4  board-certified pediatricians;

 5         5.  Establish eligibility criteria which children must

 6  meet in order to participate in the program;

 7         6.  Establish procedures under which applicants to and

 8  participants in the program may have grievances reviewed by an

 9  impartial body and reported to the board of directors of the

10  corporation;

11         7.  Establish participation criteria and, if

12  appropriate, contract with an authorized insurer, health

13  maintenance organization, or insurance administrator to

14  provide administrative services to the corporation;

15         8.  Establish enrollment criteria which shall include

16  penalties or waiting periods of not fewer than 60 days for

17  reinstatement of coverage upon voluntary cancellation for

18  nonpayment of family premiums;

19         9.  If a space is available, establish a special open

20  enrollment period of 30 days' duration for any child who is

21  enrolled in Medicaid or Medikids if such child loses Medicaid

22  or Medikids eligibility and becomes eligible for the Florida

23  Healthy Kids program;

24         10.  Contract with authorized insurers or any provider

25  of health care services, meeting standards established by the

26  corporation, for the provision of comprehensive insurance

27  coverage to participants.  Such standards shall include

28  criteria under which the corporation may contract with more

29  than one provider of health care services in program sites.

30  Health plans shall be selected through a competitive bid

31  process. The selection of health plans shall be based

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                                                   HOUSE AMENDMENT

                      Bill No. CS for SB's 1414 and 2520, 1st Eng.

    Amendment No.     (for drafter's use only)





 1  primarily on quality criteria established by the board. The

 2  health plan selection criteria and scoring system, and the

 3  scoring results, shall be available upon request for

 4  inspection after the bids have been awarded;

 5         11.  Develop and implement a plan to publicize the

 6  Florida Healthy Kids Corporation, the eligibility requirements

 7  of the program, and the procedures for enrollment in the

 8  program and to maintain public awareness of the corporation

 9  and the program;

10         12.  Secure staff necessary to properly administer the

11  corporation. Staff costs shall be funded from state and local

12  matching funds and such other private or public funds as

13  become available. The corporation shall reduce or waive local

14  match requirements, provided funds are designated for this

15  purpose in the General Appropriations Act.  The board of

16  directors shall determine the number of staff members

17  necessary to administer the corporation;

18         13.  As appropriate, enter into contracts with local

19  school boards or other agencies to provide onsite information,

20  enrollment, and other services necessary to the operation of

21  the corporation;

22         14.  Provide a report on an annual basis to the

23  Governor, Insurance Commissioner, Commissioner of Education,

24  Senate President, Speaker of the House of Representatives, and

25  Minority Leaders of the Senate and the House of

26  Representatives;

27         15.  Each fiscal year, establish a maximum number of

28  participants by county, on a statewide basis, who may enroll

29  in the program without the benefit of local matching funds.

30  Thereafter, the corporation may establish local matching

31  requirements for supplemental participation in the program.

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                                                   HOUSE AMENDMENT

                      Bill No. CS for SB's 1414 and 2520, 1st Eng.

    Amendment No.     (for drafter's use only)





 1  The corporation may vary local matching requirements and

 2  enrollment by county depending on factors which may influence

 3  the generation of local match, including, but not limited to,

 4  population density, per capita income, existing local tax

 5  effort, and other factors. The corporation also may accept

 6  in-kind match in lieu of cash for the local match requirement

 7  to the extent allowed by Title XXI of the Social Security Act.

 8  The corporation shall reduce or waive local match

 9  requirements, provided funds are designated for this purpose

10  in the General Appropriations Act; and

11         16.  Establish eligibility criteria, premium and

12  cost-sharing requirements, and benefit packages which conform

13  to the provisions of the Florida Kidcare program, as created

14  in ss. 409.810-409.820.

15         Section 5.  For the 1999-2000 fiscal year only, the

16  Agency for Health Care Administration is authorized to use the

17  following amounts from the increased funds provided in the

18  General Appropriations Act for the Florida Kidcare Program:

19         (1)  Up to $142,511 in state funds and the up to

20  $184,800 in federal trust funds to fund presumptive

21  eligibility as authorized in this act; and

22         (2)  Up to $88,344 in state funds and up to $201,976 in

23  federal trust funds to fund up to 1,000 children in up to

24  three dental pilot sites, including administrative costs, as

25  authorized in this act.

26         Section 6.  This act shall take effect July 1, 1999.

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 2-22,

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                                                   HOUSE AMENDMENT

                      Bill No. CS for SB's 1414 and 2520, 1st Eng.

    Amendment No.     (for drafter's use only)





 1  remove from the title of the bill:  all of said lines

 2

 3  and insert in lieu thereof:

 4         An act relating to children's health; amending

 5         s. 409.8132, F.S.; removing applicability of

 6         Medicaid third-party liability requirements to

 7         the Medikids program; authorizing the Agency

 8         for Health Care Administration to implement

 9         mandatory assignment of certain Medikids

10         applicants; amending s. 409.815, F.S.; creating

11         a Kidcare dental program, subject to annual

12         appropriation; providing requirements; amending

13         s. 409.904, F.S.; providing presumptive

14         eligibility of children for Medicaid; amending

15         s. 624.91, F.S.; authorizing the Florida

16         Healthy Kids Corporation to reduce or waive

17         local match requirements under certain

18         circumstances; specifying use of appropriated

19         funds; providing an effective date.

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