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





                                                  SENATE AMENDMENT

    Bill No. HB 2231, 1st Eng.

    Amendment No.    

                            CHAMBER ACTION
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11  Senators Casas and Klein moved the following amendment:

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13         Senate Amendment (with title amendment) 

14         On page 15, between lines 30 and 31,

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16  insert:

17         Section 5.  Subsections (4) and (7) of section 409.910,

18  Florida Statutes, 1998 Supplement, are amended to read:

19         409.910  Responsibility for payments on behalf of

20  Medicaid-eligible persons when other parties are liable.--

21         (4)  After the department has provided medical

22  assistance under the Medicaid program, it shall seek recovery

23  of reimbursement from third-party benefits to the limit of

24  legal liability and for the full amount of third-party

25  benefits, but not in excess of the amount of medical

26  assistance paid by Medicaid, as to:

27         (a)  Claims for which the department has a waiver

28  pursuant to federal law; or

29         (b)  Situations in which the department learns of the

30  existence of a liable third party or in which third-party

31  benefits are discovered or become available after medical

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                                                  SENATE AMENDMENT

    Bill No. HB 2231, 1st Eng.

    Amendment No.    





 1  assistance has been provided by Medicaid. Nothing in this

 2  subsection shall limit the authority of the state or any

 3  agency thereof to bring or maintain actions seeking recoveries

 4  in excess of the amount paid as Medicaid benefits under

 5  alternative theories of liability in conjunction with an

 6  action filed pursuant to this section.

 7         (7)  The department shall recover the full amount of

 8  all medical assistance provided by Medicaid on behalf of the

 9  recipient to the full extent of third-party benefits.

10         (a)  Recovery of such benefits shall be collected

11  directly from:

12         1.  Any third party;

13         2.  The recipient or legal representative, if he or she

14  has received third-party benefits;

15         3.  The provider of a recipient's medical services if

16  third-party benefits have been recovered by the provider;

17  notwithstanding any provision of this section, to the

18  contrary, however, no provider shall be required to refund or

19  pay to the department any amount in excess of the actual

20  third-party benefits received by the provider from a

21  third-party payor for medical services provided to the

22  recipient; or

23         4.  Any person who has received the third-party

24  benefits.

25         (b)  Upon receipt of any recovery or other collection

26  pursuant to this section, the department shall distribute the

27  amount collected as follows:

28         1.  To itself, an amount equal to the state Medicaid

29  expenditures for the recipient plus any incentive payment made

30  in accordance with paragraph (14)(a).

31         2.  To the Federal Government, the federal share of the

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                                                  SENATE AMENDMENT

    Bill No. HB 2231, 1st Eng.

    Amendment No.    





 1  state Medicaid expenditures minus any incentive payment made

 2  in accordance with paragraph (14)(a) and federal law, and

 3  minus any other amount permitted by federal law to be

 4  deducted.

 5         3.  To the recipient, after deducting any known amounts

 6  owed to the department for any related medical assistance or

 7  to health care providers, any remaining amount. This amount

 8  shall be treated as income or resources in determining

 9  eligibility for Medicaid.

10

11  The provisions of this subsection do not apply to any proceeds

12  received by the state, or any agency thereof, pursuant to a

13  final order, judgment, or settlement agreement, in any matter

14  in which the state asserts claims brought on its own behalf,

15  and not as a subrogee of a recipient, or under other theories

16  of liability. The provisions of this subsection do not apply

17  to any proceeds received by the state, or an agency thereof,

18  pursuant to a final order, judgment, or settlement agreement,

19  in any matter in which the state asserted both claims as a

20  subrogee and additional claims, except as to those sums

21  specifically identified in the final order, judgment, or

22  settlement agreement as reimbursements to the recipient as

23  expenditures for the named recipient on the subrogation claim.

24         Section 6.  The amendments to section 409.910, Florida

25  Statutes, 1998 Supplement, made by this act are intended to

26  clarify existing law and are remedial in nature.  As such,

27  they are specifically made retroactive to October 1, 1990, and

28  shall apply to all causes of action arising on or after

29  October 1, 1990.

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31  (Redesignate subsequent sections.)

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                                                  SENATE AMENDMENT

    Bill No. HB 2231, 1st Eng.

    Amendment No.    





 1  ================ T I T L E   A M E N D M E N T ===============

 2  And the title is amended as follows:

 3         On page 1, line 24, after the semicolon

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 5  insert:

 6         amending s. 409.910, F.S.; clarifying that the

 7         state may recover and retain damages in excess

 8         of Medicaid payments made under certain

 9         circumstances; providing for retroactive

10         application;

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