Senate Bill 2520

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



    Florida Senate - 1999                                  SB 2520

    By Senator Dawson-White





    30-1526A-99                                             See HB

  1                      A bill to be entitled

  2         An act relating to children's health; amending

  3         s. 409.8132, F.S.; providing for year-round

  4         enrollment in the Medikids program; revising

  5         enrollment procedures; amending s. 409.8134,

  6         F.S.; providing for a statewide enrollment

  7         ceiling for the Florida Kidcare program;

  8         amending s. 409.814, F.S.; revising eligibility

  9         for certain children under the Florida Kidcare

10         program; amending s. 409.904, F.S.; revising

11         eligibility for certain children under the

12         Medicaid program; providing for presumptive

13         eligibility under certain circumstances;

14         amending s. 624.91, F.S.; providing for

15         year-round enrollment under the Florida Healthy

16         Kids Corporation program; revising contract

17         standards; eliminating authority of the

18         corporation to establish local matching fund

19         requirements; providing an effective date.

20

21  Be It Enacted by the Legislature of the State of Florida:

22

23         Section 1.  Subsection (7) of section 409.8132, Florida

24  Statutes, 1998 Supplement, is amended to read:

25         409.8132  Medikids program component.--

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

27  shall occur year-round until the enrollment ceiling is met.

28  However, component may only occur during periodic open

29  enrollment periods as specified by the agency. During the

30  first 12 months of the program, there shall be at least one,

31  but no more than three, open enrollment periods. The initial

                                  1

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






    Florida Senate - 1999                                  SB 2520
    30-1526A-99                                             See HB




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

  2  open enrollment periods during the first year of operation of

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

  4  program, the agency shall determine the frequency and duration

  5  of open enrollment periods. An applicant may apply for

  6  enrollment in the Medikids program component and proceed

  7  through the eligibility determination process at any time

  8  throughout the year. However, enrollment in Medikids shall not

  9  begin until the next open enrollment period; and a child may

10  not receive services under the Medikids program until the

11  child is enrolled in a managed care plan or MediPass. In

12  addition, Once determined eligible, an applicant may receive

13  choice counseling and select a managed care plan or MediPass.

14  If the applicant does not select a managed care plan or

15  MediPass within 30 days after receiving choice counseling, the

16  agency shall assign the applicant to a managed care plan or

17  MediPass. Assignments shall be divided equally between the

18  MediPass program and managed care plans. An applicant may

19  select MediPass under the Medikids program component only in

20  counties that have fewer than two managed care plans available

21  to serve Medicaid recipients and only if the federal Health

22  Care Financing Administration determines that MediPass

23  constitutes "health insurance coverage" as defined in Title

24  XXI of the Social Security Act.

25         Section 2.  Subsection (1) of section 409.8134, Florida

26  Statutes, 1998 Supplement, is amended to read:

27         409.8134  Program enrollment and expenditure

28  ceilings.--

29         (1)  Except for the Medicaid program, a ceiling shall

30  be placed on annual federal and state expenditures and on

31  enrollment in the Florida Kidcare program as provided each

                                  2

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






    Florida Senate - 1999                                  SB 2520
    30-1526A-99                                             See HB




  1  year in the General Appropriations Act. Except for the

  2  Medicaid program, a statewide enrollment ceiling shall be

  3  established for each Florida Kidcare program component, and

  4  children may be enrolled in each Florida Kidcare program

  5  component on a first-come, first-served basis until enrollment

  6  ceilings are met or the procedures in subsection (2) are

  7  invoked. The agency, in consultation with the Department of

  8  Health, may propose to increase the enrollment ceiling in

  9  accordance with chapter 216.

10         Section 3.  Present subsections (4) and (6) of section

11  409.814, Florida Statutes, 1998 Supplement, are amended, and

12  subsection (7) is added to that section, to read:

13         409.814  Eligibility.--A child whose family income is

14  equal to or below 200 percent of the federal poverty level is

15  eligible for the Florida Kidcare program as provided in this

16  section. In determining the eligibility of such a child, an

17  assets test is not required.

18         (4)  The following children are not eligible to receive

19  premium assistance for health benefits coverage under ss.

20  409.810-409.820, except under Medicaid if the child would have

21  been eligible for Medicaid under s. 409.903 or s. 409.904 as

22  of June 1, 1997:

23         (a)  A child who is eligible for coverage under a state

24  health benefit plan on the basis of a family member's

25  employment with a public agency in the state;

26         (b)  A child who is covered under a group health

27  benefit plan or under other health insurance coverage,

28  excluding coverage provided under the Florida Healthy Kids

29  Corporation as established under s. 624.91;

30         (c)  A child who is seeking premium assistance for

31  employer-sponsored group coverage, if the child has been

                                  3

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






    Florida Senate - 1999                                  SB 2520
    30-1526A-99                                             See HB




  1  covered by the same employer's group coverage during the 6

  2  months prior to the family's submitting an application for

  3  determination of eligibility under the Florida Kidcare

  4  program; or

  5         (d)  A child who is an alien, but who does not meet the

  6  definition of qualified alien, in the United States; or

  7         (d)(e)  A child who is an inmate of a public

  8  institution or a patient in an institution for mental

  9  diseases.

10         (6)  Once a child is determined eligible for the

11  Florida Kidcare program, the child is eligible for coverage

12  under the program for 12 6 months without a redetermination or

13  reverification of eligibility, if the family continues to pay

14  the applicable premium. Effective January 1, 1999, a child who

15  has not attained the age of 5 and who has been determined

16  eligible for the Medicaid program is eligible for coverage for

17  12 months without a redetermination or reverification of

18  eligibility.

19         (7)  Children who are ineligible for federal funding

20  under Medicaid and Title XXI of the Social Security Act due to

21  their immigration status shall be enrolled in the appropriate

22  Florida Kidcare program based on the family income, and their

23  coverage shall be provided by state funds only.

24         Section 4.  Subsection (7) of section 409.904, Florida

25  Statutes, 1998 Supplement, is amended, and subsection (8) is

26  added to that section, to read:

27         409.904  Optional payments for eligible persons.--The

28  agency may make payments for medical assistance and related

29  services on behalf of the following persons who are determined

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

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

                                  4

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






    Florida Senate - 1999                                  SB 2520
    30-1526A-99                                             See HB




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

  2  availability of moneys and any limitations established by the

  3  General Appropriations Act or chapter 216.

  4         (7)  A child who has not attained the age of 19 who has

  5  been determined eligible for the Medicaid program is deemed to

  6  be eligible for a total of 12 6 months, regardless of changes

  7  in circumstances other than attainment of the maximum age.

  8  Effective January 1, 1999, a child who has not attained the

  9  age of 5 and who has been determined eligible for the Medicaid

10  program is deemed to be eligible for a total of 12 months

11  regardless of changes in circumstances other than attainment

12  of the maximum age.

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

14  applies for eligibility for the Medicaid program through a

15  qualified Medicaid provider must be offered the opportunity,

16  subject to federal rules, to be made presumptively eligible

17  for the Medicaid program.

18         Section 5.  Paragraph (b) of subsection (4) of section

19  624.91, Florida Statutes, 1998 Supplement, is amended to read:

20         624.91  The Florida Healthy Kids Corporation Act.--

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

22         (b)  The Florida Healthy Kids Corporation shall phase

23  in a program to:

24         1.  Organize school children groups to facilitate the

25  provision of comprehensive health insurance coverage to

26  children;

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

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

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

30  payment of premiums for comprehensive insurance coverage and

31  for the actual or estimated administrative expenses;

                                  5

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






    Florida Senate - 1999                                  SB 2520
    30-1526A-99                                             See HB




  1         3.  Establish the administrative and accounting

  2  procedures for the operation of the corporation;

  3         4.  Establish, with consultation from appropriate

  4  professional organizations, standards for preventive health

  5  services and providers and comprehensive insurance benefits

  6  appropriate to children; provided that such standards for

  7  rural areas shall not limit primary care providers to

  8  board-certified pediatricians;

  9         5.  Establish eligibility criteria which children must

10  meet in order to participate in the program;

11         6.  Establish procedures under which applicants to and

12  participants in the program may have grievances reviewed by an

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

14  corporation;

15         7.  Establish participation criteria and, if

16  appropriate, contract with an authorized insurer, health

17  maintenance organization, or insurance administrator to

18  provide administrative services to the corporation;

19         8.  Establish enrollment criteria which shall include

20  year-round enrollment if space is available penalties or

21  waiting periods of not fewer than 60 days for reinstatement of

22  coverage upon voluntary cancellation for nonpayment of family

23  premiums;

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

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

26  enrolled in Medicaid or Medikids if such child loses Medicaid

27  or Medikids eligibility and becomes eligible for the Florida

28  Healthy Kids program;

29         9.10.  Contract with authorized insurers or any

30  provider of health care services, meeting standards

31  established by the corporation, for the provision of

                                  6

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






    Florida Senate - 1999                                  SB 2520
    30-1526A-99                                             See HB




  1  comprehensive insurance coverage to participants.  Such

  2  standards shall include criteria under which the corporation

  3  shall may contract with more than one provider of health care

  4  services in program sites. Health plans shall be selected

  5  through a competitive bid process. The selection of health

  6  plans shall be based primarily on quality criteria established

  7  by the board. The health plan selection criteria and scoring

  8  system, and the scoring results, shall be available upon

  9  request for inspection after the bids have been awarded;

10         10.11.  Develop and implement a plan to publicize the

11  Florida Healthy Kids Corporation, the eligibility requirements

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

13  program and to maintain public awareness of the corporation

14  and the program;

15         11.12.  Secure staff necessary to properly administer

16  the corporation. Staff costs shall be funded from state and

17  local matching funds and such other private or public funds as

18  become available. The board of directors shall determine the

19  number of staff members necessary to administer the

20  corporation;

21         12.13.  As appropriate, enter into contracts with local

22  school boards or other agencies to provide onsite information,

23  enrollment, and other services necessary to the operation of

24  the corporation;

25         13.14.  Provide a report on an annual basis to the

26  Governor, Insurance Commissioner, Commissioner of Education,

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

28  Minority Leaders of the Senate and the House of

29  Representatives;

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

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

                                  7

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






    Florida Senate - 1999                                  SB 2520
    30-1526A-99                                             See HB




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

  2  Thereafter, the corporation may establish local matching

  3  requirements for supplemental participation in the program.

  4  The corporation may vary local matching requirements and

  5  enrollment by county depending on factors which may influence

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

  7  population density, per capita income, existing local tax

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

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

10  to the extent allowed by Title XXI of the Social Security Act;

11  and

12         14.16.  Establish eligibility criteria, premium and

13  cost-sharing requirements, and benefit packages which conform

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

15  in ss. 409.810-409.820.

16         Section 6.  This act shall take effect upon becoming a

17  law.

18

19            *****************************************

20                       LEGISLATIVE SUMMARY

21
      Removes provisions relating to periodic open enrollment
22    under the Medikids program, and provides for year-round
      enrollment until the enrollment ceiling is met. Provides
23    for assignment of applicants to a managed care plan or
      MediPass, under described circumstances. Provides for
24    establishment of a statewide enrollment ceiling under the
      Florida Kidcare program. Provides eligibility under the
25    Florida Kidcare program for certain immigrant children,
      based on family income. Provides for coverage of such
26    children using state funds only. Provides for eligibility
      redeterminations after 12 months, rather than 6 months,
27    for certain children under the Kidcare and Medicaid
      programs, and provides for presumptive Medicaid
28    eligibility for certain children. Provides for year-round
      enrollment on a space-available basis under the Florida
29    Healthy Kids Corporation program. Eliminates corporation
      authority to establish local matching fund requirements
30    for supplemental participation in the program.

31

                                  8