HOUSE AMENDMENT

                                                   Bill No. SB 562

    Amendment No.     (for drafter's use only)

                            CHAMBER ACTION
              Senate                               House
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 5                                           ORIGINAL STAMP BELOW

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11  Representative(s) Sembler offered the following:

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13         Amendment (with title amendment) 

14  Remove from the bill:  Everything after the enacting clause

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16  and insert in lieu thereof:

17         Section 1.  (1)  Subsection (7) of section 409.910,

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

19         409.910  Responsibility for payments on behalf of

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

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

22  all medical assistance provided by Medicaid on behalf of the

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

24         (a)  Recovery of such benefits shall be collected

25  directly from:

26         1.  Any third party;

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

28  has received third-party benefits;

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

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

31  notwithstanding any provision of this section, to the

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    File original & 9 copies    04/28/99
    hap0008                     08:38 am         00562-0080-184535




                                                   HOUSE AMENDMENT

                                                   Bill No. SB 562

    Amendment No.     (for drafter's use only)





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

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

 3  third-party benefits received by the provider from a

 4  third-party payor for medical services provided to the

 5  recipient; or

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

 7  benefits.

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

 9  pursuant to this section, the department shall distribute the

10  amount collected as follows:

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

12  expenditures for the recipient plus any incentive payment made

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

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

15  state Medicaid expenditures minus any incentive payment made

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

17  minus any other amount permitted by federal law to be

18  deducted.

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

20  owed to the department for any related medical assistance or

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

22  shall be treated as income or resources in determining

23  eligibility for Medicaid.

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

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

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

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

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

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

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

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    File original & 9 copies    04/28/99
    hap0008                     08:38 am         00562-0080-184535




                                                   HOUSE AMENDMENT

                                                   Bill No. SB 562

    Amendment No.     (for drafter's use only)





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

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

 3  subrogee and additional claims, except as to those sums

 4  specifically identified in the final order, judgment, or

 5  settlement agreement as reimbursements to the recipient as

 6  expenditures for the named recipient on the subrogation claim.

 7         (2)  The amendments to Section 409.910, Florida

 8  Statutes, 1998 Supplement, provided herein are intended to

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

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

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

12  October 1, 1990.

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

16  And the title is amended as follows:

17         On page ,

18  remove from the title of the bill:  the entire title

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20  and insert in lieu thereof:

21                      A bill to be entitled

22         An act relating to Medicaid fraud; amending s.

23         409.910, F.S., relating to Medicaid third-party

24         liability; clarifying that the state may

25         recover and retain damages in excess of

26         Medicaid payments made under certain

27         circumstances; providing for retroactive

28         application; providing an effective date.

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    File original & 9 copies    04/28/99
    hap0008                     08:38 am         00562-0080-184535