House Bill hb1603

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    Florida House of Representatives - 2002                HB 1603

        By Representative Machek






  1                      A bill to be entitled

  2         An act relating to payments on behalf of

  3         Medicaid-eligible persons; amending s. 409.910,

  4         F.S.; revising requirements for the

  5         distribution of funds recovered from third

  6         parties that are liable for making payments for

  7         medical care furnished to Medicaid recipients;

  8         providing an effective date.

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

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12         Section 1.  Paragraph (b) of subsection (7) of section

13  409.910, Florida Statutes, is amended to read:

14         409.910  Responsibility for payments on behalf of

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

16         (7)  The agency shall recover the full amount of all

17  medical assistance provided by Medicaid on behalf of the

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

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

20  pursuant to this section, the agency shall distribute the

21  amount collected as follows:

22         1.  To itself and to any county that has responsibility

23  for certain items of care and service as mandated in s.

24  409.915, amounts equal to a pro rata distribution of the

25  county's contribution and the state's respective Medicaid

26  expenditures an amount equal to the state Medicaid

27  expenditures for the recipient plus any incentive payment made

28  in accordance with paragraph (14)(a). However, if a county has

29  been billed for its participation but has not paid the amount

30  due, the agency shall offset that amount and notify the county

31  of the amount of the offset. If the county has divided its

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    Florida House of Representatives - 2002                HB 1603

    779-121-02






  1  financial responsibility between the county and a special

  2  taxing district or authority as contemplated in s. 409.915(6),

  3  the county must proportionately divide any refund or offset in

  4  accordance with the proration that it has established.

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

  6  state Medicaid expenditures minus any incentive payment made

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

  8  minus any other amount permitted by federal law to be

  9  deducted.

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

11  owed to the agency for any related medical assistance or to

12  health care providers, any remaining amount. This amount shall

13  be treated as income or resources in determining eligibility

14  for Medicaid.

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

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

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

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

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

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

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

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

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

25  subrogee and additional claims, except as to those sums

26  specifically identified in the final order, judgment, or

27  settlement agreement as reimbursements to the recipient as

28  expenditures for the named recipient on the subrogation claim.

29         Section 2.  This act shall take effect July 1, 2002.

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    Florida House of Representatives - 2002                HB 1603

    779-121-02






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  2                          SENATE SUMMARY

  3    Revises requirements for the distribution of funds
      recovered from third parties that are liable for making
  4    payments for medical care furnished to Medicaid
      recipients.
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