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



                                                   HOUSE AMENDMENT

                                                Bill No. CS/HB 507

    Amendment No. 3 (for drafter's use only)

                            CHAMBER ACTION
              Senate                               House
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  5                                           ORIGINAL STAMP BELOW

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10  ______________________________________________________________

11  Representative(s) Pickens offered the following:

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13         Amendment to Amendment (121137) (with title amendment) 

14         On page 105, between lines 24 & 25

15

16  insert:

17         Section 101.  Paragraph (b) of subsection (7) of

18  section 409.910, Florida Statutes, 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 agency shall recover the full amount of all

22  medical assistance provided by Medicaid on behalf of the

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

24         (b)  From this share the agency shall credit a county

25  on its county billing invoice the county's proportionate share

26  of Medicaid third party recoveries in the areas of estate

27  recoveries and casualty claims, minus the agency's cost of

28  recovering the third party payments, based on the county's

29  percentage of the sum of total county billing divided by total

30  Medicaid expenditures. Upon receipt of any recovery or other

31  collection pursuant to this section, the agency shall

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    File original & 9 copies    03/12/02
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                                                   HOUSE AMENDMENT

                                                Bill No. CS/HB 507

    Amendment No. 3 (for drafter's use only)





  1  distribute the amount collected as follows:

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

  3  expenditures for the recipient plus any incentive payment made

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

  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 102.  Subsection (26) of section 409.913,

30  Florida Statutes, is added to read:

31         409.913  Oversight of the integrity of the Medicaid

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                                                   HOUSE AMENDMENT

                                                Bill No. CS/HB 507

    Amendment No. 3 (for drafter's use only)





  1  program.--The agency shall operate a program to oversee the

  2  activities of Florida Medicaid recipients, and providers and

  3  their representatives, to ensure that fraudulent and abusive

  4  behavior and neglect of recipients occur to the minimum extent

  5  possible, and to recover overpayments and impose sanctions as

  6  appropriate.

  7         (26)  With regards to any recoveries of Medicaid

  8  overpayment collected by the agency, by September 30 each

  9  year, the agency shall credit a county on its county billing

10  invoices the county's proportionate share of Medicaid

11  overpayment recovered, during the previous state fiscal year

12  from hospitals for inpatient services and nursing homes.

13  However, if a county has been billed for its participation but

14  has not paid the amount due, the agency shall offset that

15  amount and notify the county of the amount of the offset. If

16  the county has divided its financial responsibility between

17  the county and a special taxing district or authority as

18  contemplated in s. 409.915(6), the county must proportionately

19  divide any refund or offset in accordance with the proration

20  that it has established. This credit shall be calculated

21  separately for inpatient hospital services and nursing home

22  services as follows:

23         a.  The state share of the amount recovered from

24  hospital for inpatient services and nursing homes for which

25  the county has not previously received credit,

26         b.  Less the state share of the agency's cost of

27  recovering such payment,

28         c.  Times the Total County Share. The Total County

29  Share shall be calculated as the sum of total county billing

30  for inpatient hospital services and nursing home services,

31  respectively, divided by the state share of Medicaid

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                                                   HOUSE AMENDMENT

                                                Bill No. CS/HB 507

    Amendment No. 3 (for drafter's use only)





  1  expenditures for inpatient hospital services and nursing home

  2  services, respectively.

  3         d.  The credit given to each county shall be their

  4  proportionate share of the Total County Share calculated in c,

  5  above.

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

  9  And the title is amended as follows:

10         On page 116, line 4, of the amendment, after the

11  semicolon, of the amendment

12

13  insert:

14         amending s. 409.910, F.S., to credit counties

15         for the county's proportionate share of certain

16         Medicaid recoveries; amending s. 409.913, F.S.,

17         to establish a formula for calculating a

18         county's share of Medicaid recoveries;

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    File original & 9 copies    03/12/02
    hcs0005                     02:43 pm         00507-0021-632815