Senate Bill sb2020e2

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    CS for SB 2020                          Second Engrossed (ntc)



  1                      A bill to be entitled

  2         An act relating to health flex plans; amending

  3         s. 408.909, F.S.; revising the definition of

  4         the term "health flex plans"; authorizing plans

  5         to limit the term of coverage; extending the

  6         required period without coverage before one is

  7         eligible to participate; extending the

  8         expiration date for the program; amending s.

  9         409.904, F.S.; postponing the effective date of

10         changes to standards for eligibility for

11         certain optional medical assistance, including

12         coverage under the medically needy program;

13         providing appropriations; providing for

14         retroactive application; providing effective

15         dates.

16  

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

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19         Section 1.  Subsections (2), (3), (5), and (10) of

20  section 408.909, Florida Statutes, are amended to read:

21         408.909  Health flex plans.--

22         (2)  DEFINITIONS.--As used in this section, the term:

23         (a)  "Agency" means the Agency for Health Care

24  Administration.

25         (b)  "Department" means the Department of Insurance.

26         (c)  "Enrollee" means an individual who has been

27  determined to be eligible for and is receiving health care

28  coverage under a health flex plan approved under this section.

29         (d)  "Health care coverage" or "health flex plan

30  coverage" means health care services that are covered as

31  benefits under an approved health flex plan or that are


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    CS for SB 2020                          Second Engrossed (ntc)



 1  otherwise provided, either directly or through arrangements

 2  with other persons, via a health flex plan on a prepaid per

 3  capita basis or on a prepaid aggregate fixed-sum basis.

 4         (e)  "Health flex plan" means a health plan approved

 5  under subsection (3) which guarantees payment for specified

 6  health care coverage provided to the enrollee who purchases

 7  coverage directly from the plan or through a small business

 8  purchasing arrangement sponsored by a local government, or who

 9  enrolls through his or her employer and payment for coverage

10  is made in whole or in part by the employer.

11         (f)  "Health flex plan entity" means a health insurer,

12  health maintenance organization,

13  health-care-provider-sponsored organization, local government,

14  health care district, or other public or private

15  community-based organization that develops and implements an

16  approved health flex plan and is responsible for administering

17  the health flex plan and paying all claims for health flex

18  plan coverage by enrollees of the health flex plan.

19         (3)  PILOT PROGRAM.--The agency and the department

20  shall each approve or disapprove health flex plans that

21  provide health care coverage for eligible participants who

22  reside in the three areas of the state that have the highest

23  number of uninsured persons, as identified in the Florida

24  Health Insurance Study conducted by the agency and in Indian

25  River County and Duval County. A health flex plan may limit or

26  exclude benefits otherwise required by law for insurers

27  offering coverage in this state, may cap the total amount of

28  claims paid per year per enrollee, may limit the number of

29  enrollees or the term of coverage, or may take any combination

30  of those actions.

31  


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    CS for SB 2020                          Second Engrossed (ntc)



 1         (a)  The agency shall develop guidelines for the review

 2  of applications for health flex plans and shall disapprove or

 3  withdraw approval of plans that do not meet or no longer meet

 4  minimum standards for quality of care and access to care.

 5         (b)  The department shall develop guidelines for the

 6  review of health flex plan applications and shall disapprove

 7  or shall withdraw approval of plans that:

 8         1.  Contain any ambiguous, inconsistent, or misleading

 9  provisions or any exceptions or conditions that deceptively

10  affect or limit the benefits purported to be assumed in the

11  general coverage provided by the health flex plan;

12         2.  Provide benefits that are unreasonable in relation

13  to the premium charged or contain provisions that are unfair

14  or inequitable or contrary to the public policy of this state,

15  that encourage misrepresentation, or that result in unfair

16  discrimination in sales practices; or

17         3.  Cannot demonstrate that the health flex plan is

18  financially sound and that the applicant is able to underwrite

19  or finance the health care coverage provided.

20         (c)  The agency and the department may adopt rules as

21  needed to administer this section.

22         (5)  ELIGIBILITY.--Eligibility to enroll in an approved

23  health flex plan is limited to residents of this state who:

24         (a)  Are 64 years of age or younger;

25         (b)  Have a family income equal to or less than 200

26  percent of the federal poverty level;

27         (c)  Are not covered by a private insurance policy and

28  are not eligible for coverage through a public health

29  insurance program, such as Medicare or Medicaid, or another

30  public health care program, such as KidCare, and have not been

31  covered at any time during the past 6 months, except that a


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    CS for SB 2020                          Second Engrossed (ntc)



 1  small business purchasing arrangement sponsored by a local

 2  government may limit enrollment to residents of this state who

 3  have not been covered at any time during the past 12 months;

 4  and

 5         (d)  Have applied for health care coverage through an

 6  approved health flex plan and have agreed to make any payments

 7  required for participation, including periodic payments or

 8  payments due at the time health care services are provided.

 9         (10)  EXPIRATION.--This section expires July 1, 2008

10  2004.

11         Section 2.  Effective May 1, 2003, subsection (2) of

12  section 409.904, Florida Statutes, is amended to read:

13         409.904  Optional payments for eligible persons.--The

14  agency may make payments for medical assistance and related

15  services on behalf of the following persons who are determined

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

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

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

19  availability of moneys and any limitations established by the

20  General Appropriations Act or chapter 216.

21         (2)  A caretaker relative or parent, a pregnant woman,

22  a child under age 19 who would otherwise qualify for Florida

23  Kidcare Medicaid, a child up to age 21 who would otherwise

24  qualify under s. 409.903(1), a person age 65 or over, or a

25  blind or disabled person, who would otherwise be eligible for

26  Florida Medicaid, except that the income or assets of such

27  family or person exceed established limitations. For a family

28  or person in one of these coverage groups, medical expenses

29  are deductible from income in accordance with federal

30  requirements in order to make a determination of eligibility.

31  Expenses used to meet spend-down liability are not


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    CS for SB 2020                          Second Engrossed (ntc)



 1  reimbursable by Medicaid. Effective July May 1, 2003, when

 2  determining the eligibility of a pregnant woman, a child, or

 3  an aged, blind, or disabled individual, $270 shall be deducted

 4  from the countable income of the filing unit. When determining

 5  the eligibility of the parent or caretaker relative as defined

 6  by Title XIX of the Social Security Act, the additional income

 7  disregard of $270 does not apply. A family or person eligible

 8  under the coverage known as the "medically needy," is eligible

 9  to receive the same services as other Medicaid recipients,

10  with the exception of services in skilled nursing facilities

11  and intermediate care facilities for the developmentally

12  disabled.

13         Section 3.  The non-recurring sums of $8,265,777 from

14  the General Revenue Fund, $2,505,224 from the Grants and

15  Donations Trust Fund, and $11,727,287 from the Medical Care

16  Trust Fund are appropriated to the Agency for Health Care

17  Administration to implement section 2 of this act during the

18  2002-2003 fiscal year. This section takes effect May 1, 2003.

19         Section 4.  Except as otherwise expressly provided,

20  this act shall take July 1, 2003, but if it becomes a law

21  after May 1, 2003, sections 2 and 3 of this act shall operate

22  retroactively to that date.

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