HB 1073

1	A bill to be entitled
2	An act relating to the Florida KidCare program; amending
3	s. 409.811, F.S.; defining the term "Florida KidCare
4	program"; deleting a definition to conform; amending s.
5	409.8132, F.S.; limiting when an applicant may apply for
6	Medikids program enrollment; deleting a special enrollment
7	period provision; amending s. 409.8134, F.S.; eliminating
8	the Agency for Health Care Administration's ability to
9	request an increase in the Florida KidCare program
10	enrollment ceiling; providing for open enrollment periods;
11	providing a timeframe for statewide announcement of open
12	enrollment periods; providing limitations; providing an
13	exception; providing a disenrollment process under certain
14	circumstances; providing additional data for certain
15	agencies to collect and analyze; amending s. 409.814,
16	F.S.; revising Florida KidCare program eligibility
17	criteria; limiting coverage; providing an exception for
18	certain children otherwise eligible or covered under a
19	family member's employer health coverage; restricting
20	enrollment of children whose coverage was voluntarily
21	canceled; providing an age limitation for certain
22	components; requiring certain transfers to be managed
23	within authorized levels of funding; requiring certain
24	reserves to be established and reviewed; requiring each
25	applicant to provide certain documentation; requiring the
26	program to withhold benefits from certain enrollees;
27	providing additional fraudulent activities; amending s.
28	409.815, F.S.; providing that dental services shall be
29	covered; amending s. 624.91, F.S.; removing the
30	requirement for the Florida Healthy Kids Corporation to
31	work with the Florida Partnership for School Readiness;
32	limiting eligibility for state-funded assistance in paying
33	Florida Healthy Kids premiums; providing for future repeal
34	of certain provisions; providing additional criteria for
35	the corporation to determine eligibility; eliminating
36	authority to establish an open enrollment period; revising
37	the corporation's purchasing criteria; removing a
38	restriction; eliminating authority to contract with
39	certain entities; eliminating authority to establish a
40	maximum number of participants; eliminating authority to
41	establish eligibility criteria or premium and cost-sharing
42	requirements; providing that contracted insurers are the
43	payors of last resort; requiring contracted insurers to
44	coordinate benefits with certain payors; requiring the
45	Auditor General to provide recommendations to prevent
46	enrollment of ineligible children in the Florida KidCare
47	program and report such recommendations to the Governor
48	and Legislature; requiring the Florida Healthy Kids
49	Corporation to use certain funds to contract for an
50	actuarial study; requiring the Auditor General to perform
51	audits to ensure the eligibility of children enrolled in
52	the Florida Healthy Kids program; authorizing the Auditor
53	General to require and receive any books, accounts,
54	records, or other documentation relating to the Florida
55	Healthy Kids Corporation; requiring the Office of Program
56	Policy Analysis and Government Accountability to perform a
57	study to determine the appropriate family premium for the
58	Florida KidCare program and report its findings to the
59	Legislature; amending s. 409.818, F.S.; deleting a cross
60	reference; repealing s. 409.819, F.S., relating to a
61	program identifying low-income, uninsured children for
62	certain purposes; providing appropriations; providing
63	effective dates.
64
65	Be It Enacted by the Legislature of the State of Florida:
66
67	Section 1.  Subsections (14) through (22) of section
68	409.811, Florida Statutes, are renumbered as subsections (15)
69	through (23), respectively, present subsection (23) of said
70	section is amended, and a new subsection (14) is added to said
71	section, to read:
72	409.811  Definitions relating to Florida KidCare Kidcare
73	Act.--As used in ss. 409.810-409.820, the term:
74	(14)  "Florida KidCare program," "KidCare program," or
75	"program" means the health benefits program administered through
76	ss. 409.810-409.820.
77	(23)  "Program" means the Florida Kidcare program, the
78	medical assistance program authorized by Title XXI of the Social
79	Security Act as part of the federal Balanced Budget Act of 1997.
80	Section 2.  Subsections (7), (8), and (9) of section
81	409.8132, Florida Statutes, are amended to read:
82	409.8132  Medikids program component.--
83	(7)  ENROLLMENT.--Enrollment in the Medikids program
84	component may only occur during periodic open enrollment periods
85	as specified in s. 409.8134 by the agency. An applicant may
86	apply for enrollment in the Medikids program component and
87	proceed through the eligibility determination process at any
88	time throughout the year. However, enrollment in Medikids shall
89	not begin until the next open enrollment period; and A child may
90	not receive services under the Medikids program until the child
91	is enrolled in a managed care plan or MediPass. In addition,
92	Once determined eligible, an applicant may receive choice
93	counseling and select a managed care plan or MediPass. The
94	agency may initiate mandatory assignment for a Medikids
95	applicant who has not chosen a managed care plan or MediPass
96	provider after the applicant's voluntary choice period ends. An
97	applicant may select MediPass under the Medikids program
98	component only in counties that have fewer than two managed care
99	plans available to serve Medicaid recipients and only if the
100	federal Health Care Financing Administration determines that
101	MediPass constitutes "health insurance coverage" as defined in
102	Title XXI of the Social Security Act.
103	(8)  SPECIAL ENROLLMENT PERIODS.--The agency shall
104	establish a special enrollment period of 30 days' duration for
105	any child who is enrolled in Medicaid if such child loses
106	Medicaid eligibility and becomes eligible for Medikids, or for
107	any child who is enrolled in Medikids if such child moves to
108	another county that is not within the coverage area of the
109	child's Medikids managed care plan or MediPass provider.
110	(8)(9)  PENALTIES FOR VOLUNTARY CANCELLATION.--The agency
111	shall establish enrollment criteria that must include penalties
112	or waiting periods of not fewer than 60 days for reinstatement
113	of coverage upon voluntary cancellation for nonpayment of
114	premiums.
115	Section 3.  Section 409.8134, Florida Statutes, is amended
116	to read:
117	409.8134  Program enrollment and expenditure ceilings.--
118	(1)  Except for the Medicaid program, a ceiling shall be
119	placed on annual federal and state expenditures and on
120	enrollment in the Florida KidCare Kidcare program as provided
121	each year in the General Appropriations Act. The agency, in
122	consultation with the Department of Health, may propose to
123	increase the enrollment ceiling in accordance with chapter 216.
124	(2)  Upon a unanimous recommendation by representatives
125	from each of the four Florida KidCare administrators, the
126	Florida KidCare program may conduct an open enrollment period
127	for the purpose of enrolling children eligible for all program
128	components listed in s. 409.813 except Medicaid. The four
129	Florida KidCare administrators shall work together to ensure
130	that the open enrollment period is announced statewide at least
131	1 month before the open enrollment is to begin. Eligible
132	children shall be enrolled on a first-come, first-served basis
133	using the date the open enrollment application is received. The
134	potential open enrollment periods shall be January 1 through
135	January 30 and September 1 through September 30 of each year.
136	Open enrollment shall immediately cease when the enrollment
137	ceiling is reached. An open enrollment shall only be held if the
138	Social Services Estimating Conference determines that sufficient
139	federal and state funds will be available to finance the
140	increased enrollment through federal fiscal year 2007. Any
141	individual who is not enrolled, including those added to the
142	waiting list after January 30, 2004, must reapply by submitting
143	a new application during the next open enrollment period.
144	However, the Children?s Medical Services Network may enroll up
145	to 120 additional children annually based on emergency
146	disability criteria outside of the open enrollment periods
147	provided that the cost of serving these children is within the
148	KidCare program?s appropriated or authorized levels of funding.
149	Except for the Medicaid program, whenever the Social Services
150	Estimating Conference determines that there is presently, or
151	will be by the end of the current fiscal year, insufficient
152	funds to finance the current or projected enrollment in the
153	Florida Kidcare program, all additional enrollment must cease
154	and additional enrollment may not resume until sufficient funds
155	are available to finance such enrollment.
156	(3)  Upon determination by the Social Services Estimating
157	Conference that there are insufficient funds to finance the
158	current enrollment in the Florida KidCare program within current
159	appropriations, the program shall initiate disenrollment
160	procedures to remove enrollees, except those children enrolled
161	in the Children's Medical Services network, on a last-in, first-
162	out basis until the expenditure and appropriation levels are
163	balanced.
164	(4)(3)  The agencies that administer the Florida KidCare
165	Kidcare program components shall collect and analyze the data
166	needed to project Florida Kidcare program enrollment costs,
167	including price level adjustments outreach impacts,
168	participation and attrition rates, current and projected
169	caseloads, utilization, and current and projected expenditures
170	for the next 3 years. The agencies shall report the caseload and
171	expenditure trends to the Social Services Estimating Conference
172	in accordance with chapter 216.
173	Section 4.  Effective July 1, 2004, section 409.814,
174	Florida Statutes, is amended to read:
175	409.814  Eligibility.--A child who has not reached 19 years
176	of age whose family income is equal to or below 200 percent of
177	the federal poverty level is eligible for the Florida KidCare
178	Kidcare program as provided in this section. In determining the
179	eligibility of such a child, an assets test is not required. An
180	applicant under 19 years of age who, based on a complete
181	application, appears to be eligible for the Medicaid component
182	of the Florida Kidcare program is presumed eligible for coverage
183	under Medicaid, subject to federal rules. A child who has been
184	deemed presumptively eligible for Medicaid shall not be enrolled
185	in a managed care plan until the child's full eligibility
186	determination for Medicaid has been completed. The Florida
187	Healthy Kids Corporation may, subject to compliance with
188	applicable requirements of the Agency for Health Care
189	Administration and the Department of Children and Family
190	Services, be designated as an entity to conduct presumptive
191	eligibility determinations. An applicant under 19 years of age
192	who, based on a complete application, appears to be eligible for
193	the Medikids, Florida Healthy Kids, or Children's Medical
194	Services network program component, who is screened as
195	ineligible for Medicaid and prior to the monthly verification of
196	the applicant's enrollment in Medicaid or of eligibility for
197	coverage under the state employee health benefit plan, may be
198	enrolled in and begin receiving coverage from the appropriate
199	program component on the first day of the month following the
200	receipt of a completed application. For enrollment in the
201	Children's Medical Services network, a complete application
202	includes the medical or behavioral health screening. If,
203	subsequently after verification, an individual is determined to
204	be ineligible for coverage, he or she must immediately be
205	disenrolled from the respective Florida KidCare Title XXI-funded
206	Kidcare program component.
207	(1)  A child who is eligible for Medicaid coverage under s.
208	409.903 or s. 409.904 must be enrolled in Medicaid and is not
209	eligible to receive health benefits under any other health
210	benefits coverage authorized under the Florida KidCare program
211	ss. 409.810-409.820.
212	(2)  A child who is not eligible for Medicaid, but who is
213	eligible for the Florida KidCare Kidcare program, may obtain
214	health benefits coverage under any of the other components
215	listed in s. 409.813 types of health benefits coverage
216	authorized in ss. 409.810-409.820 if such coverage is approved
217	and available in the county in which the child resides. However,
218	a child who is eligible for Medikids may participate in the
219	Florida Healthy Kids program only if the child has a sibling
220	participating in the Florida Healthy Kids program and the
221	child's county of residence permits such enrollment.
222	(3)  A child who is eligible for the Florida KidCare
223	Kidcare program who is a child with special health care needs,
224	as determined through a medical or behavioral screening
225	instrument, is eligible for health benefits coverage from and
226	shall be referred to the Children's Medical Services network.
227	(4)  The following children are not eligible to receive
228	premium assistance for health benefits coverage under the
229	Florida KidCare program ss. 409.810-409.820, except under
230	Medicaid if the child would have been eligible for Medicaid
231	under s. 409.903 or s. 409.904 as of June 1, 1997:
232	(a)  A child who is eligible for coverage under a state
233	health benefit plan on the basis of a family member's employment
234	with a public agency in the state.
235	(b)  A child who is currently eligible for or covered under
236	a family member's group health benefit plan or under other
237	employer health insurance coverage, excluding coverage provided
238	under the Florida Healthy Kids Corporation as established under
239	s. 624.91, provided that the cost of the child's participation
240	is not greater than 5 percent of the family's income. This
241	provision shall be applied during redetermination for children
242	who were enrolled prior to July 1, 2004. These enrollees shall
243	have 6 months of eligibility following redetermination to allow
244	for a transition to the other health benefit plan.
245	(c)  A child who is seeking premium assistance for the
246	Florida KidCare program through employer-sponsored group
247	coverage, if the child has been covered by the same employer's
248	group coverage during the 6 months prior to the family's
249	submitting an application for determination of eligibility under
250	the Florida Kidcare program.
251	(d)  A child who is an alien, but who does not meet the
252	definition of qualified alien, in the United States.
253	(e)  A child who is an inmate of a public institution or a
254	patient in an institution for mental diseases.
255	(f)  A child who has had his or her coverage in an
256	employer-sponsored health benefit plan voluntarily canceled in
257	the last 6 months, except those children who were on the waiting
258	list prior to January 31, 2004.
259	(5)  A child whose family income is above 200 percent of
260	the federal poverty level or a child who is excluded under the
261	provisions of subsection (4) may participate in the Florida
262	KidCare Kidcare program, excluding the Medicaid program, but is
263	subject to the following provisions:
264	(a)  The family is not eligible for premium assistance
265	payments and must pay the full cost of the premium, including
266	any administrative costs.
267	(b)  The agency is authorized to place limits on enrollment
268	in Medikids by these children in order to avoid adverse
269	selection. The number of children participating in Medikids
270	whose family income exceeds 200 percent of the federal poverty
271	level must not exceed 10 percent of total enrollees in the
272	Medikids program.
273	(c)  The board of directors of the Florida Healthy Kids
274	Corporation is authorized to place limits on enrollment of these
275	children in order to avoid adverse selection. In addition, the
276	board is authorized to offer a reduced benefit package to these
277	children in order to limit program costs for such families. The
278	number of children participating in the Florida Healthy Kids
279	program whose family income exceeds 200 percent of the federal
280	poverty level must not exceed 10 percent of total enrollees in
281	the Florida Healthy Kids program.
282	(d)  Children described in this subsection are not counted
283	in the annual enrollment ceiling for the Florida KidCare Kidcare
284	program.
285	(6)  Once a child is enrolled in the Florida KidCare
286	Kidcare program, the child is eligible for coverage under the
287	program for 6 months without a redetermination or reverification
288	of eligibility, if the family continues to pay the applicable
289	premium. Eligibility for program components funded through Title
290	XXI of the Social Security Act shall terminate when a child
291	attains the age of 19. Effective January 1, 1999, a child who
292	has not attained the age of 5 and who has been determined
293	eligible for the Medicaid program is eligible for coverage for
294	12 months without a redetermination or reverification of
295	eligibility.
296	(7)  When determining or reviewing a child's eligibility
297	under the Florida KidCare program, the applicant shall be
298	provided with reasonable notice of changes in eligibility which
299	may affect enrollment in one or more of the program components.
300	When a transition from one program component to another is
301	authorized appropriate, there shall be cooperation between the
302	program components and the affected family which promotes
303	continuity of health care coverage. Any authorized transfers
304	must be managed within the program's overall appropriated or
305	authorized levels of funding. Each component of the program
306	shall establish a reserve to ensure that transfers between
307	components will be accomplished within current year
308	appropriations. These reserves shall be reviewed by each
309	convening of the Social Services Estimating Conference to
310	determine the adequacy of such reserves to meet actual
311	experience.
312	(8)  In determining the eligibility of a child, an assets
313	test is not required. Each applicant shall provide written
314	documentation during the application process and the
315	redetermination process, including, but not limited to, the
316	following:
317	(a)  Proof of family income.
318	(b)  A statement from all family members that:
319	1.  Their employer does not sponsor a health benefit plan
320	for employees; or
321	2.  The potential enrollee is not covered by the employer-
322	sponsored health benefit plan because the potential enrollee is
323	not eligible for coverage, or, if the potential enrollee is
324	eligible but not covered, a statement of the cost to enroll the
325	potential enrollee in the employer-sponsored health benefit
326	plan.
327	(9)  Subject to paragraph (4)(b) and s. 624.91(3), the
328	Florida KidCare program shall withhold benefits from an enrollee
329	if the program obtains evidence that the enrollee is no longer
330	eligible, submitted incorrect or fraudulent information in order
331	to establish eligibility, or failed to provide verification of
332	eligibility. The applicant or enrollee shall be notified that
333	because of such evidence program benefits will be withheld
334	unless the applicant or enrollee contacts a designated
335	representative of the program by a specified date, which must be
336	within 10 days after the date of notice, to discuss and resolve
337	the matter. The program shall make every effort to resolve the
338	matter within a timeframe that will not cause benefits to be
339	withheld from an eligible enrollee.
340	(10)  The following individuals may be subject to
341	prosecution in accordance with s. 414.39:
342	(a)  An applicant obtaining or attempting to obtain
343	benefits for a potential enrollee under the Florida KidCare
344	program when the applicant knows or should have known the
345	potential enrollee does not qualify for the Florida KidCare
346	program.
347	(b)  An individual who assists an applicant in obtaining or
348	attempting to obtain benefits for a potential enrollee under the
349	Florida KidCare program when the individual knows or should have
350	known the potential enrollee does not qualify for the Florida
351	KidCare program.
352	Section 5.  Paragraph (q) of subsection (2) of section
353	409.815, Florida Statutes, is amended to read:
354	409.815  Health benefits coverage; limitations.--
355	(2)  BENCHMARK BENEFITS.--In order for health benefits
356	coverage to qualify for premium assistance payments for an
357	eligible child under ss. 409.810-409.820, the health benefits
358	coverage, except for coverage under Medicaid and Medikids, must
359	include the following minimum benefits, as medically necessary.
360	(q)  Dental services.--Dental services shall be covered and
361	may services include those dental benefits services provided to
362	children by the Florida Medicaid program under s. 409.906(6)(5),
363	up to a maximum benefit of $750 per enrollee per year.
364	Section 6.  Subsections (3) through (7) of section 624.91,
365	Florida Statutes, are renumbered as subsections (4) through (8),
366	respectively, present subsections (2) and (4) of said section
367	are amended, and a new subsection (3) is added to said section,
368	to read:
369	624.91  The Florida Healthy Kids Corporation Act.--
370	(2)  LEGISLATIVE INTENT.--
371	(a)  The Legislature finds that increased access to health
372	care services could improve children's health and reduce the
373	incidence and costs of childhood illness and disabilities among
374	children in this state. Many children do not have comprehensive,
375	affordable health care services available. It is the intent of
376	the Legislature that the Florida Healthy Kids Corporation
377	provide comprehensive health insurance coverage to such
378	children. The corporation is encouraged to cooperate with any
379	existing health service programs funded by the public or the
380	private sector and to work cooperatively with the Florida
381	Partnership for School Readiness.
382	(b)  It is the intent of the Legislature that the Florida
383	Healthy Kids Corporation serve as one of several providers of
384	services to children eligible for medical assistance under Title
385	XXI of the Social Security Act. Although the corporation may
386	serve other children, the Legislature intends the primary
387	recipients of services provided through the corporation be
388	school-age children with a family income below 200 percent of
389	the federal poverty level, who do not qualify for Medicaid. It
390	is also the intent of the Legislature that state and local
391	government Florida Healthy Kids funds be used to continue and
392	expand coverage, subject to specific appropriations in the
393	General Appropriations Act, to children not eligible for federal
394	matching funds under Title XXI.
395	(3)  ELIGIBILITY FOR STATE-FUNDED ASSISTANCE.-?Only the
396	following individuals are eligible for state-funded assistance
397	in paying Florida Healthy Kids premiums:
398	(a)  Residents of this state who are eligible for the
399	Florida KidCare program pursuant to s. 409.814.
400	(b)  Notwithstanding s. 409.814, legal aliens who are
401	enrolled in the Florida Healthy Kids program as of January 31,
402	2004, who do not qualify for Title XXI federal funds because
403	they are not qualified aliens as defined in s. 409.811.
404	(c)  Notwithstanding s. 409.814, individuals who have
405	attained the age of 19 as of March 31, 2004, who were receiving
406	Florida Healthy Kids benefits prior to the enactment of the
407	Florida KidCare program. This paragraph shall be repealed March
408	31, 2005.
409	(d)  Notwithstanding s. 409.814, state employee dependents
410	who were enrolled in the Florida Healthy Kids program as of
411	January 31, 2004. Such individuals shall remain eligible until
412	January 1, 2005.
413	(5)(4)  CORPORATION AUTHORIZATION, DUTIES, POWERS.--
414	(a)  There is created the Florida Healthy Kids Corporation,
415	a not-for-profit corporation.
416	(b)  The Florida Healthy Kids Corporation shall:
417	1.  Arrange for the collection of any family, local
418	contributions, or employer payment or premium, in an amount to
419	be determined by the board of directors, to provide for payment
420	of premiums for comprehensive insurance coverage and for the
421	actual or estimated administrative expenses.;
422	2.  Arrange for the collection of any voluntary
423	contributions to provide for payment of premiums for children
424	who are not eligible for medical assistance under Title XXI of
425	the Social Security Act. Each fiscal year, the corporation shall
426	establish a local match policy for the enrollment of non-Title-
427	XXI-eligible children in the Healthy Kids program. By May 1 of
428	each year, the corporation shall provide written notification of
429	the amount to be remitted to the corporation for the following
430	fiscal year under that policy. Local match sources may include,
431	but are not limited to, funds provided by municipalities,
432	counties, school boards, hospitals, health care providers,
433	charitable organizations, special taxing districts, and private
434	organizations. The minimum local match cash contributions
435	required each fiscal year and local match credits shall be
436	determined by the General Appropriations Act. The corporation
437	shall calculate a county's local match rate based upon that
438	county's percentage of the state's total non-Title-XXI
439	expenditures as reported in the corporation's most recently
440	audited financial statement. In awarding the local match
441	credits, the corporation may consider factors including, but not
442	limited to, population density, per capita income, and existing
443	child-health-related expenditures and services.;
444	3.  Subject to the provisions of s. 409.8134, accept
445	voluntary supplemental local match contributions that comply
446	with the requirements of Title XXI of the Social Security Act
447	for the purpose of providing additional coverage in contributing
448	counties under Title XXI.;
449	4.  Establish the administrative and accounting procedures
450	for the operation of the corporation.;
451	5.  Establish, with consultation from appropriate
452	professional organizations, standards for preventive health
453	services and providers and comprehensive insurance benefits
454	appropriate to children,; provided that such standards for rural
455	areas shall not limit primary care providers to board-certified
456	pediatricians.;
457	6.  Determine Establish eligibility for criteria which
458	children seeking must meet in order to participate in the Title
459	XXI-funded components of the Florida KidCare program consistent
460	with the requirements specified in s. 409.814, as well as the
461	non-Title-XXI-eligible children as provided in subsection (3).;
462	7.  Establish procedures under which providers of local
463	match to, applicants to and participants in the program may have
464	grievances reviewed by an impartial body and reported to the
465	board of directors of the corporation.;
466	8.  Establish participation criteria and, if appropriate,
467	contract with an authorized insurer, health maintenance
468	organization, or third-party insurance administrator to provide
469	administrative services to the corporation.;
470	9.  Establish enrollment criteria which shall include
471	penalties or waiting periods of not fewer than 60 days for
472	reinstatement of coverage upon voluntary cancellation for
473	nonpayment of family premiums.;
474	10.  If a space is available, establish a special open
475	enrollment period of 30 days' duration for any child who is
476	enrolled in Medicaid or Medikids if such child loses Medicaid or
477	Medikids eligibility and becomes eligible for the Florida
478	Healthy Kids program;
479	10.11.  Contract with authorized insurers or any provider
480	of health care services, meeting standards established by the
481	corporation, for the provision of comprehensive insurance
482	coverage to participants. Such standards shall include criteria
483	under which the corporation may contract with more than one
484	provider of health care services in program sites. Health plans
485	shall be selected through a competitive bid process. The Florida
486	Healthy Kids Corporation shall purchase goods and services in
487	the most cost-effective manner consistent with the delivery of
488	quality medical care. The maximum administrative cost for a
489	Florida Healthy Kids Corporation contract shall be 15 percent.
490	The minimum medical loss ratio for a Florida Healthy Kids
491	Corporation contract shall be 85 percent. The selection of
492	health plans shall be based primarily on quality criteria
493	established by the board. The health plan selection criteria and
494	scoring system, and the scoring results, shall be available upon
495	request for inspection after the bids have been awarded.;
496	11.12.  Establish disenrollment criteria in the event local
497	matching funds are insufficient to cover enrollments.;
498	12.13.  Develop and implement a plan to publicize the
499	Florida Healthy Kids Corporation, the eligibility requirements
500	of the program, and the procedures for enrollment in the program
501	and to maintain public awareness of the corporation and the
502	program.;
503	13.14.  Secure staff necessary to properly administer the
504	corporation. Staff costs shall be funded from state and local
505	matching funds and such other private or public funds as become
506	available. The board of directors shall determine the number of
507	staff members necessary to administer the corporation.;
508	15.  As appropriate, enter into contracts with local school
509	boards or other agencies to provide onsite information,
510	enrollment, and other services necessary to the operation of the
511	corporation;
512	14.16.  Provide a report annually to the Governor, Chief
513	Financial Officer, Commissioner of Education, Senate President,
514	Speaker of the House of Representatives, and Minority Leaders of
515	the Senate and the House of Representatives.;
516	17.  Each fiscal year, establish a maximum number of
517	participants, on a statewide basis, who may enroll in the
518	program; and
519	15.18.  Establish eligibility criteria, premium and cost-
520	sharing requirements, and benefit packages which conform to the
521	provisions of the Florida KidCare Kidcare program, as created in
522	ss. 409.810-409.820.
523	(c)  Coverage under the corporation's program is secondary
524	to any other available private coverage held by, or applicable
525	to, the participant child or family member. Insurers under
526	contract with the corporation are the payors of last resort and
527	must coordinate benefits with any other third-party payor that
528	may be liable for the participant's medical care The corporation
529	may establish procedures for coordinating benefits under this
530	program with benefits under other public and private coverage.
531	(d)  The Florida Healthy Kids Corporation shall be a
532	private corporation not for profit, organized pursuant to
533	chapter 617, and shall have all powers necessary to carry out
534	the purposes of this act, including, but not limited to, the
535	power to receive and accept grants, loans, or advances of funds
536	from any public or private agency and to receive and accept from
537	any source contributions of money, property, labor, or any other
538	thing of value, to be held, used, and applied for the purposes
539	of this act.
540	Section 7.  The Auditor General shall provide
541	recommendations to implement mechanisms to prevent enrollment of
542	children in the Florida KidCare program who are ineligible
543	pursuant to the requirements of s. 409.814(4), Florida Statutes.
544	Such recommendations shall be reported to the Governor, the
545	President of the Senate, and the Speaker of the House of
546	Representatives by March 1, 2005.
547	Section 8.  The Florida Healthy Kids Corporation shall use
548	existing funds from their operating fund established by s.
549	624.915, Florida Statutes, to contract for an actuarial study on
550	the impact of full-pay enrollees on the cost of services for
551	each Florida KidCare program component.
552	Section 9.  The Auditor General shall perform periodic
553	audits through the 2005-2006 fiscal year to ensure that children
554	enrolled in the Florida Healthy Kids program are eligible
555	pursuant to ss. 409.814 and 624.91, Florida Statutes. The
556	Auditor General shall have the authority to require and receive
557	from the Florida Healthy Kids Corporation or from its
558	independent auditor any books, accounts, records, or other
559	documentation relating to the corporation. Any contract entered
560	into by the corporation pursuant to s. 624.91(4)(b)11. or s.
561	624.91(4)(b)15., Florida Statutes, shall specify that the
562	records of the contractor relating to the contract or its
563	performance must be available for review and audit by the
564	Auditor General.
565	Section 10.  The Office of Program Policy Analysis and
566	Government Accountability shall perform a study to determine the
567	appropriate family premium for the Florida KidCare program and
568	submit a report to the President of the Senate and the Speaker
569	of the House of Representatives by January 1, 2005. The report
570	shall set out no fewer than three options and shall make a
571	recommendation as to the appropriate family premium for the
572	Florida KidCare program. Each option shall include a detailed
573	explanation of the analysis that led to the conclusion. A
574	discussion of family premiums collected by Title XXI programs in
575	other states shall be part of the report.
576	Section 11.  Subsection (2) of section 409.818, Florida
577	Statutes, is amended to read:
578	409.818  Administration.--In order to implement ss.
579	409.810-409.820, the following agencies shall have the following
580	duties:
581	(2)  The Department of Health shall:
582	(a)  Design an eligibility intake process for the program,
583	in coordination with the Department of Children and Family
584	Services, the agency, and the Florida Healthy Kids Corporation.
585	The eligibility intake process may include local intake points
586	that are determined by the Department of Health in coordination
587	with the Department of Children and Family Services.
588	(b)  Design and implement program outreach activities under
589	s. 409.819.
590	(b)(c)  Chair a state-level coordinating council to review
591	and make recommendations concerning the implementation and
592	operation of the program. The coordinating council shall include
593	representatives from the department, the Department of Children
594	and Family Services, the agency, the Florida Healthy Kids
595	Corporation, the Office of Insurance Regulation of the Financial
596	Services Commission, local government, health insurers, health
597	maintenance organizations, health care providers, families
598	participating in the program, and organizations representing
599	low-income families.
600	(c)(d)  In consultation with the Florida Healthy Kids
601	Corporation and the Department of Children and Family Services,
602	establish establishing a toll-free telephone line to assist
603	families with questions about the program.
604	(d)(e)  Adopt rules necessary to implement outreach
605	activities.
606	Section 12.  Section 409.819, Florida Statutes, is
607	repealed.
608	Section 13.  The sums of $6,566,073 from the General
609	Revenue Fund, $454,687 from the Grants and Donations Trust Fund,
610	and $16,272,440 from the Medical Care Trust Fund are
611	appropriated to the Agency for Health Care Administration, and
612	the sum of $1,984,113 is appropriated from the Donations Trust
613	Fund to the Department of Health, for the 2003-2004 fiscal year
614	for the purpose of serving children on whose behalf applications
615	are submitted to the Florida KidCare program as of January 30,
616	2004, and who are determined to be eligible for program
617	components funded under Title XXI of the Social Security Act.
618	Section 14.  Except as otherwise provided herein, this act
619	shall take effect upon becoming a law.

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