Senate Bill sb1522

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    Florida Senate - 2005                                  SB 1522

    By Senator Baker





    20-1426-05                                          See HB 543

  1                      A bill to be entitled

  2         An act relating to Medicaid eligibility;

  3         amending s. 409.902, F.S.; providing asset

  4         transfer limitations for determination of

  5         eligibility for nursing facility services under

  6         the Medicaid program; authorizing the

  7         Department of Children and Family Services to

  8         adopt rules; providing a contingent effective

  9         date.

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

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13         Section 1.  Section 409.902, Florida Statutes, is

14  amended to read:

15         409.902  Designated single state agency; payment

16  requirements; program title; release of medical records;

17  eligibility requirements.--

18         (1)  The Agency for Health Care Administration is

19  designated as the single state agency authorized to make

20  payments for medical assistance and related services under

21  Title XIX of the Social Security Act. These payments shall be

22  made, subject to any limitations or directions provided for in

23  the General Appropriations Act, only for services included in

24  the program, shall be made only on behalf of eligible

25  individuals, and shall be made only to qualified providers in

26  accordance with federal requirements for Title XIX of the

27  Social Security Act and the provisions of state law. This

28  program of medical assistance is designated the "Medicaid

29  program." The Department of Children and Family Services is

30  responsible for Medicaid eligibility determinations,

31  including, but not limited to, policy, rules, and the

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    Florida Senate - 2005                                  SB 1522
    20-1426-05                                          See HB 543




 1  agreement with the Social Security Administration for Medicaid

 2  eligibility determinations for Supplemental Security Income

 3  recipients, as well as the actual determination of

 4  eligibility. As a condition of Medicaid eligibility, subject

 5  to federal approval, the Agency for Health Care Administration

 6  and the Department of Children and Family Services shall

 7  ensure that each recipient of Medicaid consents to the release

 8  of her or his medical records to the Agency for Health Care

 9  Administration and the Medicaid Fraud Control Unit of the

10  Department of Legal Affairs.

11         (2)(a)  In determining eligibility for nursing facility

12  services under the Medicaid program, the Department of

13  Children and Family Services shall apply the following asset

14  transfer limitations effective for transfers made after

15  October 1, 2005:

16         1.  All transfers of assets for less than fair market

17  value are prohibited.

18         2.  All transfers of assets for less than fair market

19  value, including transfers of assets to trusts, are subject to

20  a 72-month look-back period.

21         3.  The penalty period associated with all transfers of

22  assets for less than fair market value begins on the first day

23  of the month in which an individual applies for medical

24  assistance and is otherwise eligible. For recipients of

25  medical assistance, the penalty period begins on the first day

26  of the month in which the Department of Children and Family

27  Services or the Agency for Health Care Administration becomes

28  aware of the transfer or on the first day of the month

29  following a period of ineligibility that existed when the

30  transfer was made.

31  

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    Florida Senate - 2005                                  SB 1522
    20-1426-05                                          See HB 543




 1         4.  Transfers of the eligible individual's interest in

 2  a homestead for less than fair market value are prohibited

 3  even to those relatives specified under federal law; however,

 4  the homestead retains its excluded status so long as the

 5  specified relative continues to reside in the household.

 6         5.  Transfers of assets to community spouses for less

 7  than fair market value after medical assistance eligibility is

 8  established are permitted only up to the amount of the asset

 9  threshold for spousal impoverishment.

10         6.  Payments for care or personal services provided by

11  a relative are prohibited, unless the compensation was

12  stipulated in a notarized written agreement that was in

13  existence when the service was performed; the care or services

14  directly benefited the person, are reasonably related to the

15  person's health condition, and do not duplicate services

16  otherwise provided by Medicaid; and the payments made

17  represent reasonable compensation for the care or services

18  provided. A notarized written agreement is not required if

19  payment for the services was made within 60 days after the

20  care or service was provided.

21         7.  Transfers of assets are prohibited to any annuity

22  that exceeds the value of the benefit likely to be returned to

23  the annuitant or the annuitant's spouse while alive, based on

24  estimated life expectancy using the life expectancy tables

25  employed by the Supplemental Security Income program or based

26  on a shorter life expectancy if the annuitant has a medical

27  condition that would shorten the annuitant's life expectancy

28  and that was diagnosed before funds were placed into the

29  annuity. The department may request and receive a physician's

30  statement to determine if the annuitant has a diagnosed

31  medical condition that would shorten the annuitant's life

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    Florida Senate - 2005                                  SB 1522
    20-1426-05                                          See HB 543




 1  expectancy. If so, the department shall determine the expected

 2  value of the benefits based upon the physician's statement

 3  instead of using a life expectancy table. This section applies

 4  to an annuity described in this subparagraph that was

 5  purchased on or after October 1, 2005, and that:

 6         a.  Is not purchased from an insurance company or

 7  financial institution that is subject to licensing or

 8  regulation by the Office of Insurance Regulation or a similar

 9  regulatory agency of another state;

10         b.  Does not pay out principal and interest in equal

11  monthly installments; or

12         c.  Does not begin payment at the earliest possible

13  date after annuitization.

14         (b)  The Department of Children and Family Services may

15  adopt rules pursuant to ss. 120.536(1) and 120.54 to implement

16  the requirements of this subsection.

17         Section 2.  This act shall take effect July 1, 2005,

18  except that if any provision of subsection (2) of section

19  409.902, Florida Statutes, as created by this act, is

20  prohibited by federal law, that provision shall take effect

21  when federal law is changed to permit its application or when

22  a waiver is received. If, by October 1, 2005, any provision of

23  subsection (2) of section 409.902, Florida Statutes, as

24  created by this act, has not taken effect because of

25  prohibitions in federal law, the Secretary of Health Care

26  Administration shall apply to the Federal Government by

27  January 1, 2006, for a waiver of the prohibitions in federal

28  law or other federal authority, and the provisions of

29  subsection (2) of section 409.902, Florida Statutes, as

30  created by this act, shall take effect upon receipt of a

31  federal waiver or other federal approval, notification to the

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    Florida Senate - 2005                                  SB 1522
    20-1426-05                                          See HB 543




 1  Secretary of State, and publication of a notice in the Florida

 2  Administrative Weekly to that effect.

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