HB 371

1	A bill to be entitled
2	An act relating to long-term care coverage; amending s.
3	409.905, F.S.; providing conditions for eligibility;
4	creating s. 409.9102, F.S.; directing the Agency for
5	Health Care Administration to establish the Long-term Care
6	Partnership Program; providing purpose and duties;
7	directing the agency to submit a plan and proposed
8	legislation to the Legislature; providing a contingent
9	effective date.
10
11	Be It Enacted by the Legislature of the State of Florida:
12
13	Section 1.  Subsection (8) of section 409.905, Florida
14	Statutes, is amended to read:
15	409.905  Mandatory Medicaid services.--The agency may make
16	payments for the following services, which are required of the
17	state by Title XIX of the Social Security Act, furnished by
18	Medicaid providers to recipients who are determined to be
19	eligible on the dates on which the services were provided. Any
20	service under this section shall be provided only when medically
21	necessary and in accordance with state and federal law.
22	Mandatory services rendered by providers in mobile units to
23	Medicaid recipients may be restricted by the agency. Nothing in
24	this section shall be construed to prevent or limit the agency
25	from adjusting fees, reimbursement rates, lengths of stay,
26	number of visits, number of services, or any other adjustments
27	necessary to comply with the availability of moneys and any
28	limitations or directions provided for in the General
29	Appropriations Act or chapter 216.
30	(8)  NURSING FACILITY SERVICES.--The agency shall pay for
31	24-hour-a-day nursing and rehabilitative services for a
32	recipient in a nursing facility licensed under part II of
33	chapter 400 or in a rural hospital, as defined in s. 395.602, or
34	in a Medicare certified skilled nursing facility operated by a
35	hospital, as defined by s. 395.002(11), that is licensed under
36	part I of chapter 395, and in accordance with provisions set
37	forth in s. 409.908(2)(a), which services are ordered by and
38	provided under the direction of a licensed physician. However,
39	if a nursing facility has been destroyed or otherwise made
40	uninhabitable by natural disaster or other emergency and another
41	nursing facility is not available, the agency must pay for
42	similar services temporarily in a hospital licensed under part I
43	of chapter 395 provided federal funding is approved and
44	available. The agency shall pay only for bed-hold days if the
45	facility has an occupancy rate of 95 percent or greater. When
46	determining eligibility for nursing and rehabilitative services,
47	if the individual is a beneficiary of an approved long-term care
48	partnership program policy and has exhausted the benefits of the
49	policy, the total countable assets of the individual shall be
50	reduced by $1 for each $1 of benefits paid out under the
51	individual's approved long-term care partnership program policy.
52	The agency is authorized to seek any federal waivers to
53	implement this policy.
54	Section 2.  Section 409.9102, Florida Statutes, is created
55	to read:
56	409.9102  Florida Long-term Care Partnership Program.-- The
57	Agency for Health Care Administration is directed to establish
58	the Florida Long-term Care Partnership Program, which shall:
59	(1)  Provide incentives for an individual to obtain
60	insurance to cover the costs of long-term care.
61	(2)  Establish standards for long-term care insurance
62	policies for designation as approved long-term care partnership
63	program policies in consultation with the Office of Insurance
64	Regulation.
65	(3)  Provide a mechanism to qualify for coverage of the
66	costs of long-term care under Medicaid without first being
67	required to substantially exhaust his or her resources,
68	including reducing the individual's asset valuation by $1 for
69	each $1 of benefits paid out under the individual's approved
70	long-term care partnership program policy as a determination of
71	Medicaid eligibility.
72	(4)  Provide and approve long-term care partnership plan
73	information distributed to individuals through insurance
74	companies offering approved partnership policies.
75	(5)  Alleviate the financial burden on the state's medical
76	assistance program by encouraging the pursuit of private
77	initiatives.
78	Section 3.  The Agency for Health Care Administration shall
79	develop a plan for implementation of the Florida Long-term Care
80	Partnership Program. The agency shall present the plan in the
81	form of recommended legislation to the President of the Senate
82	and the Speaker of the House of Representatives prior to the
83	commencement of the next legislative session.
84	Section 4.  This act shall take effect upon becoming a law,
85	except that section 409.9102, Florida Statutes, as created by
86	this act, and the amendment to section 409.905, Florida
87	Statutes, as provided in this act, shall take effect contingent
88	upon amendment to section 1917(b)(1)(c) of the Social Security
89	Act by the United States Congress to delete the "May 14, 1993,"
90	deadline for approval by states of long-term care partnership
91	plans.

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