Florida Senate - 2005                        SENATOR AMENDMENT
    Bill No. CS for CS for SB 838
                        Barcode 482962
                            CHAMBER ACTION
              Senate                               House
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       05/03/2005 11:38 AM         .                    
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11  Senator Peaden moved the following amendment:
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13         Senate Amendment (with title amendment) 
14         On page 69, line 24, through
15            page 71, line 7, delete those lines
16  
17  and insert:  
18         (f)  The agency shall apply for federal waivers from
19  the Centers for Medicare and Medicaid Services to allow
20  recipients to purchase health care coverage through an
21  employer-sponsored health insurance plan instead of through a
22  Medicaid-certified plan. This provision shall be known as the
23  opt-out option.
24         1.  A recipient who chooses the Medicaid opt-out option
25  shall have an opportunity for a specified period of time, as
26  authorized under a waiver granted by the Centers for Medicare
27  and Medicaid Services, to select and enroll in a
28  Medicaid-certified plan. If the recipient remains in the
29  employer-sponsored plan after the specified period, the
30  recipient shall remain in the opt-out program for at least 1
31  year or until the recipient no longer has access to
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    9:28 PM   05/01/05                             s0838c2c-02-j18

Florida Senate - 2005 SENATOR AMENDMENT Bill No. CS for CS for SB 838 Barcode 482962 1 employer-sponsored coverage, until the employer's open 2 enrollment period for a person who opts out in order to 3 participate in employer-sponsored coverage, or until the 4 person is no longer eligible for Medicaid, whichever time 5 period is shorter. 6 2. Notwithstanding any other provision of this 7 section, coverage, cost sharing, and any other component of 8 employer-sponsored health insurance shall be governed by 9 applicable state and federal laws. 10 (5) This section does not authorize the agency to 11 implement any provision of s. 1115 of the Social Security Act 12 experimental, pilot, or demonstration project waiver to reform 13 the state Medicaid program in any part of the state other than 14 the two geographic areas specified in this section unless 15 approved by the Legislature. 16 (6) The agency shall develop and submit for approval 17 applications for waivers of applicable federal laws and 18 regulations as necessary to implement the managed care pilot 19 project as defined in this section. The agency shall post all 20 waiver applications under this section on its Internet website 21 30 days before submitting the applications to the United 22 States Centers for Medicare and Medicaid Services. All waiver 23 applications shall be provided for review and comment to the 24 appropriate committees of the Senate and House of 25 Representatives for at least 10 working days prior to 26 submission. All waivers submitted to and approved by the 27 United States Centers for Medicare and Medicaid Services under 28 this section must be submitted to the appropriate committees 29 of the Senate and the House of Representatives in order to 30 obtain authority for implementation as required by s. 31 409.912(11), before program implementation. The appropriate 2 9:28 PM 05/01/05 s0838c2c-02-j18
Florida Senate - 2005 SENATOR AMENDMENT Bill No. CS for CS for SB 838 Barcode 482962 1 committees shall recommend whether to approve the 2 implementation of the waivers to the Legislature or to the 3 Legislative Budget Commission if the Legislature is not in 4 session. The agency shall submit a plan containing a detailed 5 timeline for implementation and budgetary projections of the 6 effect of the pilot program on the total Medicaid budget for 7 the 2006-2007 through 2009-2010 fiscal years. 8 (7) Upon review and approval of the applications for 9 waivers of applicable federal laws and regulations to 10 implement the managed care pilot program by the Legislature, 11 the agency may initiate adoption of rules pursuant to ss. 12 120.536(1) and 120.54 to implement and administer the managed 13 care pilot program as provided in this section. 14 15 16 ================ T I T L E A M E N D M E N T =============== 17 And the title is amended as follows: 18 On page 3, lines 9-11, delete those lines 19 20 and insert: 21 pilot program; requiring that the agency submit 22 any waivers to the Legislature for approval 23 before implementation; allowing the agency to 24 develop rules; requiring that 25 26 27 28 29 30 31 3 9:28 PM 05/01/05 s0838c2c-02-j18