Florida Senate - 2008 SB 2032
By Senator Fasano
11-03213A-08 20082032__
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A bill to be entitled
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An act relating to the Florida Kidcare program; amending.
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s. 409.8132, F.S.; requiring the Agency for Health Care
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Administration to assign a Medikids applicant to the same
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or related managed care plan or same MediPass provider to
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which other family members are assigned; conforming
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provisions to changes made by the act; amending s.
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409.8134, F.S.; revising provisions relating to the
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Kidcare program expenditure ceiling; providing that an
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invalid application may be reactivated rather than
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resubmitted; amending s. 409.814, F.S.; providing that a
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child who is losing eligibility for Title XIX-funded
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Kidcare coverage is eligible for the Title XXI-funded
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program and has a specified time of continued eligibility
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until transferred; requiring the agency to seek a state
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plan amendment or federal waiver authority and secure
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federal matching funds; revising provisions relating to
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ineligibility for premium assistance under the program;
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requiring health plan and health care providers to promote
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continued health care coverage under the program;
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requiring certain agencies to provide advanced notice to
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Medicaid managed care plans and MediPass providers when
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members or patients are losing eligibility; requiring an
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applicant's information to be available electronically;
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providing an exception for applicants seeking full-pay
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coverage under the program; amending. s. 409.816, F.S.;
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conforming a cross-reference; amending s. 409.818, F.S.;
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requiring the Department of Children and Family Services
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to develop a standardized eligibility application by a
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specified date; requiring the department to redetermine or
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reverify eligibility after enrollment; requiring the
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department to design a plan for determining an applicant's
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eligibility for public assistance or Medicaid and submit
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such plan to the Governor and the Legislature by a
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specified date; deleting the Department of Health's duties
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with regard to the Kidcare program; requiring certain
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agencies to establish a single toll-free telephone number
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by a specified date; requiring the Agency for Health Care
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Administration to develop and implement an outreach and
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marketing program promoting public awareness of the
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program; requiring the agency to seek and implement
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federal waivers or state plan amendments; amending s.
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624.91, F.S.; providing that health and dental plans
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participating in the Florida Healthy Kids program may
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develop and distribute marketing and promotional materials
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and participate in public events; providing that such
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plans may contact current and former enrollees to
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encourage continued participation and assist with
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transfers from one plan to another; requiring the Florida
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Healthy Kids Corporation and the agency to establish an
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assignment process that keeps family members assigned to
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the same or related plan and allows an applicant to enroll
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in a sibling's Medicaid provider service network or health
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maintenance organization for coverage under the Florida
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Healthy Kids program under certain circumstances;
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providing an effective date.
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Be It Enacted by the Legislature of the State of Florida:
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Section 1. Paragraph (b) of subsection (6) and subsection
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(7) of section 409.8132, Florida Statutes, are amended to read:
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409.8132 Medikids program component.--
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(6) ELIGIBILITY.--
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(b) The provisions of s. 409.814(3), (4), (5) (4), and (6)
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(5) shall be applicable to the Medikids program.
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(7) ENROLLMENT.--Enrollment in the Medikids program
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component may occur at any time throughout the year. A child may
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not receive services under the Medikids program until the child
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is enrolled in a managed care plan or MediPass. Once determined
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eligible, an applicant may receive choice counseling and select a
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managed care plan or MediPass. The agency may initiate mandatory
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assignment for a Medikids applicant who has not chosen a managed
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care plan or MediPass provider after the applicant's voluntary
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choice period ends. The agency shall assign the Medikids
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applicant to the same managed care plan or to the same MediPass
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provider to which other family members are assigned, to the
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greatest extent possible, even if some family members are
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enrolled in Medicaid and others are enrolled in the Medikids
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program. An applicant may select MediPass under the Medikids
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program component only in counties that have fewer than two
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managed care plans available to serve Medicaid recipients and
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only if the federal Health Care Financing Administration
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determines that MediPass constitutes "health insurance coverage"
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as defined in Title XXI of the Social Security Act.
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Section 2. Subsection (2) of section 409.8134, Florida
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Statutes, is amended to read:
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409.8134 Program expenditure ceiling.--
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(2) The Florida Kidcare program may conduct enrollment at
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any time throughout the year for the purpose of enrolling
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children eligible for all program components listed in s. 409.813
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except Medicaid. The four Florida Kidcare administrators shall
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work together to ensure that the year-round enrollment period is
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announced statewide. Eligible children shall be enrolled on a
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first-come, first-served basis using the date the enrollment
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application is received. Enrollment shall immediately cease when
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the expenditure ceiling is reached. Year-round enrollment shall
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only be held only if the Social Services Estimating Conference
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determines that sufficient federal and state funds will be
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available to finance the increased enrollment through federal
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fiscal year 2007. Any individual who is not enrolled must reapply
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by submitting a new application. The application for the Florida
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Kidcare program is shall be valid for a period of 120 days after
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the date it was received. At the end of the 120-day period, if
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the applicant has not been enrolled in the program, the
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application is shall be invalid and the applicant must shall be
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notified of the action. The applicant may reactivate resubmit the
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application after notification of the action taken by the
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program. Except for the Medicaid program, whenever the Social
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Services Estimating Conference determines that there are
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presently, or will be by the end of the current fiscal year,
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insufficient funds to finance the current or projected enrollment
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in the Florida Kidcare program, all additional enrollment must
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cease and additional enrollment may not resume until sufficient
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funds are available to finance such enrollment.
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Section 3. Section 409.814, Florida Statutes, is amended to
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read:
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409.814 Eligibility.--A child who has not reached 19 years
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of age and whose family income is equal to or below 200 percent
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of the federal poverty level is eligible for the Florida Kidcare
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program as provided in this section. For enrollment in the
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Children's Medical Services Network, a complete application
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includes the medical or behavioral health screening. If,
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subsequently, an individual is determined to be ineligible for
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coverage, he or she must be immediately be disenrolled from the
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respective Florida Kidcare program component.
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(1) A child who is eligible for Medicaid coverage under s.
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eligible to receive health benefits under any other health
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benefits coverage authorized under the Florida Kidcare program.
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(2) A child who is not eligible for Medicaid, but who is
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eligible for the Florida Kidcare program, may obtain health
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benefits coverage under any of the other components listed in s.
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409.813 if such coverage is approved and available in the county
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in which the child resides. However, a child who is eligible for
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Medikids may participate in the Florida Healthy Kids program only
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if the child has a sibling participating in the Florida Healthy
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Kids program and the child's county of residence permits such
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enrollment.
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(3) A child who is eligible for the Florida Kidcare program
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and has who is a child with special health care needs, as
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determined through a medical or behavioral screening instrument,
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is eligible for health benefits coverage from and must shall be
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referred to the Children's Medical Services Network.
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(4) A child who will lose eligibility for Title XIX-funded
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Florida Kidcare coverage due to income limits or age limits is
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presumed eligible for the Title XXI-funded Florida Kidcare
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program and, following redetermination, has 60 days of continued
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eligibility within his or her existing plan or coverage to allow
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for the transition to Title XXI-funded Florida Kidcare coverage.
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In order to ensure there is no lapse in coverage, the child's
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eligibility within his or her existing plan or coverage must be
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extended beyond the 60 days, if necessary. The Agency for Health
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Care Administration shall seek a state plan amendment or federal
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waiver authority under Title XIX or Title XXI of the Social
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Security Act to continue eligibility and secure federal matching
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funds consistent with the federal State Children's Health
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Insurance Program match for the additional 60 days of
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eligibility.
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(5)(4) The following children are not eligible to receive
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premium assistance for health benefits coverage under the Florida
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Kidcare program, except under Medicaid if the child would have
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June 1, 1997:
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(a) A child who is eligible for coverage under a state
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health benefit plan on the basis of a family member's employment
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with a public agency in the state.
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(b) A child who is currently eligible for or covered under
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a family member's group health benefit plan or under other
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employer health insurance coverage, excluding coverage provided
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under the Florida Healthy Kids Corporation as established under
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s. 624.91, if provided that the cost of the child's participation
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is not greater than 5 percent of the family's income. This
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provision shall be applied during redetermination for children
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who were enrolled prior to July 1, 2004. These enrollees shall
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have 6 months of eligibility following redetermination to allow
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for a transition to the other health benefit plan.
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(c) A child who is seeking premium assistance for the
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Florida Kidcare program through employer-sponsored group
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coverage, if the child has been covered by the same employer's
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group coverage during the 6 months before prior to the family's
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submitting an application for determination of eligibility under
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the program.
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(d) A child who is an alien, but who does not meet the
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definition of qualified alien, in the United States.
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(e) A child who is an inmate of a public institution or a
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patient in an institution for mental diseases.
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(f) A child who has had his or her coverage in an employer-
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sponsored health benefit plan voluntarily canceled in the last 90
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days 6 months, except those children who were on the waiting list
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prior to March 12, 2004.
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(g) A child who is otherwise eligible for Kidcare and who
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has a preexisting condition that prevents coverage under another
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insurance plan as described in paragraph (b) which would have
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disqualified the child for Kidcare if the child were able to
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enroll in the plan shall be eligible for Kidcare coverage when
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enrollment is possible.
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(6)(5) A child whose family income is above 200 percent of
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the federal poverty level or a child who is excluded under the
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provisions of subsection (5) (4) may participate in the Medikids
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program as provided in s. 409.8132 or, if the child is ineligible
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for Medikids by reason of age, in the Florida Healthy Kids
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program, subject to the following provisions:
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(a) The family is not eligible for premium assistance
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payments and must pay the full cost of the premium, including any
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administrative costs.
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(b) The agency is authorized to place limits on enrollment
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in Medikids by these children in order to avoid adverse
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selection. The number of children participating in Medikids whose
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family income exceeds 200 percent of the federal poverty level
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must not exceed 10 percent of total enrollees in the Medikids
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program.
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(c) The board of directors of the Florida Healthy Kids
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Corporation is authorized to place limits on enrollment of these
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children in order to avoid adverse selection. In addition, the
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board is authorized to offer a reduced benefit package to these
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children in order to limit program costs for such families. The
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number of children participating in the Florida Healthy Kids
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program whose family income exceeds 200 percent of the federal
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poverty level must not exceed 10 percent of total enrollees in
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the Florida Healthy Kids program.
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(7)(6) Once a child is enrolled in the Florida Kidcare
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program, the child is eligible for coverage under the program for
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12 months without a redetermination or reverification of
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eligibility, if the family continues to pay the applicable
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premium. Eligibility for program components funded through Title
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XXI of the Social Security Act terminates shall terminate when a
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child attains the age of 19. Effective January 1, 1999, a child
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who has not attained the age of 5 and who has been determined
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eligible for the Medicaid program is eligible for coverage for 12
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months without a redetermination or reverification of
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eligibility.
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(8)(7) When determining or reviewing a child's eligibility
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under the Florida Kidcare program, the applicant must shall be
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provided with reasonable notice of changes in eligibility which
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may affect enrollment in one or more of the program components.
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When a transition from one program component to another is
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authorized, there must shall be cooperation between the program
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components, and the affected family, the child's health plan, and
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the child's health care providers to promote which promotes
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continuity of health care coverage. The agency, in coordination
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with the Department of Children and Family Services, shall notify
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Medicaid managed care plans and MediPass providers at least 60
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days in advance of members or patients who will lose eligibility
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for Medicaid or Medikids so that the health plans and providers
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may assist the families of such members or patients in applying
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for Florida Kidcare coverage. Any authorized transfers must be
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managed within the program's overall appropriated or authorized
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levels of funding. Each component of the program shall establish
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a reserve to ensure that transfers between components will be
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accomplished within current year appropriations. These reserves
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shall be reviewed by each convening of the Social Services
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Estimating Conference to determine the adequacy of such reserves
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to meet actual experience.
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(9)(8) In determining the eligibility of a child, an assets
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test is not required. An applicant's information must be
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available electronically, if possible, to determine eligibility
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for the Florida Kidcare program. If such information cannot be
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verified electronically, each applicant shall provide written
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documentation during the application process and the
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redetermination process, including, but not limited to, the
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following:
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(a) Proof of family income that includes, which must
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include a copy of the applicant's most recent federal income tax
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return. In the absence of a federal income tax return, an
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applicant may submit wages and earnings statements (pay stubs),
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W-2 forms, or other appropriate documents.
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(b) A statement from all employed family members that:
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1. Their employer does not sponsor a health benefit plan
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for employees; or
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2. The potential enrollee is not covered by the employer-
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sponsored health benefit plan because the potential enrollee is
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not eligible for coverage, or, if the potential enrollee is
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eligible but not covered, a statement of the cost to enroll the
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potential enrollee in the employer-sponsored health benefit plan.
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(10)(9) Subject to paragraph (5)(b) (4)(b) and s.
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624.91(4), the Florida Kidcare program shall withhold benefits
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from an enrollee if the program obtains evidence that the
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enrollee is no longer eligible, submitted incorrect or fraudulent
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information in order to establish eligibility, or failed to
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provide verification of eligibility. The applicant or enrollee
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shall be notified that because of such evidence program benefits
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will be withheld unless the applicant or enrollee contacts a
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designated representative of the program by a specified date,
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which must be within 10 days after the date of notice, to discuss
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and resolve the matter. The program shall make every effort to
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resolve the matter within a timeframe that will not cause
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benefits to be withheld from an eligible enrollee.
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(11)(10) The following individuals may be subject to
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prosecution in accordance with s. 414.39:
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(a) An applicant obtaining or attempting to obtain benefits
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for a potential enrollee under the Florida Kidcare program when
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the applicant knows or should have known the potential enrollee
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does not qualify for the Florida Kidcare program.
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(b) An individual who assists an applicant in obtaining or
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attempting to obtain benefits for a potential enrollee under the
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Florida Kidcare program when the individual knows or should have
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known the potential enrollee does not qualify for the Florida
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Kidcare program.
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A person applying for full-pay coverage under the Florida Kidcare
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program is not required to provide the information required under
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this section.
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Section 4. Subsection (3) of section 409.816, Florida
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Statutes, is amended to read:
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409.816 Limitations on premiums and cost-sharing.--The
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following limitations on premiums and cost-sharing are
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established for the program.
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(3) Enrollees in families with a family income above 150
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percent of the federal poverty level, who are not receiving
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coverage under the Medicaid program or who are not eligible under
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fees, premiums, copayments, deductibles, coinsurance, or similar
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charges on a sliding scale related to income, except that the
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total annual aggregate cost-sharing with respect to all children
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in a family may not exceed 5 percent of the family's income.
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However, copayments, deductibles, coinsurance, or similar charges
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may not be imposed for preventive services, including well-baby
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and well-child care, age-appropriate immunizations, and routine
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hearing and vision screenings.
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Section 5. Section 409.818, Florida Statutes, is amended to
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read:
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409.820, the following agencies shall have the following duties:
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(1) The Department of Children and Family Services shall:
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(a) Develop a standardized simplified eligibility
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application mail-in form to be used for determining the
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eligibility of children for coverage for all components of under
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the Florida Kidcare program, in consultation with the agency, the
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Department of Health, and the Florida Healthy Kids Corporation.
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The standardized simplified eligibility application form must
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include an item that provides an opportunity for the applicant to
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indicate whether coverage is being sought for a child having with
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special health care needs. Families applying for children's
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Medicaid coverage must also be able to use the standardized
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simplified application form without having to pay a premium. The
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standardized eligibility application form must be available for
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use no later than July 1, 2009.
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(b) Establish and maintain the eligibility determination
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process under the program except as specified in subsection (4)
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(5). The department shall directly, or through the services of a
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contracted third-party administrator, establish and maintain a
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process for determining eligibility of children for coverage
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under the program. The eligibility determination process must be
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used solely for determining eligibility of applicants for health
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benefits coverage under the program. The eligibility
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determination process must include an initial determination of
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eligibility for any coverage offered under the program, as well
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as a redetermination or reverification of eligibility 12 months
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after enrollment and each subsequent 12 6 months. Effective
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January 1, 1999, a child who has not attained the age of 5 and
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who has been determined eligible for the Medicaid program is
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eligible for coverage for 12 months without a redetermination or
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reverification of eligibility. In conducting an eligibility
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determination, the department shall determine if the child has
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special health care needs. The department, in consultation with
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the Agency for Health Care Administration and the Florida Healthy
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Kids Corporation, shall develop procedures for redetermining
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eligibility which enable a family to easily update any change in
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circumstances which could affect eligibility. The department may
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accept changes in a family's status as reported to the department
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by the Florida Healthy Kids Corporation without requiring a new
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application from the family. Redetermination of a child's
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eligibility for Medicaid may not be linked to a child's
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eligibility determination for other programs.
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(c) Inform program applicants about eligibility
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determinations and provide information about eligibility of
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applicants to Medicaid, Medikids, the Children's Medical Services
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Network, and the Florida Healthy Kids Corporation, and to
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insurers and their agents, through a centralized coordinating
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office.
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(d) Design a plan, in consultation with the Florida Healthy
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Kids Corporation, to determine an applicant's eligibility for
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public assistance or Medicaid which allows:
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1. Applicants who have children and are applying for
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Medicaid or other public assistance to use the same information
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provided when applying for the Kidcare program, if they are found
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ineligible for Medicaid.
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2. Applicants to submit all information required for
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enrollment in the Kidcare program, including whether coverage is
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being sought for a child who has special health care needs.
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3. The department to forward an applicant's information and
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accompanying documentation to the Florida Healthy Kids
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Corporation, if necessary.
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4. The Florida Healthy Kids Corporation to process
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application information and other documents for enrollment in the
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Kidcare program without requiring the applicant to submit a
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separate application.
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The department shall submit the plan to the Governor, the
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President of the Senate, and the Speaker of the House of
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Representatives by December 31, 2008.
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(e)(d) Adopt rules necessary for conducting program
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eligibility functions.
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(2) The Department of Health shall:
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(a) Design an eligibility intake process for the program,
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in coordination with the Department of Children and Family
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Services, the agency, and the Florida Healthy Kids Corporation.
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The eligibility intake process may include local intake points
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that are determined by the Department of Health in coordination
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with the Department of Children and Family Services.
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(b) Chair a state-level coordinating council to review and
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make recommendations concerning the implementation and operation
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of the program. The coordinating council shall include
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representatives from the department, the Department of Children
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and Family Services, the agency, the Florida Healthy Kids
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Corporation, the Office of Insurance Regulation of the Financial
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Services Commission, local government, health insurers, health
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maintenance organizations, health care providers, families
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participating in the program, and organizations representing low-
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income families.
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(c) In consultation with the Florida Healthy Kids
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Corporation and the Department of Children and Family Services,
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establish a toll-free telephone line to assist families with
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questions about the program.
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(d) Adopt rules necessary to implement outreach activities.
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(2)(3) The Agency for Health Care Administration, under the
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authority granted in s. 409.914(1), shall:
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(a) Calculate the premium assistance payment necessary to
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comply with the premium and cost-sharing limitations specified in
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s. 409.816. The premium assistance payment for each enrollee in a
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health insurance plan participating in the Florida Healthy Kids
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Corporation must shall equal the premium approved by the Florida
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Healthy Kids Corporation and the Office of Insurance Regulation
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of the Financial Services Commission pursuant to ss. 627.410 and
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641.31, less any enrollee's share of the premium established
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within the limitations specified in s. 409.816. The premium
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assistance payment for each enrollee in an employer-sponsored
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shall equal the premium for the plan adjusted for any benchmark
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benefit plan actuarial equivalent benefit rider approved by the
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Office of Insurance Regulation pursuant to ss. 627.410 and
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641.31, less any enrollee's share of the premium established
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within the limitations specified in s. 409.816. In calculating
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the premium assistance payment levels for children with family
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coverage, the agency shall set the premium assistance payment
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levels for each child proportionately to the total cost of family
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coverage.
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(b) Make premium assistance payments to health insurance
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plans on a periodic basis. The agency may use its Medicaid fiscal
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agent or a contracted third-party administrator to make in making
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these payments. The agency may require health insurance plans
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that participate in the Medikids program or employer-sponsored
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group health insurance to collect premium payments from an
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enrollee's family. Participating health insurance plans shall
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report premium payments collected on behalf of enrollees in the
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program to the agency in accordance with a schedule established
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by the agency.
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(c) Monitor compliance with quality assurance and access
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standards developed under s. 409.820.
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(d) Establish a mechanism for investigating and resolving
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complaints and grievances from program applicants, enrollees, and
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health benefits coverage providers, and maintain a record of
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complaints and confirmed problems. In the case of a child who is
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enrolled in a health maintenance organization, the agency must
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use the provisions of s. 641.511 to address grievance reporting
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and resolution requirements.
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(e) Approve health benefits coverage for participation in
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the program, following certification by the Office of Insurance
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Regulation under subsection (3) (4).
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(f) In consultation with the Department of Children and
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Family Services and the Florida Healthy Kids Corporation,
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establish a single toll-free telephone number by July 1, 2009, to
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assist families who have questions about the Florida Kidcare
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program. The toll-free number must provide information regarding
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eligibility, enrollment, benefits, and other information relating
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to all components of the Florida Kidcare program and ensure that
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such information is easily accessible.
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(g) Seek and implement federal waivers or state plan
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amendments necessary to implement this section and ss. 409.810-
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(h)(f) Adopt rules necessary for calculating premium
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assistance payment levels, making premium assistance payments,
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monitoring access and quality assurance standards, investigating
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and resolving complaints and grievances, administering the
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Medikids program, and approving health benefits coverage.
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The agency is designated the lead state agency for Title XXI of
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the Social Security Act for purposes of receipt of federal funds,
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for reporting purposes, and for ensuring compliance with federal
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and state regulations and rules.
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(3)(4) The Office of Insurance Regulation shall certify
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that health benefits coverage plans that seek to provide services
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under the Florida Kidcare program, except those offered through
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the Florida Healthy Kids Corporation or the Children's Medical
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Services Network, meet, exceed, or are actuarially equivalent to
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the benchmark benefit plan and that health insurance plans will
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be offered at an approved rate. In determining actuarial
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equivalence of benefits coverage, the Office of Insurance
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Regulation and health insurance plans must comply with the
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requirements of s. 2103 of Title XXI of the Social Security Act.
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The department shall adopt rules necessary for certifying health
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benefits coverage plans.
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(4)(5) The Florida Healthy Kids Corporation shall retain
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its functions as authorized in s. 624.91, including eligibility
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determination for participation in the Healthy Kids program.
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(5)(6) The agency, the Department of Health, the Department
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of Children and Family Services, the Florida Healthy Kids
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Corporation, and the Office of Insurance Regulation, after
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consultation with and approval of the President of the Senate and
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the Speaker of the House of Representatives Speaker of the House
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of Representatives and the President of the Senate, are
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authorized to make program modifications that are necessary to
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overcome any objections of the United States Department of Health
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and Human Services to obtain approval of the state's child health
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insurance plan under Title XXI of the Social Security Act.
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Section 6. Paragraph (b) of subsection (5) of section
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624.91, Florida Statutes, is amended to read:
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624.91 The Florida Healthy Kids Corporation Act.--
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(5) CORPORATION AUTHORIZATION, DUTIES, POWERS.--
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(b) The Florida Healthy Kids Corporation shall:
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1. Arrange for the collection of any family, local
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contributions, or employer payment or premium, in an amount to be
513
determined by the board of directors, to provide for payment of
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premiums for comprehensive insurance coverage and for the actual
515
or estimated administrative expenses.
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2. Arrange for the collection of any voluntary
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contributions to provide for payment of premiums for children who
518
are not eligible for medical assistance under Title XXI of the
519
Social Security Act.
520
3. Subject to the provisions of s. 409.8134, accept
521
voluntary supplemental local match contributions that comply with
522
the requirements of Title XXI of the Social Security Act for the
523
purpose of providing additional coverage in contributing counties
524
under Title XXI.
525
4. Establish the administrative and accounting procedures
526
for the operation of the corporation.
527
5. Establish, with consultation from appropriate
528
professional organizations, standards for preventive health
529
services and providers and comprehensive insurance benefits
530
appropriate to children, if provided that such standards for
531
rural areas do shall not limit primary care providers to board-
532
certified pediatricians.
533
6. Determine eligibility for children seeking to
534
participate in the Title XXI-funded components of the Florida
535
Kidcare program consistent with the requirements specified in s.
536
409.814, as well as the non-Title-XXI-eligible children as
537
provided in subsection (3).
538
7. Establish procedures under which providers of local
539
match to, applicants to and participants in the program may have
540
grievances reviewed by an impartial body and reported to the
541
board of directors of the corporation.
542
8. Establish participation criteria and, if appropriate,
543
contract with an authorized insurer, health maintenance
544
organization, or third-party administrator to provide
545
administrative services to the corporation.
546
9. Establish enrollment criteria that include which shall
547
include penalties or waiting periods of not fewer than 60 days
548
for reinstatement of coverage upon voluntary cancellation for
549
nonpayment of family premiums.
550
10. Contract with authorized insurers or any provider of
551
health care services, meeting standards established by the
552
corporation, for the provision of comprehensive insurance
553
coverage to participants. Such standards shall include criteria
554
under which the corporation may contract with more than one
555
provider of health care services in program sites. Health plans
556
shall be selected through a competitive bid process. The Florida
557
Healthy Kids Corporation shall purchase goods and services in the
558
most cost-effective manner consistent with the delivery of
559
quality medical care. The maximum administrative cost for a
560
Florida Healthy Kids Corporation contract shall be 15 percent.
561
For health care contracts, the minimum medical loss ratio for a
562
Florida Healthy Kids Corporation contract shall be 85 percent.
563
For dental contracts, the remaining compensation to be paid to
564
the authorized insurer or provider under a Florida Healthy Kids
565
Corporation contract shall be no less than an amount which is 85
566
percent of premium; to the extent any contract provision does not
567
provide for this minimum compensation, this section shall
568
prevail. The health plan selection criteria and scoring system,
569
and the scoring results, shall be available upon request for
570
inspection after the bids have been awarded.
571
11. Establish disenrollment criteria in the event local
572
matching funds are insufficient to cover enrollments.
573
12. Develop and implement a plan to publicize the Florida
574
Healthy Kids Corporation, the eligibility requirements of the
575
program, and the procedures for enrollment in the program and to
576
maintain public awareness of the corporation and the program.
577
Health and dental plans participating in the Florida Healthy Kids
578
program may develop and distribute marketing and promotional
579
materials and participate in activities, such as health fairs and
580
public events, which are approved by the corporation. The health
581
and dental plans may also contact their current and former
582
enrollees to encourage continued participation in the program and
583
to assist the enrollees with transferring from a Title XIX-
584
financed plan to a Title XXI-financed plan.
585
13. Secure staff necessary to properly administer the
586
corporation. Staff costs must shall be funded from state and
587
local matching funds and such other private or public funds as
588
become available. The board of directors shall determine the
589
number of staff members necessary to administer the corporation.
590
14. Provide a report annually to the Governor, Chief
591
Financial Officer, Commissioner of Education, the President of
592
the Senate President, the Speaker of the House of
593
Representatives, and Minority Leaders of the Senate and the House
594
of Representatives.
595
15. Establish benefit packages which conform to the
596
provisions of the Florida Kidcare program, as created in ss.
598
16. Establish an assignment process that keeps enrollees in
599
the Florida Healthy Kids program with family members assigned to
600
the same managed care plans, to the greatest extent possible,
601
even if some family members are enrolled in a Medicaid managed
602
care plan and others are enrolled in a plan under the program.
603
The Agency for Health Care Administration shall work with the
604
corporation to implement this subparagraph.
605
a. The assignment process must allow an enrollee in the
606
program to enroll in a sibling's Medicaid provider service
607
network for coverage under the program, if the enrollee's sibling
608
is currently enrolled in a Medicaid provider service network in
609
the same county as the enrollee and the county does not contain a
610
health plan under the program.
611
b. The assignment process must allow an enrollee in the
612
program to enroll in a sibling's Medicaid health maintenance
613
organization for coverage under the program, if the enrollee's
614
sibling is currently enrolled in a Medicaid health maintenance
615
organization in the same county as the enrollee and the county
616
does not contain a health plan under the program that is operated
617
by or related to the Medicaid health maintenance organization.
618
Section 7. This act shall take effect upon becoming a law.
CODING: Words stricken are deletions; words underlined are additions.