Florida Senate - 2023 COMMITTEE AMENDMENT Bill No. CS for SB 246 Ì723386AÎ723386 LEGISLATIVE ACTION Senate . House Comm: RCS . 04/21/2023 . . . . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— The Committee on Fiscal Policy (Calatayud) recommended the following: 1 Senate Amendment (with title amendment) 2 3 Delete everything after the enacting clause 4 and insert: 5 Section 1. Effective January 1, 2024, paragraph (a) of 6 subsection (6) of section 409.8132, Florida Statutes, is amended 7 to read: 8 409.8132 Medikids program component.— 9 (6) ELIGIBILITY.— 10 (a) A child who has attained the age of 1 year but who is 11 under the age of 5 years is eligible to enroll in the Medikids 12 program component of the Florida Kidcare program, if the child 13 is a member of a family that has a family income which exceeds 14 the Medicaid applicable income level as specified in s. 409.903, 15 but which is equal to or below 300200percent of the current 16 federal poverty level. In determining the eligibility of such a 17 child, an assets test is not required. A child who is eligible 18 for Medikids may elect to enroll in Florida Healthy Kids 19 coverage or employer-sponsored group coverage. However, a child 20 who is eligible for Medikids may participate in the Florida 21 Healthy Kids program only if the child has a sibling 22 participating in the Florida Healthy Kids program and the 23 child’s county of residence permits such enrollment. 24 Section 2. Effective January 1, 2024, section 409.814, 25 Florida Statutes, is amended to read: 26 409.814 Eligibility.—A child who has not reached 19 years 27 of age whose family income is equal to or below 300200percent 28 of the federal poverty level is eligible for the Florida Kidcare 29 program as provided in this section. If an enrolled individual 30 is determined to be ineligible for coverage, he or she must be 31 immediately disenrolled from the respective Florida Kidcare 32 program component. 33 (1) A child who is eligible for Medicaid coverage under s. 34 409.903 or s. 409.904 must be enrolled in Medicaid and is not 35 eligible to receive health benefits under any other health 36 benefits coverage authorized under the Florida Kidcare program. 37 (2) A child who is not eligible for Medicaid, but who is 38 eligible for the Florida Kidcare program, may obtain health 39 benefits coverage under any of the other components listed in s. 40 409.813 if such coverage is approved and available in the county 41 in which the child resides. 42 (3) A Title XXI-funded child who is eligible for the 43 Florida Kidcare program who is a child with special health care 44 needs, as determined through a medical or behavioral screening 45 instrument, is eligible for health benefits coverage from and 46 shall be assigned to and may opt out of the Children’s Medical 47 Services Network. 48 (4) A Title XXI-funded child who reaches 19 years of age is 49 eligible for continued Title XXI-funded coverage for the 50 duration of a pregnancy and the postpartum period consisting of 51 the 12-month period beginning on the last day of a pregnancy, if 52 such pregnancy or postpartum period begins prior to the child 53 reaching 19 years of age, and if the child is ineligible for 54 Medicaid. 55 (5) The following children are not eligible to receive 56 Title XXI-funded premium assistance for health benefits coverage 57 under the Florida Kidcare program, except under Medicaid if the 58 child would have been eligible for Medicaid under s. 409.903 or 59 s. 409.904 as of June 1, 1997: 60 (a) A child who is covered under a family member’s group 61 health benefit plan or under other private or employer health 62 insurance coverage, if the cost of the child’s participation is 63 not greater than 5 percent of the family’s income. If a child is 64 otherwise eligible for a subsidy under the Florida Kidcare 65 program and the cost of the child’s participation in the family 66 member’s health insurance benefit plan is greater than 5 percent 67 of the family’s income, the child may enroll in the appropriate 68 subsidized Kidcare program. 69 (b) A child who is seeking premium assistance for the 70 Florida Kidcare program through employer-sponsored group 71 coverage, if the child has been covered by the same employer’s 72 group coverage during the 60 days before the family submitted an 73 application for determination of eligibility under the program. 74 (c) A child who is an alien but who does not meet the 75 definition of a lawfully residing child. This paragraph does not 76 extend eligibility for the Florida Kidcare program to an 77 undocumented immigrant. 78 (d) A child who is an inmate of a public institution or a 79 patient in an institution for mental diseases. 80 (e) A child who is otherwise eligible for premium 81 assistance for the Florida Kidcare program and has had his or 82 her coverage in an employer-sponsored or private health benefit 83 plan voluntarily canceled in the last 60 days, except those 84 children whose coverage was voluntarily canceled for good cause, 85 including, but not limited to, the following circumstances: 86 1. The cost of participation in an employer-sponsored 87 health benefit plan is greater than 5 percent of the family’s 88 income; 89 2. The parent lost a job that provided an employer 90 sponsored health benefit plan for children; 91 3. The parent who had health benefits coverage for the 92 child is deceased; 93 4. The child has a medical condition that, without medical 94 care, would cause serious disability, loss of function, or 95 death; 96 5. The employer of the parent canceled health benefits 97 coverage for children; 98 6. The child’s health benefits coverage ended because the 99 child reached the maximum lifetime coverage amount; 100 7. The child has exhausted coverage under a COBRA 101 continuation provision; 102 8. The health benefits coverage does not cover the child’s 103 health care needs; or 104 9. Domestic violence led to loss of coverage. 105 (6) A child who is otherwise eligible for the Florida 106 Kidcare program and who has a preexisting condition that 107 prevents coverage under another insurance plan as described in 108 paragraph (5)(a) which would have disqualified the child for the 109 Florida Kidcare program if the child were able to enroll in the 110 plan is eligible for Florida Kidcare coverage when enrollment is 111 possible. 112 (7) A child whose family income is above 300200percent of 113 the federal poverty level or a child who is excluded under the 114 provisions of subsection (5) may participate in the Florida 115 Kidcare program as provided in s. 409.8132 or, if the child is 116 ineligible for Medikids by reason of age, in the Florida Healthy 117 Kids program, subject to the following: 118 (a) The family is not eligible for premium assistance 119 payments and must pay the full cost of the premium, including 120 any administrative costs. 121 (b) The board of directors of the Florida Healthy Kids 122 Corporation may offer a reduced benefit package to these 123 children in order to limit program costs for such families. 124 (8) Once a child is enrolled in the Florida Kidcare 125 program, the child is eligible for coverage for 12 months 126 without a redetermination or reverification of eligibility, if 127 the family continues to pay the applicable premium. Eligibility 128 for program components funded through Title XXI of the Social 129 Security Act terminates when a child attains the age of 19. A 130 child who has not attained the age of 5 and who has been 131 determined eligible for the Medicaid program is eligible for 132 coverage for 12 months without a redetermination or 133 reverification of eligibility. 134 (9) When determining or reviewing a child’s eligibility 135 under the Florida Kidcare program, the applicant shall be 136 provided with reasonable notice of changes in eligibility which 137 may affect enrollment in one or more of the program components. 138 If a transition from one program component to another is 139 authorized, there shall be cooperation between the program 140 components and the affected family which promotes continuity of 141 health care coverage. Any authorized transfers must be managed 142 within the program’s overall appropriated or authorized levels 143 of funding. Each component of the program shall establish a 144 reserve to ensure that transfers between components will be 145 accomplished within current year appropriations. These reserves 146 shall be reviewed by each convening of the Social Services 147 Estimating Conference to determine the adequacy of such reserves 148 to meet actual experience. 149 (10) In determining the eligibility of a child, an assets 150 test is not required. If eligibility for the Florida Kidcare 151 program cannot be verified using reliable data sources in 152 accordance with federal requirements, each applicant mustshall153 provide documentation during the application process and the 154 redetermination process, including, but not limited to, the 155 following: 156 (a) Proof of family income, which must be verified 157 electronically to determine financial eligibility for the 158 Florida Kidcare program. Written documentation, which may 159 include wages and earnings statements or pay stubs, W-2 forms, 160 or a copy of the applicant’s most recent federal income tax 161 return, is required only if the electronic verification is not 162 available or does not substantiate the applicant’s income. 163 (b) A statement from all applicable, employed family 164 members that: 165 1. Their employers do not sponsor health benefit plans for 166 employees; 167 2. The potential enrollee is not covered by an employer 168 sponsored health benefit plan; or 169 3. The potential enrollee is covered by an employer 170 sponsored health benefit plan and the cost of the employer 171 sponsored health benefit plan is more than 5 percent of the 172 family’s income. 173 (c) To enroll in the Children’s Medical Services Network, a 174 completed application, including a clinical screening. 175 (11) Subject to paragraph (5)(a), the Florida Kidcare 176 program shall withhold benefits from an enrollee if the program 177 obtains evidence that the enrollee is no longer eligible, 178 submitted incorrect or fraudulent information in order to 179 establish eligibility, or failed to provide verification of 180 eligibility. The applicant or enrollee mustshallbe notified 181 that because of such evidence program benefits will be withheld 182 unless the applicant or enrollee contacts a designated 183 representative of the program by a specified date, which must be 184 within 10 working days after the date of notice, to discuss and 185 resolve the matter. The program shall make every effort to 186 resolve the matter within a timeframe that will not cause 187 benefits to be withheld from an eligible enrollee. 188 (12) The following individuals may be subject to 189 prosecution in accordance with s. 414.39: 190 (a) An applicant obtaining or attempting to obtain benefits 191 for a potential enrollee under the Florida Kidcare program when 192 the applicant knows or should have known the potential enrollee 193 does not qualify for the Florida Kidcare program. 194 (b) An individual who assists an applicant in obtaining or 195 attempting to obtain benefits for a potential enrollee under the 196 Florida Kidcare program when the individual knows or should have 197 known the potential enrollee does not qualify for the Florida 198 Kidcare program. 199 Section 3. Effective January 1, 2024, subsection (3) of 200 section 409.816, Florida Statutes, is amended to read: 201 409.816 Limitations on premiums and cost sharing.—The 202 following limitations on premiums and cost sharing are 203 established for the program. 204 (3) Enrollees in families with a family income above 150 205 percent of the federal poverty level who are not receiving 206 coverage under the Medicaid program or who are not eligible 207 under s. 409.814(7) may be required to pay enrollment fees, 208 premiums, copayments, deductibles, coinsurance, or similar 209 charges on a sliding scale related to income, except that the 210 total annual aggregate cost sharing with respect to all children 211 in a family may not exceed 5 percent of the family’s income. 212 However, copayments, deductibles, coinsurance, or similar 213 charges may not be imposed for preventive services, including 214 well-baby and well-child care, age-appropriate immunizations, 215 and routine hearing and vision screenings. Premiums for 216 enrollees who are paying enrollment fees, premiums, copayments, 217 deductibles, coinsurance, or similar charges as provided in this 218 subsection must be based on at least three but no more than six 219 tiers of uniform premiums that increase with each tier as a 220 percentage of the applicable threshold amount of the federal 221 poverty level, by tier. 222 Section 4. Effective January 1, 2024, paragraph (b) of 223 subsection (2) of section 624.91, Florida Statutes, is amended 224 to read: 225 624.91 The Florida Healthy Kids Corporation Act.— 226 (2) LEGISLATIVE INTENT.— 227 (b) It is the intent of the Legislature that the Florida 228 Healthy Kids Corporation serve as one of several providers of 229 services to children eligible for medical assistance under Title 230 XXI of the Social Security Act. Although the corporation may 231 serve other children, the Legislature intends the primary 232 recipients of services provided through the corporation be 233 school-age children with a family income equal to or below 300 234200percent of the federal poverty level, who do not qualify for 235 Medicaid. It is also the intent of the Legislature that state 236 and local government Florida Healthy Kids funds be used to 237 continue coverage, subject to specific appropriations in the 238 General Appropriations Act, to children not eligible for federal 239 matching funds under Title XXI. 240 Section 5. Except as otherwise expressly provided in this 241 act, this act shall take effect upon becoming a law. 242 243 ================= T I T L E A M E N D M E N T ================ 244 And the title is amended as follows: 245 Delete everything before the enacting clause 246 and insert: 247 A bill to be entitled 248 An act relating to Florida Kidcare program 249 eligibility; amending s. 409.8132, F.S.; increasing 250 the income eligibility threshold for coverage under 251 the Medikids program component; amending s. 409.814, 252 F.S.; increasing the income eligibility threshold for 253 coverage under the Florida Kidcare program; requiring 254 an applicant seeking coverage under the program to 255 provide certain documentation if eligibility cannot be 256 verified using reliable data sources; amending s. 257 409.816, F.S.; requiring that premiums for certain 258 enrollees under the Florida Kidcare program be based 259 on a tiered system of uniform premiums; amending s. 260 624.91, F.S.; conforming a provision to changes made 261 by the act; providing effective dates.