Florida Senate - 2025                                    SB 7032
       
       
        
       By the Appropriations Committee on Health and Human Services
       
       
       
       
       
       603-03472-25                                          20257032__
    1                        A bill to be entitled                      
    2         An act relating to Medicaid enrollment for permanently
    3         disabled individuals; amending s. 409.904, F.S.;
    4         requiring that certain persons who receive specified
    5         Medicaid-covered services and who are permanently
    6         disabled be presumed eligible for continued Medicaid
    7         coverage during redetermination processes; requiring
    8         the Agency for Health Care Administration to continue
    9         to make payments for such services; providing
   10         exceptions; requiring certain persons to notify the
   11         agency and the Department of Children and Families of
   12         certain changes in disability or economic status;
   13         authorizing the department to conduct a
   14         redetermination of eligibility under certain
   15         circumstances; requiring the department to make
   16         notifications under certain circumstances; defining
   17         the term “permanently disabled”; requiring the agency
   18         to seek federal authorization to exempt certain
   19         persons from annual redetermination of eligibility;
   20         requiring the agency and the department to develop a
   21         specified process; providing an effective date.
   22          
   23  Be It Enacted by the Legislature of the State of Florida:
   24  
   25         Section 1. Subsection (1) of section 409.904, Florida
   26  Statutes, is amended to read:
   27         409.904 Optional payments for eligible persons.—The agency
   28  may make payments for medical assistance and related services on
   29  behalf of the following persons who are determined to be
   30  eligible subject to the income, assets, and categorical
   31  eligibility tests set forth in federal and state law. Payment on
   32  behalf of these Medicaid eligible persons is subject to the
   33  availability of moneys and any limitations established by the
   34  General Appropriations Act or chapter 216.
   35         (1)(a) Subject to federal waiver approval, a person who is
   36  age 65 or older or is determined to be disabled, whose income is
   37  at or below 88 percent of the federal poverty level, whose
   38  assets do not exceed established limitations, and who is not
   39  eligible for Medicare or, if eligible for Medicare, is also
   40  eligible for and receiving Medicaid-covered institutional care
   41  services, hospice services, or home and community-based
   42  services. The agency shall seek federal authorization through a
   43  waiver to provide this coverage.
   44         (b)1. A person who was initially determined eligible for
   45  Medicaid under paragraph (a) and is receiving Medicaid-covered
   46  institutional care services, hospice services, or home and
   47  community-based services pursuant to s. 393.066 or s. 409.978,
   48  and who is permanently disabled, shall be presumed eligible for
   49  continued coverage for these Medicaid-covered services during
   50  any redetermination process, and the agency shall continue to
   51  make payments for such services, unless the person experiences a
   52  material change in his or her disability or economic status
   53  which results in a loss of eligibility. In the event of such a
   54  change in disability or economic status, the person or his or
   55  her designated caregiver or responsible party shall notify the
   56  agency and the Department of Children and Families of such
   57  change, and the Department of Children and Families may conduct
   58  a redetermination of eligibility. If such redetermination is
   59  conducted, the Department of Children and Families must notify
   60  the person or his or her designated caregiver or responsible
   61  party before the commencement of the redetermination and, at its
   62  conclusion, the results of the redetermination.
   63         2. As used in this paragraph, the term “permanently
   64  disabled” means that a person has been determined to be disabled
   65  under paragraph (a) and has had his or her qualifying disability
   66  or disabilities certified by a physician licensed under chapter
   67  458 or chapter 459 as permanent in nature. The agency shall, no
   68  later than October 1, 2025, seek federal authorization to exempt
   69  a Medicaid-eligible permanently disabled person from annual
   70  redetermination of eligibility under the parameters of this
   71  paragraph.
   72         3. The agency and the Department of Children and Families
   73  shall develop a process to facilitate the notifications required
   74  under subparagraph 1.
   75         Section 2. This act shall take effect July 1, 2025.