Florida 2022 Regular Session

Florida House Bill H0135 Compare Versions

Only one version of the bill is available at this time.

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3	3	HB 135 2022
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8	8	hb0135-00
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10	10	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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14	14	A bill to be entitled 1
15	15	An act relating to Florida Kidcare program 2
16	16	eligibility; amending s. 409.8132, F.S.; conforming a 3
17	17	provision to changes made by the act; amending s. 4
18	18	409.814, F.S.; increasing the income eligibility 5
19	19	threshold for coverage under the Florida Kidcare 6
20	20	program; requiring an applicant seeking coverage under 7
21	21	the program to provide certain documentation if 8
22	22	eligibility cannot be verified using reliable data 9
23	23	sources; creating s. 409.8141, F.S.; requiring the 10
24	24	Agency for Health Care Administration to examine 11
25	25	graduated family contribution rates for newly 12
26	26	qualifying families under the program; providing 13
27	27	guidelines for such rates; providing applicability; 14
28	28	requiring the agency to inc rease the income 15
29	29	eligibility threshold for coverage under the program 16
30	30	each fiscal year until meeting a specified income 17
31	31	threshold; authorizing the agency to seek federal 18
32	32	waiver approval or submit state plan amendments as 19
33	33	necessary; amending s. 624.91, F.S. ; conforming a 20
34	34	provision to changes made by the act; providing an 21
35	35	effective date. 22
36	36	23
37	37	Be It Enacted by the Legislature of the State of Florida: 24
38	38	25
39	39
40	40	HB 135 2022
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45	45	hb0135-00
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47	47	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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51	51	Section 1. Paragraph (a) of subsection (6) of section 26
52	52	409.8132, Florida Statutes, is amended to read: 27
53	53	409.8132 Medikids program component. — 28
54	54	(6) ELIGIBILITY.— 29
55	55	(a) A child who has attained the age of 1 year but who is 30
56	56	under the age of 5 years is eligible to enroll in the Medikids 31
57	57	program component of the Florida Kidcare program, if the child 32
58	58	is a member of a family that has a family income which exceeds 33
59	59	the Medicaid applicable income level as specified in s. 409.903, 34
60	60	but which is equal to or below 250 200 percent of the current 35
61	61	federal poverty level. In determining the eligibility of such a 36
62	62	child, an assets test is not required. A child who is eligible 37
63	63	for Medikids may elect to enroll in Florida Healthy Kids 38
64	64	coverage or employer -sponsored group coverage. However, a child 39
65	65	who is eligible for Medikids may participate in the Florida 40
66	66	Healthy Kids program only if the child has a sibling 41
67	67	participating in the Florida Healthy Kids program and the 42
68	68	child's county of residence permits such enrollment. 43
69	69	Section 2. Section 409.814, Florida Statutes, is amended 44
70	70	to read: 45
71	71	409.814 Eligibility. —A child who has not reached 19 years 46
72	72	of age whose family income is equal to or below 250 200 percent 47
73	73	of the federal poverty level is eligible for the Florida Kidcare 48
74	74	program as provided in this section. If an enrolled individual 49
75	75	is determined to be ineligible for coverage, he or she must be 50
76	76
77	77	HB 135 2022
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81	81	CODING: Words stricken are deletions; words underlined are additions.
82	82	hb0135-00
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84	84	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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86	86
87	87
88	88	immediately disenrolled from the respective Florida Kidcare 51
89	89	program component. 52
90	90	(1) A child who is eligible for Medicaid coverage under s. 53
91	91	409.903 or s. 409.904 must be enrolled in Medicaid and is not 54
92	92	eligible to receive health benefits under any other health 55
93	93	benefits coverage authorized under the Florida Kidcare program. 56
94	94	(2) A child who is not eligible for Medicaid, but who is 57
95	95	eligible for the Florida Kidcare program, may obtain health 58
96	96	benefits coverage under any of the other components listed in s. 59
97	97	409.813 if such coverage is approved and available in the county 60
98	98	in which the child resides. 61
99	99	(3) A Title XXI-funded child who is eligible for the 62
100	100	Florida Kidcare program who is a child with special health care 63
101	101	needs, as determined through a medical or behavioral screening 64
102	102	instrument, is eligible for health benefits coverage from and 65
103	103	shall be assigned to and may opt out of the Children's Medical 66
104	104	Services Network. 67
105	105	(4) The following children are not eligible to receive 68
106	106	Title XXI-funded premium assist ance for health benefits coverage 69
107	107	under the Florida Kidcare program, except under Medicaid if the 70
108	108	child would have been eligible for Medicaid under s. 409.903 or 71
109	109	s. 409.904 as of June 1, 1997: 72
110	110	(a) A child who is covered under a family member's group 73
111	111	health benefit plan or under other private or employer health 74
112	112	insurance coverage, if the cost of the child's participation is 75
113	113
114	114	HB 135 2022
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118	118	CODING: Words stricken are deletions; words underlined are additions.
119	119	hb0135-00
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121	121	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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123	123
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125	125	not greater than 5 percent of the family's income. If a child is 76
126	126	otherwise eligible for a subsidy under the Florida Kidcare 77
127	127	program and the cost of the child's participation in the family 78
128	128	member's health insurance benefit plan is greater than 5 percent 79
129	129	of the family's income, the child may enroll in the appropriate 80
130	130	subsidized Kidcare program. 81
131	131	(b) A child who is seeking premium assistan ce for the 82
132	132	Florida Kidcare program through employer -sponsored group 83
133	133	coverage, if the child has been covered by the same employer's 84
134	134	group coverage during the 60 days before the family submitted an 85
135	135	application for determination of eligibility under the progr am. 86
136	136	(c) A child who is an alien but who does not meet the 87
137	137	definition of a lawfully residing child. This paragraph does not 88
138	138	extend eligibility for the Florida Kidcare program to an 89
139	139	undocumented immigrant. 90
140	140	(d) A child who is an inmate of a public institution or a 91
141	141	patient in an institution for mental diseases. 92
142	142	(e) A child who is otherwise eligible for premium 93
143	143	assistance for the Florida Kidcare program and has had his or 94
144	144	her coverage in an employer -sponsored or private health benefit 95
145	145	plan voluntarily canceled in the last 60 days, except those 96
146	146	children whose coverage was voluntarily canceled for good cause, 97
147	147	including, but not limited to, the following circumstances: 98
148	148	1. The cost of participation in an employer -sponsored 99
149	149	health benefit plan is greate r than 5 percent of the family's 100
150	150
151	151	HB 135 2022
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156	156	hb0135-00
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158	158	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
159	159
160	160
161	161
162	162	income; 101
163	163	2. The parent lost a job that provided an employer -102
164	164	sponsored health benefit plan for children; 103
165	165	3. The parent who had health benefits coverage for the 104
166	166	child is deceased; 105
167	167	4. The child has a medical condition tha t, without medical 106
168	168	care, would cause serious disability, loss of function, or 107
169	169	death; 108
170	170	5. The employer of the parent canceled health benefits 109
171	171	coverage for children; 110
172	172	6. The child's health benefits coverage ended because the 111
173	173	child reached the maximum lifet ime coverage amount; 112
174	174	7. The child has exhausted coverage under a COBRA 113
175	175	continuation provision; 114
176	176	8. The health benefits coverage does not cover the child's 115
177	177	health care needs; or 116
178	178	9. Domestic violence led to loss of coverage. 117
179	179	(5) A child who is otherwi se eligible for the Florida 118
180	180	Kidcare program and who has a preexisting condition that 119
181	181	prevents coverage under another insurance plan as described in 120
182	182	paragraph (4)(a) which would have disqualified the child for the 121
183	183	Florida Kidcare program if the child were a ble to enroll in the 122
184	184	plan is eligible for Florida Kidcare coverage when enrollment is 123
185	185	possible. 124
186	186	(6) A child whose family income is above 250 200 percent 125
187	187
188	188	HB 135 2022
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193	193	hb0135-00
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195	195	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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197	197
198	198
199	199	of the federal poverty level or a child who is excluded under 126
200	200	the provisions of subsection (4) may pa rticipate in the Florida 127
201	201	Kidcare program as provided in s. 409.8132 or, if the child is 128
202	202	ineligible for Medikids by reason of age, in the Florida Healthy 129
203	203	Kids program, subject to the following: 130
204	204	(a) The family is not eligible for premium assistance 131
205	205	payments and must pay the full cost of the premium, including 132
206	206	any administrative costs. 133
207	207	(b) The board of directors of the Florida Healthy Kids 134
208	208	Corporation may offer a reduced benefit package to these 135
209	209	children in order to limit program costs for such families. 136
210	210	(7) Once a child is enrolled in the Florida Kidcare 137
211	211	program, the child is eligible for coverage for 12 months 138
212	212	without a redetermination or reverification of eligibility, if 139
213	213	the family continues to pay the applicable premium. Eligibility 140
214	214	for program components funded through Title XXI of the Social 141
215	215	Security Act terminates when a child attains the age of 19. A 142
216	216	child who has not attained the age of 5 and who has been 143
217	217	determined eligible for the Medicaid program is eligible for 144
218	218	coverage for 12 months without a redetermination or 145
219	219	reverification of eligibility. 146
220	220	(8) When determining or reviewing a child's eligibility 147
221	221	under the Florida Kidcare program, the applicant shall be 148
222	222	provided with reasonable notice of changes in eligibility which 149
223	223	may affect enrollment in one or more of the program components. 150
224	224
225	225	HB 135 2022
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229	229	CODING: Words stricken are deletions; words underlined are additions.
230	230	hb0135-00
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232	232	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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236	236	If a transition from one program component to another is 151
237	237	authorized, there shall be cooperation between the program 152
238	238	components and the affected family which promotes continuity of 153
239	239	health care coverage. Any authorized transfers must be managed 154
240	240	within the program's overall appropriated or authorized levels 155
241	241	of funding. Each component of the program shall establish a 156
242	242	reserve to ensure that transfers between components will be 157
243	243	accomplished within current year appropriations . These reserves 158
244	244	shall be reviewed by each convening of the Social Services 159
245	245	Estimating Conference to determine the adequacy of such reserves 160
246	246	to meet actual experience. 161
247	247	(9) In determining the eligibility of a child, an assets 162
248	248	test is not required. If eligibility for the Florida Kidcare 163
249	249	program cannot be verified using reliable data sources in 164
250	250	accordance with federal requirements, each applicant shall 165
251	251	provide documentation during the application process and the 166
252	252	redetermination process, including, but not li mited to, the 167
253	253	following: 168
254	254	(a) Proof of family income, which must be verified 169
255	255	electronically to determine financial eligibility for the 170
256	256	Florida Kidcare program. Written documentation, which may 171
257	257	include wages and earnings statements or pay stubs, W -2 forms, 172
258	258	or a copy of the applicant's most recent federal income tax 173
259	259	return, is required only if the electronic verification is not 174
260	260	available or does not substantiate the applicant's income. 175
261	261
262	262	HB 135 2022
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266	266	CODING: Words stricken are deletions; words underlined are additions.
267	267	hb0135-00
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269	269	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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273	273	(b) A statement from all applicable, employed family 176
274	274	members that: 177
275	275	1. Their employers do not sponsor health benefit plans for 178
276	276	employees; 179
277	277	2. The potential enrollee is not covered by an employer -180
278	278	sponsored health benefit plan; or 181
279	279	3. The potential enrollee is covered by an employer -182
280	280	sponsored health benefit plan and the cost of the employer-183
281	281	sponsored health benefit plan is more than 5 percent of the 184
282	282	family's income. 185
283	283	(c) To enroll in the Children's Medical Services Network, 186
284	284	a completed application, including a clinical screening. 187
285	285	(10) Subject to paragraph (4)(a), the Flori da Kidcare 188
286	286	program shall withhold benefits from an enrollee if the program 189
287	287	obtains evidence that the enrollee is no longer eligible, 190
288	288	submitted incorrect or fraudulent information in order to 191
289	289	establish eligibility, or failed to provide verification of 192
290	290	eligibility. The applicant or enrollee shall be notified that 193
291	291	because of such evidence program benefits will be withheld 194
292	292	unless the applicant or enrollee contacts a designated 195
293	293	representative of the program by a specified date, which must be 196
294	294	within 10 working da ys after the date of notice, to discuss and 197
295	295	resolve the matter. The program shall make every effort to 198
296	296	resolve the matter within a timeframe that will not cause 199
297	297	benefits to be withheld from an eligible enrollee. 200
298	298
299	299	HB 135 2022
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306	306	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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310	310	(11) The following individuals may be subj ect to 201
311	311	prosecution in accordance with s. 414.39: 202
312	312	(a) An applicant obtaining or attempting to obtain 203
313	313	benefits for a potential enrollee under the Florida Kidcare 204
314	314	program when the applicant knows or should have known the 205
315	315	potential enrollee does not qualify for the Florida Kidcare 206
316	316	program. 207
317	317	(b) An individual who assists an applicant in obtaining or 208
318	318	attempting to obtain benefits for a potential enrollee under the 209
319	319	Florida Kidcare program when the individual knows or should have 210
320	320	known the potential enrollee doe s not qualify for the Florida 211
321	321	Kidcare program. 212
322	322	Section 3. Section 409.8141, Florida Statutes, is created 213
323	323	to read: 214
324	324	409.8141 Graduated family contribution rates. — 215
325	325	(1) Subject to federal waiver approval and in accordance 216
326	326	with the cost containment goals for the Florida Kidcare program 217
327	327	and for the state, the agency shall examine graduated family 218
328	328	contribution rates for newly qualifying families under the 219
329	329	Florida Kidcare program which are consistent with the existing 220
330	330	standard established under the Chil dren's Health Insurance 221
331	331	Program (CHIP) as follows: 222
332	332	(a) For a child or children whose family has an income 223
333	333	between 200 and 225 percent of the federal poverty level, a 224
334	334	contribution rate of at least $30 per month per family. 225
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336	336	HB 135 2022
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340	340	CODING: Words stricken are deletions; words underlined are additions.
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343	343	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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347	347	(b) For a child or children wh ose family has an income 226
348	348	between 225 and 250 percent of the federal poverty level, a 227
349	349	contribution rate of at least $40 per month per family. 228
350	350	(2) The graduated family contribution rates in subsection 229
351	351	(1) are in addition to the existing contribution rates of $15 230
352	352	per month per family for a child or children whose family has an 231
353	353	income between 138 and 158 percent of the federal poverty level 232
354	354	and $20 per month per family for a child or children whose 233
355	355	family has an income between 158 and 215 percent of the feder al 234
356	356	poverty level, allowing the state to attain additional cost 235
357	357	savings for the expansion of the Florida Kidcare program and to 236
358	358	attain the federal Centers for Medicare and Medicaid Services' 237
359	359	stated goals for CHIP to expand coverage and healthcare access 238
360	360	for uninsured and underinsured children. 239
361	361	(3) Subject to federal waiver approval, the agency shall 240
362	362	increase the income eligibility threshold for coverage under the 241
363	363	Florida Kidcare program to 210 percent of the federal poverty 242
364	364	level for the 2022-2023 fiscal year, and shall increase the 243
365	365	income eligibility threshold by 10 percent each fiscal year 244
366	366	thereafter until meeting an income eligibility threshold of 250 245
367	367	percent of the federal poverty level. 246
368	368	(4) The agency may seek federal waiver approval or submit 247
369	369	any state plan amendments necessary to implement this section. 248
370	370	Section 4. Paragraph (b) of subsection (2) of section 249
371	371	624.91, Florida Statutes, is amended to read: 250
372	372
373	373	HB 135 2022
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380	380	F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
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384	384	624.91 The Florida Healthy Kids Corporation Act. — 251
385	385	(2) LEGISLATIVE INTENT. — 252
386	386	(b) It is the intent of the Legislature that the Florida 253
387	387	Healthy Kids Corporation serve as one of several providers of 254
388	388	services to children eligible for medical assistance under Title 255
389	389	XXI of the Social Security Act. Although the corporation may 256
390	390	serve other children, the Legislature intends the primary 257
391	391	recipients of services provided through the corporation be 258
392	392	school-age children with a family income below 250 200 percent 259
393	393	of the federal poverty level, who do not qualify for Medicaid. 260
394	394	It is also the intent of the Legislatu re that state and local 261
395	395	government Florida Healthy Kids funds be used to continue 262
396	396	coverage, subject to specific appropriations in the General 263
397	397	Appropriations Act, to children not eligible for federal 264
398	398	matching funds under Title XXI. 265
399	399	Section 5. This act s hall take effect July 1, 2022. 266