Florida 2022 Regular Session

Florida House Bill H0419 Compare Versions

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

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3	3	HB 419 2022
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7	7	CODING: Words stricken are deletions; words underlined are additions.
8	8	hb0419-00
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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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12	12
13	13
14	14	A bill to be entitled 1
15	15	An act relating to Florida Kidcare program income 2
16	16	eligibility; creating s. 409.8141, F.S.; establishing 3
17	17	a tiered system of family premiums for Title -XXI 4
18	18	coverage under the Florida Kidcare program beginning 5
19	19	with a specified fiscal year; prohibiting the total 6
20	20	monthly aggregate family premium from exceeding a 7
21	21	specified amount; authorizing the Agency for Health 8
22	22	Care Administration to seek federal waiver approval or 9
23	23	submit any state plan amendments as necessary; 10
24	24	providing for future expiration; amending ss. 11
25	25	409.8132, 409.814, and 624.91, F.S.; increasing the 12
26	26	income eligibility threshold for coverage under the 13
27	27	program to conform to changes made by the act; 14
28	28	providing applicability; providing for reversion of 15
29	29	certain provisions; requiring the agency to notify the 16
30	30	Division of Law Revision within a specified timeframe 17
31	31	after receiving federal approval through a waiver or 18
32	32	state plan amendment; providing an effective date. 19
33	33	20
34	34	Be It Enacted by the Legislature of the State of Florida: 21
35	35	22
36	36	Section 1. Section 409.8141, Florida Statutes, is created 23
37	37	to read: 24
38	38	409.8141 Tiered system of family premiums for Title -XXI 25
39	39
40	40	HB 419 2022
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42	42
43	43
44	44	CODING: Words stricken are deletions; words underlined are additions.
45	45	hb0419-00
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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
48	48
49	49
50	50
51	51	coverage under the Florida Kidcare program. — 26
52	52	(1) Beginning with th e 2022-2023 fiscal year and subject 27
53	53	to federal approval through a waiver or a state plan amendment, 28
54	54	the following tiered system of family premiums for Title -XXI 29
55	55	coverage under the Florida Kidcare program shall apply: 30
56	56	(a) For a child whose family has an i ncome from 201 31
57	57	through 250 percent of the federal poverty level, a family 32
58	58	premium of $50 per month per child. 33
59	59	(b) For a child whose family has an income from 251 34
60	60	through 300 percent of the federal poverty level, a family 35
61	61	premium of $100 per month per chi ld. 36
62	62	(c) For a child whose family has an income from 301 37
63	63	through 350 percent of the federal poverty level, a family 38
64	64	premium of $150 per month per child. 39
65	65	(d) For a child whose family has an income from 351 40
66	66	through 400 percent of the federal poverty level , a family 41
67	67	premium of $200 per month per child. 42
68	68	(2) For the coverage specified in subsection (1), the 43
69	69	total monthly aggregate family premium for all children in a 44
70	70	family may not exceed $800 per month. 45
71	71	(3) The agency may seek federal waiver approval or submit 46
72	72	any state plan amendments necessary to implement this section. 47
73	73	(4) This section expires July 1, 2025. 48
74	74	Section 2. Paragraph (a) of subsection (6) of section 49
75	75	409.8132, Florida Statutes, is amended to read: 50
76	76
77	77	HB 419 2022
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79	79
80	80
81	81	CODING: Words stricken are deletions; words underlined are additions.
82	82	hb0419-00
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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	409.8132 Medikids program component. — 51
89	89	(6) ELIGIBILITY.— 52
90	90	(a) A child who has attained the age of 1 year but who is 53
91	91	under the age of 5 years is eligible to enroll in the Medikids 54
92	92	program component of the Florida Kidcare program, if the child 55
93	93	is a member of a family that has a family income which exceeds 56
94	94	the Medicaid applicable income level as specified in s. 409.903, 57
95	95	but which is equal to or below 400 200 percent of the current 58
96	96	federal poverty level. In determining the eligibility of such a 59
97	97	child, an assets test is not required. A child who is eligible 60
98	98	for Medikids may elect to enroll in Florida Healthy Kids 61
99	99	coverage or employer -sponsored group coverage. However, a child 62
100	100	who is eligible for Medikids may participate in the Florida 63
101	101	Healthy Kids program only if the child has a sibling 64
102	102	participating in the Florida Healthy Kids program and the 65
103	103	child's county of residence permits such enrollment. 66
104	104	Section 3. Section 409.814, Florida Statutes, is amended 67
105	105	to read: 68
106	106	409.814 Eligibility. —A child who has not reached 19 years 69
107	107	of age whose family incom e is equal to or below 400 200 percent 70
108	108	of the federal poverty level is eligible for the Florida Kidcare 71
109	109	program as provided in this section. If an enrolled individual 72
110	110	is determined to be ineligible for coverage, he or she must be 73
111	111	immediately disenrolled fr om the respective Florida Kidcare 74
112	112	program component. 75
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114	114	HB 419 2022
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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
124	124
125	125	(1) A child who is eligible for Medicaid coverage under s. 76
126	126	409.903 or s. 409.904 must be enrolled in Medicaid and is not 77
127	127	eligible to receive health benefits under any other health 78
128	128	benefits coverage aut horized under the Florida Kidcare program. 79
129	129	(2) A child who is not eligible for Medicaid, but who is 80
130	130	eligible for the Florida Kidcare program, may obtain health 81
131	131	benefits coverage under any of the other components listed in s. 82
132	132	409.813 if such coverage is a pproved and available in the county 83
133	133	in which the child resides. 84
134	134	(3) A Title XXI-funded child who is eligible for the 85
135	135	Florida Kidcare program who is a child with special health care 86
136	136	needs, as determined through a medical or behavioral screening 87
137	137	instrument, is eligible for health benefits coverage from and 88
138	138	shall be assigned to and may opt out of the Children's Medical 89
139	139	Services Network. 90
140	140	(4) The following children are not eligible to receive 91
141	141	Title XXI-funded premium assistance for health benefits coverage 92
142	142	under the Florida Kidcare program, except under Medicaid if the 93
143	143	child would have been eligible for Medicaid under s. 409.903 or 94
144	144	s. 409.904 as of June 1, 1997: 95
145	145	(a) A child who is covered under a family member's group 96
146	146	health benefit plan or under other priv ate or employer health 97
147	147	insurance coverage, if the cost of the child's participation is 98
148	148	not greater than 5 percent of the family's income. If a child is 99
149	149	otherwise eligible for a subsidy under the Florida Kidcare 100
150	150
151	151	HB 419 2022
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155	155	CODING: Words stricken are deletions; words underlined are additions.
156	156	hb0419-00
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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	program and the cost of the child's participa tion in the family 101
163	163	member's health insurance benefit plan is greater than 5 percent 102
164	164	of the family's income, the child may enroll in the appropriate 103
165	165	subsidized Kidcare program. 104
166	166	(b) A child who is seeking premium assistance for the 105
167	167	Florida Kidcare program through employer-sponsored group 106
168	168	coverage, if the child has been covered by the same employer's 107
169	169	group coverage during the 60 days before the family submitted an 108
170	170	application for determination of eligibility under the program. 109
171	171	(c) A child who is an alien b ut who does not meet the 110
172	172	definition of a lawfully residing child. This paragraph does not 111
173	173	extend eligibility for the Florida Kidcare program to an 112
174	174	undocumented immigrant. 113
175	175	(d) A child who is an inmate of a public institution or a 114
176	176	patient in an institution for mental diseases. 115
177	177	(e) A child who is otherwise eligible for premium 116
178	178	assistance for the Florida Kidcare program and has had his or 117
179	179	her coverage in an employer -sponsored or private health benefit 118
180	180	plan voluntarily canceled in the last 60 days, except th ose 119
181	181	children whose coverage was voluntarily canceled for good cause, 120
182	182	including, but not limited to, the following circumstances: 121
183	183	1. The cost of participation in an employer -sponsored 122
184	184	health benefit plan is greater than 5 percent of the family's 123
185	185	income; 124
186	186	2. The parent lost a job that provided an employer -125
187	187
188	188	HB 419 2022
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190	190
191	191
192	192	CODING: Words stricken are deletions; words underlined are additions.
193	193	hb0419-00
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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	sponsored health benefit plan for children; 126
200	200	3. The parent who had health benefits coverage for the 127
201	201	child is deceased; 128
202	202	4. The child has a medical condition that, without medical 129
203	203	care, would cause serio us disability, loss of function, or 130
204	204	death; 131
205	205	5. The employer of the parent canceled health benefits 132
206	206	coverage for children; 133
207	207	6. The child's health benefits coverage ended because the 134
208	208	child reached the maximum lifetime coverage amount; 135
209	209	7. The child has ex hausted coverage under a COBRA 136
210	210	continuation provision; 137
211	211	8. The health benefits coverage does not cover the child's 138
212	212	health care needs; or 139
213	213	9. Domestic violence led to loss of coverage. 140
214	214	(5) A child who is otherwise eligible for the Florida 141
215	215	Kidcare program and who has a preexisting condition that 142
216	216	prevents coverage under another insurance plan as described in 143
217	217	paragraph (4)(a) which would have disqualified the child for the 144
218	218	Florida Kidcare program if the child were able to enroll in the 145
219	219	plan is eligible for Florida Kidcare coverage when enrollment is 146
220	220	possible. 147
221	221	(6) A child whose family income is above 400 200 percent 148
222	222	of the federal poverty level or a child who is excluded under 149
223	223	the provisions of subsection (4) may participate in the Florida 150
224	224
225	225	HB 419 2022
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229	229	CODING: Words stricken are deletions; words underlined are additions.
230	230	hb0419-00
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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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234	234
235	235
236	236	Kidcare program as provided in s. 409.8132 or, if the child is 151
237	237	ineligible for Medikids by reason of age, in the Florida Healthy 152
238	238	Kids program, subject to the following: 153
239	239	(a) The family is not eligible for premium assistance 154
240	240	payments and must pay the full cost of the premiu m, including 155
241	241	any administrative costs. 156
242	242	(b) The board of directors of the Florida Healthy Kids 157
243	243	Corporation may offer a reduced benefit package to these 158
244	244	children in order to limit program costs for such families. 159
245	245	(7) Once a child is enrolled in the Flori da Kidcare 160
246	246	program, the child is eligible for coverage for 12 months 161
247	247	without a redetermination or reverification of eligibility, if 162
248	248	the family continues to pay the applicable premium. Eligibility 163
249	249	for program components funded through Title XXI of the Socia l 164
250	250	Security Act terminates when a child attains the age of 19. A 165
251	251	child who has not attained the age of 5 and who has been 166
252	252	determined eligible for the Medicaid program is eligible for 167
253	253	coverage for 12 months without a redetermination or 168
254	254	reverification of elig ibility. 169
255	255	(8) When determining or reviewing a child's eligibility 170
256	256	under the Florida Kidcare program, the applicant shall be 171
257	257	provided with reasonable notice of changes in eligibility which 172
258	258	may affect enrollment in one or more of the program components. 173
259	259	If a transition from one program component to another is 174
260	260	authorized, there shall be cooperation between the program 175
261	261
262	262	HB 419 2022
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266	266	CODING: Words stricken are deletions; words underlined are additions.
267	267	hb0419-00
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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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271	271
272	272
273	273	components and the affected family which promotes continuity of 176
274	274	health care coverage. Any authorized transfers must be managed 177
275	275	within the program's overall appropriated or authorized levels 178
276	276	of funding. Each component of the program shall establish a 179
277	277	reserve to ensure that transfers between components will be 180
278	278	accomplished within current year appropriations. These reserves 181
279	279	shall be reviewed by each convening of the Social Services 182
280	280	Estimating Conference to determine the adequacy of such reserves 183
281	281	to meet actual experience. 184
282	282	(9) In determining the eligibility of a child, an assets 185
283	283	test is not required. Each applicant shall provide documentation 186
284	284	during the application process and the redetermination process, 187
285	285	including, but not limited to, the following: 188
286	286	(a) Proof of family income, which must be verified 189
287	287	electronically to determine financial eligibility for the 190
288	288	Florida Kidcare program. Written document ation, which may 191
289	289	include wages and earnings statements or pay stubs, W -2 forms, 192
290	290	or a copy of the applicant's most recent federal income tax 193
291	291	return, is required only if the electronic verification is not 194
292	292	available or does not substantiate the applicant's in come. 195
293	293	(b) A statement from all applicable, employed family 196
294	294	members that: 197
295	295	1. Their employers do not sponsor health benefit plans for 198
296	296	employees; 199
297	297	2. The potential enrollee is not covered by an employer -200
298	298
299	299	HB 419 2022
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303	303	CODING: Words stricken are deletions; words underlined are additions.
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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	sponsored health benefit plan; or 201
311	311	3. The potential enrollee is covered by an employer -202
312	312	sponsored health benefit plan and the cost of the employer -203
313	313	sponsored health benefit plan is more than 5 percent of the 204
314	314	family's income. 205
315	315	(c) To enroll in the Children's Medical Services Network, 206
316	316	a completed application , including a clinical screening. 207
317	317	(10) Subject to paragraph (4)(a), the Florida Kidcare 208
318	318	program shall withhold benefits from an enrollee if the program 209
319	319	obtains evidence that the enrollee is no longer eligible, 210
320	320	submitted incorrect or fraudulent informatio n in order to 211
321	321	establish eligibility, or failed to provide verification of 212
322	322	eligibility. The applicant or enrollee shall be notified that 213
323	323	because of such evidence program benefits will be withheld 214
324	324	unless the applicant or enrollee contacts a designated 215
325	325	representative of the program by a specified date, which must be 216
326	326	within 10 working days after the date of notice, to discuss and 217
327	327	resolve the matter. The program shall make every effort to 218
328	328	resolve the matter within a timeframe that will not cause 219
329	329	benefits to be withheld from an eligible enrollee. 220
330	330	(11) The following individuals may be subject to 221
331	331	prosecution in accordance with s. 414.39: 222
332	332	(a) An applicant obtaining or attempting to obtain 223
333	333	benefits for a potential enrollee under the Florida Kidcare 224
334	334	program when the applicant knows or should have known the 225
335	335
336	336	HB 419 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	potential enrollee does not qualify for the Florida Kidcare 226
348	348	program. 227
349	349	(b) An individual who assists an applicant in obtaining or 228
350	350	attempting to obtain benefits for a potential enrollee under the 229
351	351	Florida Kidcare program when the individual knows or should have 230
352	352	known the potential enrollee does not qualify for the Florida 231
353	353	Kidcare program. 232
354	354	Section 4. Paragraph (b) of subsection (2) of section 233
355	355	624.91, Florida Statutes, is amended to read: 234
356	356	624.91 The Florida Healt hy Kids Corporation Act. — 235
357	357	(2) LEGISLATIVE INTENT. — 236
358	358	(b) It is the intent of the Legislature that the Florida 237
359	359	Healthy Kids Corporation serve as one of several providers of 238
360	360	services to children eligible for medical assistance under Title 239
361	361	XXI of the Social Security Act. Although the corporation may 240
362	362	serve other children, the Legislature intends the primary 241
363	363	recipients of services provided through the corporation be 242
364	364	school-age children with a family income equal to or below 400 243
365	365	200 percent of the federal pover ty level, who do not qualify for 244
366	366	Medicaid. It is also the intent of the Legislature that state 245
367	367	and local government Florida Healthy Kids funds be used to 246
368	368	continue coverage, subject to specific appropriations in the 247
369	369	General Appropriations Act, to children n ot eligible for federal 248
370	370	matching funds under Title XXI. 249
371	371	Section 5. (1) The amendments to ss. 409.8132, 409.814, 250
372	372
373	373	HB 419 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	and 624.91, Florida Statutes, made by this act are subject to 251
385	385	federal approval through a waiver or state plan amendment and 252
386	386	expire July 1, 2025. Upon expiration, the text of ss. 409.8132, 253
387	387	409.814, and 624.91, Florida Statutes, shall revert to that in 254
388	388	existence on June 30, 2022; however: 255
389	389	(a) This act shall remain in effect for any child enrolled 256
390	390	in the Title XXI-funded Florida Kidcare progra m on July 1, 2025, 257
391	391	until such time as the child ceases enrollment in the Title XXI -258
392	392	funded Florida Kidcare program. 259
393	393	(b) Any amendments to the text of ss. 409.8132, 409.814, 260
394	394	and 624.91, Florida Statutes, enacted other than by this act 261
395	395	shall be preserved an d continue to operate to the extent that 262
396	396	such amendments are not dependent upon the portions of text 263
397	397	which expire pursuant to this section. 264
398	398	(2) The Agency for Health Care Administration shall notify 265
399	399	the Division of Law Revision within 10 days after recei ving 266
400	400	federal approval through a waiver or state plan amendment. 267
401	401	Section 6. This act shall take effect July 1, 2022. 268