Florida 2022 Regular Session

Florida House Bill H1181 Compare Versions

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

Old	New	Differences
1	1
2	2
3	3	HB 1181 2022
4	4
5	5
6	6
7	7	CODING: Words stricken are deletions; words underlined are additions.
8	8	hb1181-00
9	9	Page 1 of 19
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
11	11
12	12
13	13
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; amending s. 409.816, F.S.; requiring that 10
24	24	premiums for certain enrollees under the program be 11
25	25	based on a tiered system of uniform premiums; amending 12
26	26	s. 624.91, F.S.; conforming a provision to changes 13
27	27	made by the act; providing effective dates. 14
28	28	15
29	29	WHEREAS, as families progress up the economic ladder they 16
30	30	are adversely affected by the fiscal cliff, disincentivizing 17
31	31	upward mobility, and 18
32	32	WHEREAS, some of these families have lost access to Florida 19
33	33	Healthy Kids, which subsidizes children's health insurance, 20
34	34	creating a health care coverage gap, and 21
35	35	WHEREAS, the Legislature seeks to remove these barriers and 22
36	36	intends to facilitate a glide path for families to achieve 23
37	37	economic self-sufficiency and access the necessary health care 24
38	38	services for their children, NOW, THEREFOR E, 25
39	39
40	40	HB 1181 2022
41	41
42	42
43	43
44	44	CODING: Words stricken are deletions; words underlined are additions.
45	45	hb1181-00
46	46	Page 2 of 19
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	26
52	52	Be It Enacted by the Legislature of the State of Florida: 27
53	53	28
54	54	Section 1. Paragraph (a) of subsection (6) of section 29
55	55	409.8132, Florida Statutes, is amended to read: 30
56	56	409.8132 Medikids program component. — 31
57	57	(6) ELIGIBILITY.— 32
58	58	(a) A child who has att ained the age of 1 year but who is 33
59	59	under the age of 5 years is eligible to enroll in the Medikids 34
60	60	program component of the Florida Kidcare program, if the child 35
61	61	is a member of a family that has a family income which exceeds 36
62	62	the Medicaid applicable income l evel as specified in s. 409.903, 37
63	63	but which is equal to or below 250 200 percent of the current 38
64	64	federal poverty level. In determining the eligibility of such a 39
65	65	child, an assets test is not required. A child who is eligible 40
66	66	for Medikids may elect to enroll i n Florida Healthy Kids 41
67	67	coverage or employer -sponsored group coverage. However, a child 42
68	68	who is eligible for Medikids may participate in the Florida 43
69	69	Healthy Kids program only if the child has a sibling 44
70	70	participating in the Florida Healthy Kids program and th e 45
71	71	child's county of residence permits such enrollment. 46
72	72	Section 2. Effective July 1, 2023, paragraph (a) of 47
73	73	subsection (6) of section 409.8132, Florida Statutes, as amended 48
74	74	by this act, is amended to read: 49
75	75	409.8132 Medikids program component. — 50
76	76
77	77	HB 1181 2022
78	78
79	79
80	80
81	81	CODING: Words stricken are deletions; words underlined are additions.
82	82	hb1181-00
83	83	Page 3 of 19
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
85	85
86	86
87	87
88	88	(6) ELIGIBILITY.— 51
89	89	(a) A child who has attained the age of 1 year but who is 52
90	90	under the age of 5 years is eligible to enroll in the Medikids 53
91	91	program component of the Florida Kidcare program, if the child 54
92	92	is a member of a family that has a family income which ex ceeds 55
93	93	the Medicaid applicable income level as specified in s. 409.903, 56
94	94	but which is equal to or below 300 250 percent of the current 57
95	95	federal poverty level. In determining the eligibility of such a 58
96	96	child, an assets test is not required. A child who is eligi ble 59
97	97	for Medikids may elect to enroll in Florida Healthy Kids 60
98	98	coverage or employer -sponsored group coverage. However, a child 61
99	99	who is eligible for Medikids may participate in the Florida 62
100	100	Healthy Kids program only if the child has a sibling 63
101	101	participating in the Florida Healthy Kids program and the 64
102	102	child's county of residence permits such enrollment. 65
103	103	Section 3. Section 409.814, Florida Statutes, is amended 66
104	104	to read: 67
105	105	409.814 Eligibility. —A child who has not reached 19 years 68
106	106	of age whose family income is equal to or below 250 200 percent 69
107	107	of the federal poverty level is eligible for the Florida Kidcare 70
108	108	program as provided in this section. If an enrolled individual 71
109	109	is determined to be ineligible for coverage, he or she must be 72
110	110	immediately disenrolled from the respective Florida Kidcare 73
111	111	program component. 74
112	112	(1) A child who is eligible for Medicaid coverage under s. 75
113	113
114	114	HB 1181 2022
115	115
116	116
117	117
118	118	CODING: Words stricken are deletions; words underlined are additions.
119	119	hb1181-00
120	120	Page 4 of 19
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
122	122
123	123
124	124
125	125	409.903 or s. 409.904 must be enrolled in Medicaid and is not 76
126	126	eligible to receive health benefits under any other health 77
127	127	benefits coverage authorized under the Florida Kidcare program. 78
128	128	(2) A child who is not eligible for Medicaid, but who is 79
129	129	eligible for the Florida Kidcare program, may obtain health 80
130	130	benefits coverage under any of the other components listed in s. 81
131	131	409.813 if such coverage is approved and available in the county 82
132	132	in which the child resides. 83
133	133	(3) A Title XXI-funded child who is eligible for the 84
134	134	Florida Kidcare program who is a child with special h ealth care 85
135	135	needs, as determined through a medical or behavioral screening 86
136	136	instrument, is eligible for health benefits coverage from and 87
137	137	shall be assigned to and may opt out of the Children's Medical 88
138	138	Services Network. 89
139	139	(4) The following children are not el igible to receive 90
140	140	Title XXI-funded premium assistance for health benefits coverage 91
141	141	under the Florida Kidcare program, except under Medicaid if the 92
142	142	child would have been eligible for Medicaid under s. 409.903 or 93
143	143	s. 409.904 as of June 1, 1997: 94
144	144	(a) A child who is covered under a family member's group 95
145	145	health benefit plan or under other private or employer health 96
146	146	insurance coverage, if the cost of the child's participation is 97
147	147	not greater than 5 percent of the family's income. If a child is 98
148	148	otherwise eligible f or a subsidy under the Florida Kidcare 99
149	149	program and the cost of the child's participation in the family 100
150	150
151	151	HB 1181 2022
152	152
153	153
154	154
155	155	CODING: Words stricken are deletions; words underlined are additions.
156	156	hb1181-00
157	157	Page 5 of 19
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	member's health insurance benefit plan is greater than 5 percent 101
163	163	of the family's income, the child may enroll in the appropriate 102
164	164	subsidized Kidcare progr am. 103
165	165	(b) A child who is seeking premium assistance for the 104
166	166	Florida Kidcare program through employer -sponsored group 105
167	167	coverage, if the child has been covered by the same employer's 106
168	168	group coverage during the 60 days before the family submitted an 107
169	169	application for determination of eligibility under the program. 108
170	170	(c) A child who is an alien but who does not meet the 109
171	171	definition of a lawfully residing child. This paragraph does not 110
172	172	extend eligibility for the Florida Kidcare program to an 111
173	173	undocumented immigrant. 112
174	174	(d) A child who is an inmate of a public institution or a 113
175	175	patient in an institution for mental diseases. 114
176	176	(e) A child who is otherwise eligible for premium 115
177	177	assistance for the Florida Kidcare program and has had his or 116
178	178	her coverage in an employer -sponsored or private health benefit 117
179	179	plan voluntarily canceled in the last 60 days, except those 118
180	180	children whose coverage was voluntarily canceled for good cause, 119
181	181	including, but not limited to, the following circumstances: 120
182	182	1. The cost of participation in an employ er-sponsored 121
183	183	health benefit plan is greater than 5 percent of the family's 122
184	184	income; 123
185	185	2. The parent lost a job that provided an employer -124
186	186	sponsored health benefit plan for children; 125
187	187
188	188	HB 1181 2022
189	189
190	190
191	191
192	192	CODING: Words stricken are deletions; words underlined are additions.
193	193	hb1181-00
194	194	Page 6 of 19
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
196	196
197	197
198	198
199	199	3. The parent who had health benefits coverage for the 126
200	200	child is deceased; 127
201	201	4. The child has a medical condition that, without medical 128
202	202	care, would cause serious disability, loss of function, or 129
203	203	death; 130
204	204	5. The employer of the parent canceled health benefits 131
205	205	coverage for children; 132
206	206	6. The child's health benefits coverage ended b ecause the 133
207	207	child reached the maximum lifetime coverage amount; 134
208	208	7. The child has exhausted coverage under a COBRA 135
209	209	continuation provision; 136
210	210	8. The health benefits coverage does not cover the child's 137
211	211	health care needs; or 138
212	212	9. Domestic violence led to loss of coverage. 139
213	213	(5) A child who is otherwise eligible for the Florida 140
214	214	Kidcare program and who has a preexisting condition that 141
215	215	prevents coverage under another insurance plan as described in 142
216	216	paragraph (4)(a) which would have disqualified the child for the 143
217	217	Florida Kidcare program if the child were able to enroll in the 144
218	218	plan is eligible for Florida Kidcare coverage when enrollment is 145
219	219	possible. 146
220	220	(6) A child whose family income is above 250 200 percent 147
221	221	of the federal poverty level or a child who is excluded und er 148
222	222	the provisions of subsection (4) may participate in the Florida 149
223	223	Kidcare program as provided in s. 409.8132 or, if the child is 150
224	224
225	225	HB 1181 2022
226	226
227	227
228	228
229	229	CODING: Words stricken are deletions; words underlined are additions.
230	230	hb1181-00
231	231	Page 7 of 19
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
233	233
234	234
235	235
236	236	ineligible for Medikids by reason of age, in the Florida Healthy 151
237	237	Kids program, subject to the following: 152
238	238	(a) The family is n ot eligible for premium assistance 153
239	239	payments and must pay the full cost of the premium, including 154
240	240	any administrative costs. 155
241	241	(b) The board of directors of the Florida Healthy Kids 156
242	242	Corporation may offer a reduced benefit package to these 157
243	243	children in order to limit program costs for such families. 158
244	244	(7) Once a child is enrolled in the Florida Kidcare 159
245	245	program, the child is eligible for coverage for 12 months 160
246	246	without a redetermination or reverification of eligibility, if 161
247	247	the family continues to pay the applicab le premium. Eligibility 162
248	248	for program components funded through Title XXI of the Social 163
249	249	Security Act terminates when a child attains the age of 19. A 164
250	250	child who has not attained the age of 5 and who has been 165
251	251	determined eligible for the Medicaid program is eli gible for 166
252	252	coverage for 12 months without a redetermination or 167
253	253	reverification of eligibility. 168
254	254	(8) When determining or reviewing a child's eligibility 169
255	255	under the Florida Kidcare program, the applicant shall be 170
256	256	provided with reasonable notice of changes in e ligibility which 171
257	257	may affect enrollment in one or more of the program components. 172
258	258	If a transition from one program component to another is 173
259	259	authorized, there shall be cooperation between the program 174
260	260	components and the affected family which promotes continuit y of 175
261	261
262	262	HB 1181 2022
263	263
264	264
265	265
266	266	CODING: Words stricken are deletions; words underlined are additions.
267	267	hb1181-00
268	268	Page 8 of 19
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
270	270
271	271
272	272
273	273	health care coverage. Any authorized transfers must be managed 176
274	274	within the program's overall appropriated or authorized levels 177
275	275	of funding. Each component of the program shall establish a 178
276	276	reserve to ensure that transfers between components will be 179
277	277	accomplished within current year appropriations. These reserves 180
278	278	shall be reviewed by each convening of the Social Services 181
279	279	Estimating Conference to determine the adequacy of such reserves 182
280	280	to meet actual experience. 183
281	281	(9) In determining the eligibility of a chil d, an assets 184
282	282	test is not required. If eligibility for the Florida Kidcare 185
283	283	program cannot be verified using reliable data sources in 186
284	284	accordance with federal requirements, each applicant shall 187
285	285	provide documentation during the application process and the 188
286	286	redetermination process, including, but not limited to, the 189
287	287	following: 190
288	288	(a) Proof of family income, which must be verified 191
289	289	electronically to determine financial eligibility for the 192
290	290	Florida Kidcare program. Written documentation, which may 193
291	291	include wages and ea rnings statements or pay stubs, W -2 forms, 194
292	292	or a copy of the applicant's most recent federal income tax 195
293	293	return, is required only if the electronic verification is not 196
294	294	available or does not substantiate the applicant's income. 197
295	295	(b) A statement from all appl icable, employed family 198
296	296	members that: 199
297	297	1. Their employers do not sponsor health benefit plans for 200
298	298
299	299	HB 1181 2022
300	300
301	301
302	302
303	303	CODING: Words stricken are deletions; words underlined are additions.
304	304	hb1181-00
305	305	Page 9 of 19
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
307	307
308	308
309	309
310	310	employees; 201
311	311	2. The potential enrollee is not covered by an employer -202
312	312	sponsored health benefit plan; or 203
313	313	3. The potential enrollee is covered by an employer-204
314	314	sponsored health benefit plan and the cost of the employer -205
315	315	sponsored health benefit plan is more than 5 percent of the 206
316	316	family's income. 207
317	317	(c) To enroll in the Children's Medical Services Network, 208
318	318	a completed application, including a clinical scree ning. 209
319	319	(10) Subject to paragraph (4)(a), the Florida Kidcare 210
320	320	program shall withhold benefits from an enrollee if the program 211
321	321	obtains evidence that the enrollee is no longer eligible, 212
322	322	submitted incorrect or fraudulent information in order to 213
323	323	establish eligibility, or failed to provide verification of 214
324	324	eligibility. The applicant or enrollee shall be notified that 215
325	325	because of such evidence program benefits will be withheld 216
326	326	unless the applicant or enrollee contacts a designated 217
327	327	representative of the program by a specified date, which must be 218
328	328	within 10 working days after the date of notice, to discuss and 219
329	329	resolve the matter. The program shall make every effort to 220
330	330	resolve the matter within a timeframe that will not cause 221
331	331	benefits to be withheld from an eligible enr ollee. 222
332	332	(11) The following individuals may be subject to 223
333	333	prosecution in accordance with s. 414.39: 224
334	334	(a) An applicant obtaining or attempting to obtain 225
335	335
336	336	HB 1181 2022
337	337
338	338
339	339
340	340	CODING: Words stricken are deletions; words underlined are additions.
341	341	hb1181-00
342	342	Page 10 of 19
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
344	344
345	345
346	346
347	347	benefits for a potential enrollee under the Florida Kidcare 226
348	348	program when the applicant knows or should have known the 227
349	349	potential enrollee does not qualify for the Florida Kidcare 228
350	350	program. 229
351	351	(b) An individual who assists an applicant in obtaining or 230
352	352	attempting to obtain benefits for a potential enrollee under the 231
353	353	Florida Kidcare program when the individual kn ows or should have 232
354	354	known the potential enrollee does not qualify for the Florida 233
355	355	Kidcare program. 234
356	356	Section 4. Effective July 1, 2023, section 409.814, 235
357	357	Florida Statutes, as amended by this act, is amended to read: 236
358	358	409.814 Eligibility. —A child who has not reached 19 years 237
359	359	of age whose family income is equal to or below 300 250 percent 238
360	360	of the federal poverty level is eligible for the Florida Kidcare 239
361	361	program as provided in this section. If an enrolled individual 240
362	362	is determined to be ineligible for coverage, he or she must be 241
363	363	immediately disenrolled from the respective Florida Kidcare 242
364	364	program component. 243
365	365	(1) A child who is eligible for Medicaid coverage under s. 244
366	366	409.903 or s. 409.904 must be enrolled in Medicaid and is not 245
367	367	eligible to receive health benefits under any other health 246
368	368	benefits coverage authorized under the Florida Kidcare program. 247
369	369	(2) A child who is not eligible for Medicaid, but who is 248
370	370	eligible for the Florida Kidcare program, may obtain health 249
371	371	benefits coverage under any of the other componen ts listed in s. 250
372	372
373	373	HB 1181 2022
374	374
375	375
376	376
377	377	CODING: Words stricken are deletions; words underlined are additions.
378	378	hb1181-00
379	379	Page 11 of 19
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
381	381
382	382
383	383
384	384	409.813 if such coverage is approved and available in the county 251
385	385	in which the child resides. 252
386	386	(3) A Title XXI-funded child who is eligible for the 253
387	387	Florida Kidcare program who is a child with special health care 254
388	388	needs, as determined through a medical or behavioral screening 255
389	389	instrument, is eligible for health benefits coverage from and 256
390	390	shall be assigned to and may opt out of the Children's Medical 257
391	391	Services Network. 258
392	392	(4) The following children are not eligible to receive 259
393	393	Title XXI-funded premium assistance for health benefits coverage 260
394	394	under the Florida Kidcare program, except under Medicaid if the 261
395	395	child would have been eligible for Medicaid under s. 409.903 or 262
396	396	s. 409.904 as of June 1, 1997: 263
397	397	(a) A child who is covered under a family member's group 264
398	398	health benefit plan or under other private or employer health 265
399	399	insurance coverage, if the cost of the child's participation is 266
400	400	not greater than 5 percent of the family's income. If a child is 267
401	401	otherwise eligible for a subsidy under the Florida Kidcare 268
402	402	program and the cost of the child's participation in the family 269
403	403	member's health insurance benefit plan is greater than 5 percent 270
404	404	of the family's income, the child may enroll in the appropriate 271
405	405	subsidized Kidcare program. 272
406	406	(b) A child who is seeking premiu m assistance for the 273
407	407	Florida Kidcare program through employer -sponsored group 274
408	408	coverage, if the child has been covered by the same employer's 275
409	409
410	410	HB 1181 2022
411	411
412	412
413	413
414	414	CODING: Words stricken are deletions; words underlined are additions.
415	415	hb1181-00
416	416	Page 12 of 19
417	417	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
418	418
419	419
420	420
421	421	group coverage during the 60 days before the family submitted an 276
422	422	application for determination of eligibility under the program. 277
423	423	(c) A child who is an alien but who does not meet the 278
424	424	definition of a lawfully residing child. This paragraph does not 279
425	425	extend eligibility for the Florida Kidcare program to an 280
426	426	undocumented immigrant. 281
427	427	(d) A child who is an inmate of a publ ic institution or a 282
428	428	patient in an institution for mental diseases. 283
429	429	(e) A child who is otherwise eligible for premium 284
430	430	assistance for the Florida Kidcare program and has had his or 285
431	431	her coverage in an employer -sponsored or private health benefit 286
432	432	plan voluntarily canceled in the last 60 days, except those 287
433	433	children whose coverage was voluntarily canceled for good cause, 288
434	434	including, but not limited to, the following circumstances: 289
435	435	1. The cost of participation in an employer -sponsored 290
436	436	health benefit plan is gre ater than 5 percent of the family's 291
437	437	income; 292
438	438	2. The parent lost a job that provided an employer -293
439	439	sponsored health benefit plan for children; 294
440	440	3. The parent who had health benefits coverage for the 295
441	441	child is deceased; 296
442	442	4. The child has a medical condition that, without medical 297
443	443	care, would cause serious disability, loss of function, or 298
444	444	death; 299
445	445	5. The employer of the parent canceled health benefits 300
446	446
447	447	HB 1181 2022
448	448
449	449
450	450
451	451	CODING: Words stricken are deletions; words underlined are additions.
452	452	hb1181-00
453	453	Page 13 of 19
454	454	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
455	455
456	456
457	457
458	458	coverage for children; 301
459	459	6. The child's health benefits coverage ended because the 302
460	460	child reached the maximum li fetime coverage amount; 303
461	461	7. The child has exhausted coverage under a COBRA 304
462	462	continuation provision; 305
463	463	8. The health benefits coverage does not cover the child's 306
464	464	health care needs; or 307
465	465	9. Domestic violence led to loss of coverage. 308
466	466	(5) A child who is othe rwise eligible for the Florida 309
467	467	Kidcare program and who has a preexisting condition that 310
468	468	prevents coverage under another insurance plan as described in 311
469	469	paragraph (4)(a) which would have disqualified the child for the 312
470	470	Florida Kidcare program if the child wer e able to enroll in the 313
471	471	plan is eligible for Florida Kidcare coverage when enrollment is 314
472	472	possible. 315
473	473	(6) A child whose family income is above 300 250 percent 316
474	474	of the federal poverty level or a child who is excluded under 317
475	475	the provisions of subsection (4) may participate in the Florida 318
476	476	Kidcare program as provided in s. 409.8132 or, if the child is 319
477	477	ineligible for Medikids by reason of age, in the Florida H ealthy 320
478	478	Kids program, subject to the following: 321
479	479	(a) The family is not eligible for premium assistance 322
480	480	payments and must pay the full cost of the premium, including 323
481	481	any administrative costs. 324
482	482	(b) The board of directors of the Florida Healthy Kids 325
483	483
484	484	HB 1181 2022
485	485
486	486
487	487
488	488	CODING: Words stricken are deletions; words underlined are additions.
489	489	hb1181-00
490	490	Page 14 of 19
491	491	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
492	492
493	493
494	494
495	495	Corporation may offer a reduced benefit package to these 326
496	496	children in order to limit program costs for such families. 327
497	497	(7) Once a child is enrolled in the Florida Kidcare 328
498	498	program, the child is eligible for coverage for 12 months 329
499	499	without a redetermination or reveri fication of eligibility, if 330
500	500	the family continues to pay the applicable premium. Eligibility 331
501	501	for program components funded through Title XXI of the Social 332
502	502	Security Act terminates when a child attains the age of 19. A 333
503	503	child who has not attained the age of 5 and who has been 334
504	504	determined eligible for the Medicaid program is eligible for 335
505	505	coverage for 12 months without a redetermination or 336
506	506	reverification of eligibility. 337
507	507	(8) When determining or reviewing a child's eligibility 338
508	508	under the Florida Kidcare program, th e applicant shall be 339
509	509	provided with reasonable notice of changes in eligibility which 340
510	510	may affect enrollment in one or more of the program components. 341
511	511	If a transition from one program component to another is 342
512	512	authorized, there shall be cooperation between the program 343
513	513	components and the affected family which promotes continuity of 344
514	514	health care coverage. Any authorized transfers must be managed 345
515	515	within the program's overall appropriated or authorized levels 346
516	516	of funding. Each component of the program shall establish a 347
517	517	reserve to ensure that transfers between components will be 348
518	518	accomplished within current year appropriations. These reserves 349
519	519	shall be reviewed by each convening of the Social Services 350
520	520
521	521	HB 1181 2022
522	522
523	523
524	524
525	525	CODING: Words stricken are deletions; words underlined are additions.
526	526	hb1181-00
527	527	Page 15 of 19
528	528	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
529	529
530	530
531	531
532	532	Estimating Conference to determine the adequacy of such reserves 351
533	533	to meet actual experience. 352
534	534	(9) In determining the eligibility of a child, an assets 353
535	535	test is not required. If eligibility for the Florida Kidcare 354
536	536	program cannot be verified using reliable data sources in 355
537	537	accordance with federal requirements, each applicant sha ll 356
538	538	provide documentation during the application process and the 357
539	539	redetermination process, including, but not limited to, the 358
540	540	following: 359
541	541	(a) Proof of family income, which must be verified 360
542	542	electronically to determine financial eligibility for the 361
543	543	Florida Kidcare program. Written documentation, which may 362
544	544	include wages and earnings statements or pay stubs, W -2 forms, 363
545	545	or a copy of the applicant's most recent federal income tax 364
546	546	return, is required only if the electronic verification is not 365
547	547	available or does not substantiate the applicant's income. 366
548	548	(b) A statement from all applicable, employed family 367
549	549	members that: 368
550	550	1. Their employers do not sponsor health benefit plans for 369
551	551	employees; 370
552	552	2. The potential enrollee is not covered by an employer -371
553	553	sponsored health ben efit plan; or 372
554	554	3. The potential enrollee is covered by an employer -373
555	555	sponsored health benefit plan and the cost of the employer -374
556	556	sponsored health benefit plan is more than 5 percent of the 375
557	557
558	558	HB 1181 2022
559	559
560	560
561	561
562	562	CODING: Words stricken are deletions; words underlined are additions.
563	563	hb1181-00
564	564	Page 16 of 19
565	565	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
566	566
567	567
568	568
569	569	family's income. 376
570	570	(c) To enroll in the Children's Medical Services N etwork, 377
571	571	a completed application, including a clinical screening. 378
572	572	(10) Subject to paragraph (4)(a), the Florida Kidcare 379
573	573	program shall withhold benefits from an enrollee if the program 380
574	574	obtains evidence that the enrollee is no longer eligible, 381
575	575	submitted incorrect or fraudulent information in order to 382
576	576	establish eligibility, or failed to provide verification of 383
577	577	eligibility. The applicant or enrollee shall be notified that 384
578	578	because of such evidence program benefits will be withheld 385
579	579	unless the applicant or enroll ee contacts a designated 386
580	580	representative of the program by a specified date, which must be 387
581	581	within 10 working days after the date of notice, to discuss and 388
582	582	resolve the matter. The program shall make every effort to 389
583	583	resolve the matter within a timeframe that will not cause 390
584	584	benefits to be withheld from an eligible enrollee. 391
585	585	(11) The following individuals may be subject to 392
586	586	prosecution in accordance with s. 414.39: 393
587	587	(a) An applicant obtaining or attempting to obtain 394
588	588	benefits for a potential enrollee under the Florida Kidcare 395
589	589	program when the applicant knows or should have known the 396
590	590	potential enrollee does not qualify for the Florida Kidcare 397
591	591	program. 398
592	592	(b) An individual who assists an applicant in obtaining or 399
593	593	attempting to obtain benefits for a potential enroll ee under the 400
594	594
595	595	HB 1181 2022
596	596
597	597
598	598
599	599	CODING: Words stricken are deletions; words underlined are additions.
600	600	hb1181-00
601	601	Page 17 of 19
602	602	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
603	603
604	604
605	605
606	606	Florida Kidcare program when the individual knows or should have 401
607	607	known the potential enrollee does not qualify for the Florida 402
608	608	Kidcare program. 403
609	609	Section 5. Subsection (3) of section 409.816, Florida 404
610	610	Statutes, is amended to read: 405
611	611	409.816 Limitations on premiums and cost sharing. —The 406
612	612	following limitations on premiums and cost sharing are 407
613	613	established for the program. 408
614	614	(3) Enrollees in families with a family income above 150 409
615	615	percent of the federal poverty level who are not receiving 410
616	616	coverage under the Medicaid program or who are not eligible 411
617	617	under s. 409.814(6) may be required to pay enrollment fees, 412
618	618	premiums, copayments, deductibles, coinsurance, or similar 413
619	619	charges on a sliding scale related to income, except that the 414
620	620	total annual aggregate c ost sharing with respect to all children 415
621	621	in a family may not exceed 5 percent of the family's income. 416
622	622	However, copayments, deductibles, coinsurance, or similar 417
623	623	charges may not be imposed for preventive services, including 418
624	624	well-baby and well-child care, age-appropriate immunizations, 419
625	625	and routine hearing and vision screenings. Premiums for 420
626	626	enrollees paying enrollment fees, premiums, copayments, 421
627	627	deductibles, coinsurance, or similar charges as provided in this 422
628	628	subsection shall be based on at least three but no more than 423
629	629	five tiers of uniform premiums that increase with each tier as a 424
630	630	percentage of the applicable threshold amount of the federal 425
631	631
632	632	HB 1181 2022
633	633
634	634
635	635
636	636	CODING: Words stricken are deletions; words underlined are additions.
637	637	hb1181-00
638	638	Page 18 of 19
639	639	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
640	640
641	641
642	642
643	643	poverty level, by tier. 426
644	644	Section 6. Paragraph (b) of subsection (2) of section 427
645	645	624.91, Florida Statutes, is amended t o read: 428
646	646	624.91 The Florida Healthy Kids Corporation Act. — 429
647	647	(2) LEGISLATIVE INTENT. — 430
648	648	(b) It is the intent of the Legislature that the Florida 431
649	649	Healthy Kids Corporation serve as one of several providers of 432
650	650	services to children eligible for medical assist ance under Title 433
651	651	XXI of the Social Security Act. Although the corporation may 434
652	652	serve other children, the Legislature intends the primary 435
653	653	recipients of services provided through the corporation be 436
654	654	school-age children with a family income equal to or below 250 437
655	655	200 percent of the federal poverty level, who do not qualify for 438
656	656	Medicaid. It is also the intent of the Legislature that state 439
657	657	and local government Florida Healthy Kids funds be used to 440
658	658	continue coverage, subject to specific appropriations in the 441
659	659	General Appropriations Act, to children not eligible for federal 442
660	660	matching funds under Title XXI. 443
661	661	Section 7. Effective July 1, 2023, paragraph (b) of 444
662	662	subsection (2) of section 624.91, Florida Statutes, as amended 445
663	663	by this act, is amended to read: 446
664	664	624.91 The Florida Healthy Kids Corporation Act. — 447
665	665	(2) LEGISLATIVE INTENT. — 448
666	666	(b) It is the intent of the Legislature that the Florida 449
667	667	Healthy Kids Corporation serve as one of several providers of 450
668	668
669	669	HB 1181 2022
670	670
671	671
672	672
673	673	CODING: Words stricken are deletions; words underlined are additions.
674	674	hb1181-00
675	675	Page 19 of 19
676	676	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
677	677
678	678
679	679
680	680	services to children eligible for medical assistance under Title 451
681	681	XXI of the Social Security Act. Although the corporation may 452
682	682	serve other children, the Legislature intends the primary 453
683	683	recipients of services provided through the corporation be 454
684	684	school-age children with a family income equal to or below 300 455
685	685	250 percent of the federal poverty level, who do not qualify for 456
686	686	Medicaid. It is also the intent of the Legislature that state 457
687	687	and local government Florida Healthy Kids funds be used to 458
688	688	continue coverage, subject to specific appropriations in the 459
689	689	General Appropriations Act, t o children not eligible for federal 460
690	690	matching funds under Title XXI. 461
691	691	Section 8. Except as otherwise expressly provided in this 462
692	692	act, this act shall take effect July 1, 2022. 463