Florida 2022 2022 Regular Session

Florida Senate Bill S1950 Analysis / Analysis

Filed 02/18/2022

                    The Florida Senate 
BILL ANALYSIS AND FISCAL IMPACT STATEMENT 
(This document is based on the provisions contained in the legislation as of the latest date listed below.) 
Prepared By: The Professional Staff of the Appropriations Subcommittee on Health and Human Services  
 
BILL: PCS/CS/SB 1950 (625186) 
INTRODUCER:  Appropriations Subcommittee on Health and Human Services; Health Policy Committee; 
and Senator Brodeur 
SUBJECT:  Statewide Medicaid Managed Care Program 
DATE: February 18, 2022 
 
 ANALYST STAFF DIRECTOR  REFERENCE  	ACTION 
1. Smith Brown HP Fav/CS 
2. McKnight Money AHS  Recommend: Fav/CS 
3.     AP  
 
Please see Section IX. for Additional Information: 
COMMITTEE SUBSTITUTE - Substantial Changes 
 
I. Summary: 
PCS/CS/SB 1950 makes changes to the Statewide Medicaid Managed Care (SMMC) program in 
anticipation of the next competitive procurement for the 2025 plan year. The bill: 
 Requires provider service networks (PSNs) to be reimbursed on a prepaid basis. 
 Authorizes the Agency for Health Care Administration (AHCA) to select eligible managed 
care plans to provide services through a single statewide procurement and deletes the 
requirement that the AHCA conduct separate and simultaneous procurements for each 
Medicaid region. 
 Authorizes the AHCA to award contracts to managed care plans on a regional or statewide 
basis. 
 Outlines a new regional structure for plan selection under the SMMC program’s Managed 
Medical Assistance (MMA) and Long-Term Care (LTC) programs with a minimum and 
maximum number of plans designated for each region. The bill provides for eight regions 
named by letters (Regions A-H), rather than the 11 regions named by numbers (Regions 1-
11) in current law. 
 Requires the AHCA to award a contract to at least one PSN in each of the eight regions under 
the MMA program and under the LTC program. 
 Requires managed care plans to include Florida cancer hospitals that meet specified federal 
criteria in their networks as essential providers. 
REVISED:   BILL: PCS/CS/SB 1950 (625186)  	Page 2 
 
 Revises MMA plan healthy behaviors program requirements to include tobacco cessation 
programs, rather than smoking cessation programs, and to clarify that substance abuse 
programs must include opioid abuse recovery. 
 Authorizes an MMA Child Welfare Specialty Plan to serve a child in a permanent 
guardianship situation whose parents receive payments through the Guardianship Assistance 
Program. 
 Deletes obsolete language. 
 
The bill has a significant negative fiscal impact to the Florida Medicaid program. See Section V 
of this analysis.  
 
The bill takes effect on July 1, 2022. 
II. Present Situation: 
Florida Medicaid Program 
The Medicaid program is a joint federal-state program that finances health coverage for 
individuals, including eligible low-income adults, children, pregnant women, elderly adults, and 
persons with disabilities.
1
 The Centers for Medicare & Medicaid Services (CMS) within the U.S. 
Department of Health and Human Services (HHS) is responsible for administering the federal 
Medicaid program. Florida Medicaid is the health care safety net for low-income Floridians. 
Florida’s program is administered by the Agency for Health Care Administration (AHCA) and 
financed through state and federal funds.
2
 
 
A Medicaid state plan is an agreement between a state and the federal government describing 
how the state administers its Medicaid programs. The state plan establishes groups of individuals 
covered under the Medicaid program, services that are provided, payment methodologies, and 
other administrative and organizational requirements. 
 
In order to participate in Medicaid, federal law requires states to cover certain population groups 
(mandatory eligibility groups) and gives states the flexibility to cover other population groups 
(optional eligibility groups).
 
States set individual eligibility criteria within federal minimum 
standards. The AHCA may seek an amendment to the state plan as necessary to comply with 
federal or state laws or to implement program changes. States send state plan amendments to the 
federal CMS for review and approval.
3
 
 
Medicaid enrollees generally receive benefits through one of two service-delivery systems: fee-
for-service or managed care. Under fee-for-service, health care providers are paid by the state 
Medicaid program for each service provided to a Medicaid enrollee. Under managed care, the 
state contracts with private managed care plans for the coordination and payment of services for 
Medicaid enrollees. The state pays the managed care plans a capitation payment, or fixed 
monthly payment, per recipient enrolled in the managed care plan. 
                                                
1
 Medicaid.gov, Medicaid, available at https://www.medicaid.gov/medicaid/index.html (last visited Jan. 23, 2022). 
2
 Section 20.42, F.S. 
3
 Medicaid.gov, Medicaid State Plan Amendments, available at https://www.medicaid.gov/medicaid/medicaid-state-plan-
amendments/index.html (last visited Jan. 23, 2022).  BILL: PCS/CS/SB 1950 (625186)  	Page 3 
 
 
Statewide Medicaid Managed Care (SMMC) Program 
In 2011, the Legislature established the Medicaid program as a statewide, integrated managed 
care program for all covered services, and directed the AHCA to create the Statewide Medicaid 
Managed Care (SMMC) program and contract with managed care plans on a regional basis to 
provide services to eligible recipients.
4
 The SMMC minimum benefits are authorized by federal 
authority and are specifically required in s. 409.973, F.S., for Managed Medical Assistance 
(MMA) plans and s. 409.98, F.S., for Long-Term Care (LTC) plans. W alt o n
H o lmes
W aku lla
M ad iso nL eo n
Gad sd en
Jackso n
B ay
L ib ert y
Gu lfF ran klin
T aylo r
L af ayet t e
H amilt o n
B aker
N assau
D u v al
F lag ler
Pu t n am
C lay
D ixie Alach u a
L ev y
M ario n
Vo lu sia
C it ru s
L ake
Oran g e
Semin o le
Osceo la
Po lk
Pasco
M an at ee
H ard ee
H ig h lan d s
St . L u cie
Saraso t a
D e So t o
C h arlo t t e
Glad es
M art in
L ee
H en d ry
Palm B each
C o llier
B ro ward
D ad e
H ern an d o
Re gi on 4
Re gi on 2
Re gi on 1
Re gi on 5
Re gi on 3
Re gi on 7
Re gi on 11
Re gi on 9
Re gi on 10
Re gi on 6
Re gi on 8
Re gi on 1: E s cambia, Ok aloos a, S anta Ros a, and Walt on 
Re gi on 2:B ay , Calhoun, Frank lin, Gadsden, Gulf, Holmes , Jac k son, Jeffers on, Leon, 
Libert y , Madis on, Tay lor, Wak ulla, and Was hingt on 
Re gi on 3:A lac hua, B radford, Cit rus, Columbia, Dix ie, Gilchris t, Hamilton, Hernando, 
Lafay et t e, Lak e, Levy , Marion, P utnam, S umter, S uwannee, and Union 
Re gi on 4:B ak er, Clay , Duval, Flagler, Nas sau, S t. Johns , and V olusia 
Re gi on 5:P as c o and P inellas 
Re gi on 6:Hardee, Highlands , Hills borough, Manat ee, and P olk 
Re gi on 7:B revard, Orange, Os c eola, and S eminole 
Re gi on 8: Charlot t e, Collier, DeSot o, Glades , Hendry , Lee, and S aras ot a 
Re gi on 9:Indian River, Mart in, Ok eec hobee, P alm B each, and S t . Lucie 
Re gi on 10: B roward 
Re gi on 11: Miami-Dade and Monroe  
 
 
Today, the majority of Florida Medicaid recipients receive their services through a managed care 
plan contracted with the AHCA under the SMMC program. The SMMC program has three 
components: 
 MMA: provides Medicaid covered medical services like doctor visits, hospital care, 
prescribed drugs, mental health care, and transportation to these services.
5
 
 LTC: provides Medicaid LTC services like care in a nursing facility, assisted living, or at 
home. To get LTC you must be at least 18 years old and meet nursing home level of care (or 
meet hospital level of care if you have Cystic Fibrosis).
6
 
 Dental: provides all Medicaid dental services for children and adults. All individuals on 
Medicaid must enroll in a dental plan.
7
 
                                                
4
 Chapter 2011-134, Laws of Fla. 
5
 Agency for Health Care Administration, Statewide Medicaid Managed Care, Health Plans and Programs, available at 
https://www.flmedicaidmanagedcare.com/health/comparehealthplans (last visited Feb. 9, 2022). 
6
 Id. 
7
 Id.  BILL: PCS/CS/SB 1950 (625186)  	Page 4 
 
Eligible Plan Selection 
The SMMC program was fully implemented in August 2014. During the initial SMMC 
procurement, the AHCA awarded contracts to 18 plans, including seven provider service 
networks (PSNs). By the end of the first contract period, due to various mergers, acquisitions, 
and conversions to HMO status, only one PSN remained.
8
 
 
During the second procurement, beginning December 2018 and ending in December 2023, the 
AHCA awarded contracts to 16 plans, including five PSNs, but only three of the PSNs currently 
remain in the program due to mergers and acquisitions with a total of 10 health plans.
9
 In 2020, 
the Legislature extended the allowable term of the SMMC contracts from five to six years.
10
 As a 
result, the AHCA’s current contracts will end in December 2024. The AHCA will conduct its 
next procurement in Fiscal Year 2022-2023 for implementation in the 2025 plan year. 
 
Various mergers and acquisitions have occurred during the lifecycle of each SMMC contract, 
resulting in a situation where a majority of enrollees are receiving services from statewide plans 
that operate in all 11 regions. As of October 1, 2021, 40 percent of the SMMC population, 
including those enrolled in a specialty plan, were enrolled in a plan operating statewide and 79 
percent were enrolled in a plan that operates in at least eight of the 11 regions. The chart below 
reflects the current operational SMMC plans in their designated regions as of October 1, 2021:
11
 
 
SMMC Health Plans by Region (2018-2024) 
 	1 2 3 4 5 6 7 8 9 10 11 
MMA Health Plans 
AmeriHealth    
Community Care Plan   
Simply Healthcare      
Vivida Health   
Comprehensive Plans (MMA & LTC Combined) 
Aetna Better Health     
Humana Medical Plan            
Molina Healthcare    
Simply Healthcare       
Sunshine Health            
United Healthcare       
Specialty Plans 
CMS Plan            
Clear Health Alliance            
Molina SMI Specialty      
Sunshine SMI Specialty            
Sunshine Child Welfare            
                                                
8
 Agency for Health Care Administration, 2022 Agency Legislative Bill Analysis for SB 1950, Jan. 19, 2022 (on file with the 
Senate Committee on Health Policy). 
9
 Id. 
10
 Chapter 2020-156, s. 44, Laws of Fla. 
11
 Agency for Health Care Administration, Statewide Medicaid Managed Care, available at 
https://ahca.myflorida.com/medicaid/statewide_mc/pdf/mma/SMMC_Plans_by_Region.pdf (last visited Feb. 9, 2022).  BILL: PCS/CS/SB 1950 (625186)  	Page 5 
 
Provider Service Networks (PSNs) 
A PSN in the Medicaid program is a managed care plan established or organized and operated by 
a health care provider, or group of affiliated health care providers, which provides a substantial 
proportion of the health care items and services under a contract directly through the provider or 
affiliated group of providers and may make arrangements with physicians or other health care 
professionals, health care institutions, or any combination of such individuals or institutions to 
assume all or part of the financial risk on a prospective basis for the provision of basic health 
services by the physicians, by other health professionals, or through the institutions.
12
 The health 
care providers must have a controlling interest in the governing body of the PSN. The AHCA is 
authorized to contract with PSNs under s. 409.912(1), F.S., and may currently reimburse PSNs 
on a fee-for-service basis with a shared savings settlement or on a prepaid basis with per-
member, per-month payments. A PSN may be reimbursed on a fee-for-service basis for only the 
first two years of the plan’s operation.
13
 
 
Specialty Plans
14
 
An MMA managed care plan can participate in the MMA program as a standard plan or as a 
specialty plan. A specialty plan is a managed care plan that serves Medicaid recipients who meet 
specified criteria based on age, medical condition, or diagnosis.
15
 Under federal Medicaid law 
and the SMMC waiver, each recipient has a choice of plans and may select any available plan 
unless that plan is restricted by contract to a specific population that does not include the 
recipient.
16
 If a specialty plan is available to accommodate a specific condition or diagnosis of a 
Medicaid recipient, the AHCA must automatically enroll the recipient in that plan unless the 
recipient chooses a different plan.
17
 MMA specialty plans cover the same health care services as 
the standard MMA plans, and in addition, they must maintain a care coordination program 
tailored to the special needs of the plan’s enrollees.  
 
When a recipient is eligible for more than one MMA specialty plan, the AHCA uses a ranking to 
determine which MMA specialty plan to assign. Unless the recipient chooses to enroll in another 
MMA specialty plan for which he or she is eligible, or in a standard MMA plan offered in his or 
her region, the recipient is automatically assigned to the specialty plan listed highest on the 
ranking. The AHCA has awarded specialty plan contracts to serve enrollees with specialty 
conditions including severe mental illness, HIV/AIDS, as well as children with special health 
care needs, and those involved with Florida’s child welfare system. 
 
 
                                                
12
 Section 409.912(1)(b), F.S. 
13
 Id. 
14
 Agency for Health Care Administration, Medicaid Managed Medical Assistance Specialty Plans available at 
https://ahca.myflorida.com/medicaid/statewide_mc/pdf/mma/Specialty_Plans_110316.pdf (last visited Jan. 23, 2022). 
15
 Section 409.962(18), F.S. 
16
 Section 409.969(1), F.S. 
17
 Section 409.977(1), F.S.  BILL: PCS/CS/SB 1950 (625186)  	Page 6 
 
III. Effect of Proposed Changes: 
Section 1 amends s. 409.912(1), F.S., to eliminate fee-for-service (FFS) reimbursement of 
provider service networks (PSNs) in conjunction with changes made to s. 409.968(2), F.S., in 
section 6 of the bill. Under these changes, PSNs must be reimbursed on a prepaid basis, 
receiving a per-member, per-month payment. This section of the bill prohibits the Agency for 
Health Care Administration (AHCA) from contracting with a PSN outside of the procurement 
process in s. 409.966, F.S., as amended by section 4 of the bill. 
 
Changes to this subsection relocate, but do not substantively change, language exempting PSNs 
from parts I and III of ch. 643, F.S. 
 
Section 2 repeals obsolete language in s. 409.9124, F.S., relating to managed care plan 
reimbursement. 
 
Section 3 amends s. 409.964, F.S., to eliminate an obsolete requirement that the AHCA provide 
public notice and the opportunity for public comment before seeking a waiver to implement the 
Statewide Medicaid Managed Care (SMMC) program. This language is obsolete as the public 
notice and public meeting requirements were met prior to the AHCA seeking federal authority to 
implement the SMMC program in 2011 and 2012. 
 
Section 4 amends s. 409.966(2), F.S., to require the AHCA’s databook consisting of Medicaid 
utilization and spending data (which must be published 90 days before issuing an invitation to 
negotiate) to include at least the 24 most recent months of data from the Medicaid Encounter 
Data System. This removes the requirement that the databook consist of data for the three most 
recent contract years, include historic fee-for-service claims, and delineate utilization by age, 
gender, eligibility group, geographic area, and aggregate clinical risk score. 
 
This section of the bill deletes the requirement for the AHCA to conduct separate and 
simultaneous procurements for each Medicaid region and outlines a new structure for regional 
awards. The new structure includes eight regions named by letters (Regions A-H), rather than the 
11 regions named by numbers (Regions 1-11) included in the original statute. 
 
The following map and chart outline the eight regions proposed in the bill:
18
 
 
                                                
18
 Agency for Health Care Administration, 2022 Agency Legislative Bill Analysis for SB 1950, Jan. 19, 2022 (on file with 
the Senate Committee on Health Policy).  BILL: PCS/CS/SB 1950 (625186)  	Page 7 
 
 
 
 
This section of the bill also deletes obsolete language in s. 409.966(3)(d), F.S., that required the 
AHCA to negotiate capitation rates for the first year of the first contract term and in 
s. 409.966(3)(e), F.S.,  that awarded additional contracts to plans who are awarded contracts in 
Current 	Counties  	Proposed 
Region 1 Escambia, Okaloosa, Santa Rosa, and Walton 
Region A 
Region 2 
Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, 
Leon, Liberty, Madison, Taylor, Wakulla, and Washington 
Region 3 
Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, 
Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, 
Suwannee, and Union 
Region B 
Region 4 Baker, Clay, Duval, Flagler, Nassau, St. Johns, and Volusia 
Region 5 Pasco and Pinellas 
Region C 
Region 6 Hardee, Highlands, Hillsborough, Manatee, and Polk 
Region 7 Brevard, Orange, Osceola, and Seminole 	Region D 
Region 8 Charlotte, Collier, DeSoto, Glades, Hendry, Lee, and Sarasota Region E 
Region 9 Indian River, Martin, Okeechobee, Palm Beach, and St. Lucie Region F 
Region 10 Broward 	Region G 
Region 11 Miami-Dade and Monroe 	Region H  BILL: PCS/CS/SB 1950 (625186)  	Page 8 
 
Regions 1 and 2. The AHCA indicates that due to the merger of Regions 1 and 2 into a single 
Region A, and because the bill provides for the award of statewide contracts, this provision is no 
longer needed.
19
 
 
Section 5 amends s. 409.967, F.S., to delete obsolete language relating to plans contracting with 
hospital facilities that became licensed and operational before January 1, 2013. This section of 
the bill also deletes obsolete language requiring the AHCA to issue a request for information to 
determine whether cost savings could be achieved through oversight and management by the end 
of the fourth year of the first contract term.  
 
Section 6 amends s. 409.968(2), F.S., to delete language allowing PSNs to receive fee-for-
service rates with a shared savings settlement. In conjunction with changes made to s. 409.912. 
F.S., in section 1 of this bill, the bill requires all PSNs to be prepaid plans, receiving a per-
member, per-month payment, and be negotiated pursuant to the procurement process in s. 
409.966, F.S. 
 
Section 7 amends s. 409.973, F.S., to revise language related to Healthy Behaviors programs 
which Managed Medical Assistance (MMA) plans are required to establish to encourage and 
reward healthy behaviors. The bill requires each plan to establish a “tobacco cessation program” 
rather than a “smoking cessation program” to ensure that each program also includes smokeless 
tobacco products. It also requires an MMA plan’s substance abuse recovery program to include 
opioid abuse recovery. 
 
This section of the bill also deletes obsolete language in 409.97(4)(b), F.S., relating to the 
Primary Care Initiative, which requires the plans to schedule an appointment with a primary care 
provider for enrollees who became eligible for Medicaid between January 1, 2014 and December 
31, 2015, within 6 months of enrollment in the plan. 
 
Section 8 amends s. 409.974(1), F.S., to outline the structure for plan selection under the MMA 
program. This section authorizes the AHCA to select eligible plans to provide services through a 
single statewide procurement and to award contracts to plans on a regional or statewide basis. It 
requires the AHCA to award a contract to at least one PSN in each of the 8 regions and to 
procure: 
 3-4 plans for Region A 
 3-6 plans for Region B 
 5-10 plans for Region C 
 3-6 plans for Region D 
 3-4 plans for Region E 
 3-5 plans for Region F 
 3-5 plans for Region G 
 5-10 plans for Region H 
 
This section of the bill also amends s. 409.974(2), F.S., to eliminate the requirement that the 
AHCA exercise a preference for plans with a provider network in which over 10 percent of the 
                                                
19
 Agency for Health Care Administration, 2022 Agency Legislative Bill Analysis for SB 1950, Jan. 19, 2022 (on file with 
the Senate Committee on Health Policy).  BILL: PCS/CS/SB 1950 (625186)  	Page 9 
 
providers use electronic health records. It is estimated that 80 percent of providers currently use 
electronic health records.
20
 
 
Section 9 amends s. 409.975(1)(b), F.S., to expand the list of statewide essential providers to 
include Florida cancer hospitals that meet the criteria in 42 U.S.C. s. 1395ww(d)(1)(B)(v). 
Currently, Moffitt Cancer Center in Tampa and Sylvester Comprehensive Cancer Center in 
Miami meet this criteria. Under the bill, managed care plans would be required to include these 
cancer hospitals in their networks as essential providers. 
 
Section 10 amends s. 409.977, F.S., to revise and relocate the requirement for the AHCA to 
maintain a recipient’s enrollment in a plan if a recipient was enrolled in a plan immediately 
before the recipient’s choice period and that plan is still available in the region, unless an 
applicable specialty plan is available from subsection (1) to subsection (2). 
 
This section of the bill deletes the obsolete requirement in s. 409.977(4), F.S., for the AHCA to 
seek federal approval to develop and implement a process to enable a Medicaid recipient with 
access to employer-sponsored health care coverage to opt out of all managed care plans and to 
use Medicaid financial assistance to pay for the recipient’s share of the cost in such employer-
sponsored coverage. The AHCA has already obtained federal approval for what has come to be 
known as their Health Insurance Premium Payment (HIPP) program
21
 and continues to 
implement this program.
22
 As of August 2021, 53 recipients were participating in the HIPP 
program.
23
 
 
This section of the bill also amends s. 409.977(5), F.S., to authorize a child welfare specialty 
managed care plan under contract with the MMA program to serve a child in a permanent 
guardianship situation.
24
 Specifically, such a child must continue to be eligible for Medicaid and 
must receive guardianship assistance payments under the Guardianship Assistance Program. 
Currently, only children in foster care, extended foster care, or subsidized adoption are eligible 
for the child welfare specialty plan. 
 
Section 11 amends s. 409.981, F.S., to outline the structure for plan selection under the Long-
Term Care program. Tracking the structure for MMA plan selection above in section 8 of this 
bill, except as noted, this section authorizes the AHCA to select eligible plans to provide services 
through a single statewide procurement and to award contracts to plans on a regional or 
                                                
20
 Email from Legislative Affairs Director, Agency for Health Care Administration, to Senate Committee on Health Policy 
Staff (Jan. 24, 2022) (on file with the Senate Committee on Health Policy). 
21
 See Rule 59G-7.007, F.A.C.  
22
 The Agency for Health Care Administration reports that for the 2020 calendar year, $95,388.79 was spent on premium 
reimbursements through the HIPP program. From January to August of 2021, $912,363.87 was spent on premium 
reimbursements through the program. Agency for Health Care Administration, 2022 Agency Legislative Bill Analysis for SB 
1950, Jan. 19, 2022 (on file with the Senate Committee on Health Policy). 
23
 Email from Legislative Affairs Director, Agency for Health Care Administration, to Senate Committee on Health Policy 
Staff (Jan. 24, 2022) (on file with the Senate Committee on Health Policy). 
24
 For more information on the Sunshine Health Child Welfare Specialty Plan and the Guardianship Assistance Program, see 
Florida Senate Bill Analysis and Fiscal Impact Statement for CS/SB 1080, Jan. 19, 2022 available at 
https://www.flsenate.gov/Session/Bill/2022/1080/Analyses/2022s01080.hp.PDF (last visited Jan. 23, 2022). The provisions 
of CS/SB 1080 are identical to the changes made to s. 409.977(5), F.S., in this bill.  BILL: PCS/CS/SB 1950 (625186)  	Page 10 
 
statewide basis. It requires the AHCA to award a contract to at least one PSN in each of the eight 
regions and to procure: 
 3-4 plans for Region A 
 3-6 plans for Region B 
 5-10 plans for Region C 
 3-6 plans for Region D 
 3-4 plans for Region E 
 3-5 plans for Region F 
 3-4 plans for Region G
25
 
 5-10 plans for region H 
 
Section 12 amends s. 409.8132, F.S., to conform a cross-reference to changes made in bill 
section 2 which repeals s. 409.9124, F.S. 
 
Section 13 reenacts s. 409.962, F.S., to incorporate changes made by this act to s. 409.912, F.S., 
in bill section 1. 
 
Section 14 reenacts s. 641.19, F.S., to incorporate changes made by this act to s. 409.912, F.S., 
in bill section 1. 
 
Section 15 reenacts s. 430.2053, F.S., to incorporate changes made by this act to s. 409.981, F.S., 
in bill section 11. 
 
Section 16 provides an effective date of July 1, 2022.  
IV. Constitutional Issues: 
A. Municipality/County Mandates Restrictions: 
None. 
B. Public Records/Open Meetings Issues: 
None. 
C. Trust Funds Restrictions: 
None. 
D. State Tax or Fee Increases: 
None. 
E. Other Constitutional Issues: 
None. 
                                                
25
 Note that the Agency for Health Care Administration must award 3-5 MMA plans for Region G under bill section 8.  BILL: PCS/CS/SB 1950 (625186)  	Page 11 
 
V. Fiscal Impact Statement: 
A. Tax/Fee Issues: 
None. 
B. Private Sector Impact: 
None. 
C. Government Sector Impact: 
The capitation rate for children in the Child Welfare Specialty Plan is higher than the 
rates for most children in other plans. If children become eligible and receive services 
through the Child Welfare Specialty Plan as authorized in the bill, the bill will have a 
significant negative fiscal impact to the Florida Medicaid program. The AHCA estimates 
a maximum recurring fiscal impact of $12.2 million ($4.7 million General Revenue) 
based on a rate year 2020-2021 estimate of 4,120 children who currently would be 
eligible for the change in plans.
26
 
 
The precise fiscal impact of children becoming newly eligible for the Child Welfare 
Specialty Plans cannot be calculated without knowing the Medicaid region in which an 
eligible child resides and the capitation rate category in which the child is currently 
categorized. This is because Medicaid capitation rates vary by region and children could 
be in different rate cells based on age, gender, Medicaid eligibility category, and other 
characteristics. 
VI. Technical Deficiencies: 
None. 
VII. Related Issues: 
None. 
VIII. Statutes Affected: 
This bill substantially amends the following sections of the Florida Statutes: 409.912, 409.964, 
409.966, 409.967, 409.968, 409.973, 409.974, 409.975, 409.977, 409.981, and 409.8132. 
 
This bill repeals section 409.9124 of the Florida Statutes. 
 
This bill reenacts the following sections of the Florida Statutes: 409.962, 641.19, and 430.2053.  
                                                
26
 Agency for Health Care Administration, 2022 Agency Legislative Bill Analysis for SB 1950, Jan. 19, 2022 (on file with 
the Senate Committee on Health Policy).  BILL: PCS/CS/SB 1950 (625186)  	Page 12 
 
IX. Additional Information: 
A. Committee Substitute – Statement of Substantial Changes: 
(Summarizing differences between the Committee Substitute and the prior version of the bill.) 
Recommended CS/CS by Appropriations Subcommittee on Health and Human 
Services on February 16, 2022: 
The committee substitute removes the achieved savings rebate provisions from the bill and 
maintains current law. 
 
CS by Health Policy on January 26, 2022: 
The CS corrects a drafting error in the underlying bill that would have inadvertently 
deleted the AHCA’s existing authority to implement the HIPP program. The amendment 
keeps the HIPP program intact and removes obsolete language from statute regarding 
already-obtained federal approval to implement the program. 
B. Amendments: 
None. 
This Senate Bill Analysis does not reflect the intent or official position of the bill’s introducer or the Florida Senate.