Florida 2023 3rd Special Session

Florida House Bill H0017 Compare Versions

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

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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 the Medicaid and Florida Kidcare 2
16	16	programs expansion; creating s. 402.723, F.S.; 3
17	17	requiring the Department of Children and Families to 4
18	18	publicly publish an online dashboard containing 5
19	19	certain data on the Medicaid and Florida Kidcare 6
20	20	programs; amending ss. 409.816 and 409.818, F.S.; 7
21	21	providing that certain enrollees in the Florida 8
22	22	Kidcare program and the Florida Healthy Kids program, 9
23	23	respectively, with family incomes at or below a 10
24	24	specified federal poverty level are not required to 11
25	25	pay any premiums; prohibiting certain charges from 12
26	26	being imposed on such enrollees under specified 13
27	27	circumstances; providing for future legislative review 14
28	28	and repeal; amending s. 409.904, F.S.; revising 15
29	29	eligibility for and length of time covered by Medicaid 16
30	30	optional payments; creating s. 409.91333, F.S.; 17
31	31	creating the Office of the Medicaid Ombudsman within 18
32	32	the Agency for Health Care Administration to provide 19
33	33	consumer protection and perform advocacy functions 20
34	34	related to Medicaid; providing a directive to the 21
35	35	Division of Law Revision; providing an effective date. 22
36	36	23
37	37	Be It Enacted by the Legislature of the State of Florida: 24
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40	40	HB 17C 2023C
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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. Section 402.723, Florida Stat utes, is created 26
52	52	to read: 27
53	53	402.723 Department of Children and Families; dashboard on 28
54	54	Medicaid and Florida Kidcare programs. —The Department of 29
55	55	Children and Families shall publicly publish each month an 30
56	56	online dashboard that presents data on the Medicaid an d Florida 31
57	57	Kidcare programs, including, but not limited to: 32
58	58	(1) The total number of enrollments and disenrollments and 33
59	59	the number of enrollments and disenrollments by county for each 34
60	60	program, including demographic data such as age, gender, race, 35
61	61	ethnicity, and language. 36
62	62	(2) The state application processing data, including the 37
63	63	number of applications processed, the number of applications 38
64	64	determined eligible and ineligible, the number of applications 39
65	65	pending, the number of ex parte renewals, and the number of 40
66	66	procedural terminations. 41
67	67	(3) The state customer service workload and performance, 42
68	68	including the average processing time for new applications, the 43
69	69	number of calls, the average call wait time, and the call 44
70	70	abandonment rate. 45
71	71	Section 2. Subsection (3) of section 409.816, Florida 46
72	72	Statutes, is amended to read: 47
73	73	409.816 Limitations on premiums and cost sharing. —The 48
74	74	following limitations on premiums and cost sharing are 49
75	75	established for the program. 50
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77	77	HB 17C 2023C
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81	81	CODING: Words stricken are deletions; words underlined are additions.
82	82	hb0017c-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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88	88	(3)(a) Except as otherwise provided in paragraph (b), 51
89	89	enrollees in families with a family income above 150 percent of 52
90	90	the federal poverty level who are not receiving coverage under 53
91	91	the Medicaid program or who are not eligible under s. 409.814(7) 54
92	92	may be required to pay enrollment fees, premiums, copayments, 55
93	93	deductibles, coinsurance, or similar charges on a sliding scale 56
94	94	related to income, except that the total annual aggregate cost 57
95	95	sharing with respect to all children in a family may not exceed 58
96	96	5 percent of the family's income. However, copayments, 59
97	97	deductibles, coinsurance, or similar charges may not be imposed 60
98	98	for preventive services, including well -baby and well-child 61
99	99	care, age-appropriate immunizations, and routine hearing and 62
100	100	vision screenings. Premiums for enrollees paying enrollment 63
101	101	fees, premiums, copaymen ts, deductibles, coinsurance, or similar 64
102	102	charges as provided in this subsection shall be based on at 65
103	103	least three but no more than six tiers of uniform premiums that 66
104	104	increase with each tier as a percentage of the applicable 67
105	105	threshold amount of the federal p overty level, by tier. 68
106	106	(b) On or after the effective date of this act, enrollees 69
107	107	in families with a family income at or below 200 percent of the 70
108	108	federal poverty level who are not receiving coverage under the 71
109	109	Medicaid program may not be required to pay an y premium. 72
110	110	Copayments, deductibles, coinsurance, or similar charges may not 73
111	111	be imposed on such enrollees for preventive services, including 74
112	112	well-baby and well-child care, age-appropriate immunizations, 75
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114	114	HB 17C 2023C
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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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125	125	and routine hearing and vision screenings. This paragr aph 76
126	126	expires on July 1, 2024, unless reviewed and saved from repeal 77
127	127	through reenactment by the Legislature. 78
128	128	Section 3. Paragraph (a) of subsection (3) of section 79
129	129	409.818, Florida Statutes, is amended to read: 80
130	130	409.818 Administration. —In order to implement ss. 409.810-81
131	131	409.821, the following agencies shall have the following duties: 82
132	132	(3) The Agency for Health Care Administration, under the 83
133	133	authority granted in s. 409.914(1), shall: 84
134	134	(a)1. Calculate the premium assistance payment necessary 85
135	135	to comply with the premium and cost -sharing limitations 86
136	136	specified in s. 409.816. The premium assistance payment for each 87
137	137	enrollee in a health insurance plan participating in the Florida 88
138	138	Healthy Kids Corporation shall equal the premium approved by the 89
139	139	Florida Healthy Kids Corporation and the Office of Insurance 90
140	140	Regulation of the Financial Services Commission pursuant to ss. 91
141	141	627.410 and 641.31, less any enrollee's share of the premium 92
142	142	established within the limitations specified in s. 409.816. The 93
143	143	premium assistance payment for each enrollee in an employer -94
144	144	sponsored health insurance plan approved under ss. 409.810 -95
145	145	409.821 shall equal the premium for the plan adjusted for any 96
146	146	benchmark benefit plan actuarial equivalent benefit rider 97
147	147	approved by the Office of In surance Regulation pursuant to ss. 98
148	148	627.410 and 641.31, less any enrollee's share of the premium 99
149	149	established within the limitations specified in s. 409.816. In 100
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151	151	HB 17C 2023C
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155	155	CODING: Words stricken are deletions; words underlined are additions.
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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
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162	162	calculating the premium assistance payment levels for children 101
163	163	with family coverage, the agency s hall set the premium 102
164	164	assistance payment levels for each child proportionately to the 103
165	165	total cost of family coverage. 104
166	166	2. On or after the effective date of this act, for an 105
167	167	enrollee in a health insurance plan participating in the Florida 106
168	168	Healthy Kids Corporation, or in an employer -sponsored health 107
169	169	insurance plan approved under ss. 409.810 -409.821, whose family 108
170	170	income is at or below 200 percent federal poverty level, the 109
171	171	premium assistance payment shall equal the premium approved by 110
172	172	the Florida Healthy Kids C orporation and the Office of Insurance 111
173	173	Regulation of the Financial Services Commission pursuant to ss. 112
174	174	627.410 and 641.31, or the premium for the plan adjusted for any 113
175	175	benchmark benefit plan actuarial equivalent benefit rider 114
176	176	approved by the Office of Insu rance Regulation pursuant to ss. 115
177	177	627.410 and 641.31, and the enrollee is not responsible for any 116
178	178	share of the premium. This subparagraph expires on July 1, 2024, 117
179	179	unless reviewed and saved from repeal through reenactment by the 118
180	180	Legislature. 119
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182	182	The agency is designated the lead state agency for Title XXI of 121
183	183	the Social Security Act for purposes of receipt of federal 122
184	184	funds, for reporting purposes, and for ensuring compliance with 123
185	185	federal and state regulations and rules. 124
186	186	Section 4. Subsection (12) of section 4 09.904, Florida 125
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188	188	HB 17C 2023C
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192	192	CODING: Words stricken are deletions; words underlined are additions.
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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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199	199	Statutes, is renumbered as subsection (13), subsections (1) and 126
200	200	(6) are amended, and a new subsection (12) is added to that 127
201	201	section, to read: 128
202	202	409.904 Optional payments for eligible persons. —The agency 129
203	203	may make payments for medical assista nce and related services on 130
204	204	behalf of the following persons who are determined to be 131
205	205	eligible subject to the income, assets, and categorical 132
206	206	eligibility tests set forth in federal and state law. Payment on 133
207	207	behalf of these Medicaid eligible persons is subje ct to the 134
208	208	availability of moneys and any limitations established by the 135
209	209	General Appropriations Act or chapter 216. 136
210	210	(1) Subject to federal waiver approval, a person who is 137
211	211	age 65 or older or is determined to be disabled, whose income is 138
212	212	at or below 133 88 percent of the federal poverty level, whose 139
213	213	assets do not exceed established limitations, and who is not 140
214	214	eligible for Medicare or, if eligible for Medicare, is also 141
215	215	eligible for and receiving Medicaid -covered institutional care 142
216	216	services, hospice services, or home and community -based 143
217	217	services. The agency shall seek federal authorization through a 144
218	218	waiver to provide this coverage. 145
219	219	(6) A child who has not attained the age of 19 who has 146
220	220	been determined eligible for the Medicaid program is deemed to 147
221	221	be eligible for a total of 12 6 months, regardless of changes in 148
222	222	circumstances other than attainment of the maximum age. 149
223	223	Effective January 1, 1999, a child who has not attained the age 150
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225	225	HB 17C 2023C
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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	of 5 and who has been determined eligible for the Medicaid 151
237	237	program is deemed to b e eligible for a total of 12 months 152
238	238	regardless of changes in circumstances other than attainment of 153
239	239	the maximum age. 154
240	240	(12) Subject to federal waiver approval, a person who is 155
241	241	age 18 or over, whose income is at or below 133 percent of the 156
242	242	federal poverty level, whose assets do not exceed established 157
243	243	limitations, and who is not eligible for Medicare. The agency 158
244	244	shall seek federal authorization through a waiver to provide 159
245	245	this coverage. 160
246	246	Section 5. Section 409.91333, Florida Statutes, is created 161
247	247	to read: 162
248	248	409.91333 Medicaid Ombudsman. —There is created within the 163
249	249	agency the Office of the Medicaid Ombudsman to provide consumer 164
250	250	protection and perform advocacy functions related to Medicaid, 165
251	251	including assisting individuals with: 166
252	252	(1) Filing complaints and obta ining information on filed 167
253	253	complaints. 168
254	254	(2) Eligibility criteria and enrollment issues. 169
255	255	(3) Service denials and reductions. 170
256	256	(4) Access to care issues, including barriers to service 171
257	257	and provider availability. 172
258	258	(5) Elevating matters within the Medicaid program that 173
259	259	individuals feel are being overlooked. 174
260	260	(6) Facilitating interactions with the agency, the 175
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262	262	HB 17C 2023C
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266	266	CODING: Words stricken are deletions; words underlined are additions.
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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	Department of Children and Families, the Department of Health, 176
274	274	the Agency for Persons with Disabilities, the Department of 177
275	275	Elderly Affairs, or any oth er state agency. 178
276	276	Section 6. The Division of Law Revision is directed to 179
277	277	replace the phrase "the effective date of this act" wherever it 180
278	278	occurs in this act with the date this act becomes a law. 181
279	279	Section 7. This act shall take effect upon becoming a law. 182