CS/CS/HB 1227 2025
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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
A bill to be entitled 1
An act relating to Medicaid enrollment for permanently 2
disabled individuals; amending s. 409.904, F.S.; 3
requiring that certain Medicaid -eligible persons who 4
receive specified Medicaid -covered services and who 5
are permanently disabled be presumed eligible for 6
continued Medicaid coverage during redetermination 7
processes; requiring the Agency for Health Care 8
Administration to continue to make payments for such 9
services; providing exceptions; requiring certain 10
persons to notify the agency and the Department of 11
Children and Families of certain changes in disability 12
or economic status; authorizing the department to 13
conduct a redetermination of eligibility under certa in 14
circumstances; requiring the department to make 15
notifications under certain circumstances; defining 16
the term "permanently disabled"; requiring the agency 17
to seek federal authorization to exempt certain 18
persons from annual redetermination of eligibility; 19
requiring the agency and the department to develop a 20
specified process; providing an effective date. 21
22
Be It Enacted by the Legislature of the State of Florida: 23
24
Section 1. Subsection (1) of section 409.904, Florida 25
CS/CS/HB 1227 2025
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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
Statutes, is amended to read: 26
409.904 Optional payments for eligible persons. —The agency 27
may make payments for medical assistance and related services on 28
behalf of the following persons who are determined to be 29
eligible subject to the income, assets, and categorical 30
eligibility tests set forth in federal and state law. Payment on 31
behalf of these Medicaid eligible persons is subject to the 32
availability of moneys and any limitations established by the 33
General Appropriations Act or chapter 216. 34
(1)(a) Subject to federal waiver approval, a person who is 35
age 65 or older or is determined to be disabled, whose income is 36
at or below 88 percent of the federal poverty level, whose 37
assets do not exceed established limitations, and who is not 38
eligible for Medicare or, if eligible for Medicare, is also 39
eligible for and receiving Medicaid -covered institutional care 40
services, hospice services, or home and community -based 41
services. The agency shall seek federal authorization through a 42
waiver to provide this coverage. 43
(b)1. A person who was initially determined eligible for 44
Medicaid under paragraph (a) and is receiving Medicaid -covered 45
institutional care services, hospice services, or home and 46
community-based services pursuant to s. 393.066 or s. 409.978 47
and who is permanently disabled shall be presume d eligible for 48
continued coverage for these Medicaid -covered services during 49
any redetermination process, and the agency shall continue to 50
CS/CS/HB 1227 2025
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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
make payments for such services, unless the person experiences a 51
material change in his or her disability or economic status 52
which results in a loss of eligibility. In the event of such a 53
change in disability or economic status, the person or his or 54
her designated caregiver or responsible party shall notify the 55
agency and the Department of Children and Families of such 56
change, and the Department of Children and Families may conduct 57
a redetermination of eligibility. If such redetermination is 58
conducted, the Department of Children and Families must notify 59
the person or his or her designated caregiver or responsible 60
party before the commencement of the redetermination and, at its 61
conclusion, the results of the redetermination. 62
2. As used in this paragraph, the term "permanently 63
disabled" means that a person has been determined to be disabled 64
under paragraph (a) and has had his or her qualifying disability 65
or disabilities certified by a physician licensed under chapter 66
458 or chapter 459 as permanent in nature. The agency shall, no 67
later than October 1, 2025, seek federal authorization to exempt 68
a Medicaid-eligible permanently disabled person from annual 69
redetermination of eligibility under the parameters of this 70
paragraph. 71
3. The agency and the Department of Children and Families 72
shall develop a process to facilitate the notifications required 73
under subparagraph 1. 74
Section 2. This act shall take effect July 1, 2025. 75