FL
Florida House Bill H1227

Florida 2025 Regular Session

Florida House Bill H1227 Compare Versions

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1010 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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1414 A bill to be entitled 1
1515 An act relating to Medicaid enrollment for permanently 2
1616 disabled individuals; amending s. 409.904, F.S.; 3
1717 requiring that certain Medicaid -eligible persons who 4
1818 receive specified Medicaid -covered services and who 5
1919 are permanently disabled be presumed eligible for 6
2020 continued Medicaid coverage during redetermination 7
2121 processes; requiring the Agency for Health Care 8
2222 Administration to continue to make payments for such 9
23-services; providing exceptions; requiring certain 10
24-persons to notify the agency and the Department of 11
25-Children and Families of certain changes in disability 12
26-or economic status; authorizing the department to 13
27-conduct a redetermination of eligibility under certa in 14
28-circumstances; requiring the department to make 15
29-notifications under certain circumstances; defining 16
30-the term "permanently disabled"; requiring the agency 17
31-to seek federal authorization to exempt certain 18
32-persons from annual redetermination of eligibility; 19
33-requiring the agency and the department to develop a 20
34-specified process; providing an effective date. 21
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36-Be It Enacted by the Legislature of the State of Florida: 23
37- 24
38- Section 1. Subsection (1) of section 409.904, Florida 25
23+services; providing exceptions; requiring the agency 10
24+to seek modifications to federal authorization to 11
25+establish lifetime benefits for such persons; 12
26+providing an effective date. 13
27+ 14
28+Be It Enacted by the Legislature of the State of Florida: 15
29+ 16
30+ Section 1. Subsection (1) of section 409.904, Florida 17
31+Statutes, is amended to read: 18
32+ 409.904 Optional payments for eligible persons. —The agency 19
33+may make payments for medical assistance and related services on 20
34+behalf of the following persons who are determined to be 21
35+eligible subject to the income, assets, and categorical 22
36+eligibility tests set forth in federal and state law. Payment on 23
37+behalf of these Medicaid eligible persons is subject to the 24
38+availability of moneys and any limitations established by the 25
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4747 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-Statutes, is amended to read: 26
52- 409.904 Optional payments for eligible persons. —The agency 27
53-may make payments for medical assistance and related services on 28
54-behalf of the following persons who are determined to be 29
55-eligible subject to the income, assets, and categorical 30
56-eligibility tests set forth in federal and state law. Payment on 31
57-behalf of these Medicaid eligible persons is subject to the 32
58-availability of moneys and any limitations established by the 33
59-General Appropriations Act or chapter 216. 34
60- (1)(a) Subject to federal waiver approval, a person who is 35
61-age 65 or older or is determined to be disabled, whose income is 36
62-at or below 88 percent of the federal poverty level, whose 37
63-assets do not exceed established limitations, and who is not 38
64-eligible for Medicare or, if eligible for Medicare, is also 39
65-eligible for and receiving Medicaid -covered institutional care 40
66-services, hospice services, or home and community -based 41
67-services. The agency shall seek federal authorization through a 42
68-waiver to provide this coverage. 43
69- (b)1. A person who was initially determined eligible for 44
70-Medicaid under paragraph (a) and is receiving Medicaid -covered 45
71-institutional care services, hospice services, or home and 46
72-community-based services pursuant to s. 393.066 or s. 409.978 47
73-and who is permanently disabled shall be presume d eligible for 48
74-continued coverage for these Medicaid -covered services during 49
75-any redetermination process, and the agency shall continue to 50
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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-make payments for such services, unless the person experiences a 51
89-material change in his or her disability or economic status 52
90-which results in a loss of eligibility. In the event of such a 53
91-change in disability or economic status, the person or his or 54
92-her designated caregiver or responsible party shall notify the 55
93-agency and the Department of Children and Families of such 56
94-change, and the Department of Children and Families may conduct 57
95-a redetermination of eligibility. If such redetermination is 58
96-conducted, the Department of Children and Families must notify 59
97-the person or his or her designated caregiver or responsible 60
98-party before the commencement of the redetermination and, at its 61
99-conclusion, the results of the redetermination. 62
100- 2. As used in this paragraph, the term "permanently 63
101-disabled" means that a person has been determined to be disabled 64
102-under paragraph (a) and has had his or her qualifying disability 65
103-or disabilities certified by a physician licensed under chapter 66
104-458 or chapter 459 as permanent in nature. The agency shall, no 67
105-later than October 1, 2025, seek federal authorization to exempt 68
106-a Medicaid-eligible permanently disabled person from annual 69
107-redetermination of eligibility under the parameters of this 70
108-paragraph. 71
109- 3. The agency and the Department of Children and Families 72
110-shall develop a process to facilitate the notifications required 73
111-under subparagraph 1. 74
112- Section 2. This act shall take effect July 1, 2025. 75
51+General Appropriations Act or chapter 216. 26
52+ (1)(a) Subject to federal waiver approval, a person who is 27
53+age 65 or older or is determined to be disabled, whose income is 28
54+at or below 88 percent of the federal poverty level, whose 29
55+assets do not exceed established limitatio ns, and who is not 30
56+eligible for Medicare or, if eligible for Medicare, is also 31
57+eligible for and receiving Medicaid -covered institutional care 32
58+services, hospice services, or home and community -based 33
59+services. The agency shall seek federal authorization thro ugh a 34
60+waiver to provide this coverage. 35
61+ (b)1. A person who is eligible for Medicaid under 36
62+paragraph (a) and receiving Medicaid -covered institutional care 37
63+services, hospice services, or home and community -based services 38
64+pursuant to s. 393.066 or s. 409.978 and who is permanently 39
65+disabled shall be presumed eligible for continued coverage for 40
66+these Medicaid-covered services during any redetermination 41
67+process, and the agency shall continue to make payments for such 42
68+services, unless information becomes availabl e that conclusively 43
69+documents a change in the person's disability or economic status 44
70+that would affect eligibility. 45
71+ 2. The agency shall seek modifications to federal 46
72+authorization to establish lifetime benefits for a permanently 47
73+disabled person as descri bed in subparagraph 1. 48
74+ Section 2. This act shall take effect July 1, 2025. 49