August 31, 2014
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Senate Bill 1208

Senate Bill sb1208er

CODING: Words stricken are deletions; words underlined are additions.


    ENROLLED

    2005 Legislature                 CS for SB 1208, 1st Engrossed



  1                                 

  2         An act relating to long-term care coverage;

  3         amending s. 409.905, F.S.; providing conditions

  4         for eligibility; creating s. 409.9102, F.S.;

  5         directing the Agency for Health Care

  6         Administration to establish the Long-term Care

  7         Partnership Program; providing purpose and

  8         duties; directing the agency to submit a plan

  9         and proposed legislation to the Legislature;

10         providing a contingent effective date.

11  

12  Be It Enacted by the Legislature of the State of Florida:

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14         Section 1.  Subsection (8) of section 409.905, Florida

15  Statutes, is amended to read:

16         409.905  Mandatory Medicaid services.--The agency may

17  make payments for the following services, which are required

18  of the state by Title XIX of the Social Security Act,

19  furnished by Medicaid providers to recipients who are

20  determined to be eligible on the dates on which the services

21  were provided. Any service under this section shall be

22  provided only when medically necessary and in accordance with

23  state and federal law. Mandatory services rendered by

24  providers in mobile units to Medicaid recipients may be

25  restricted by the agency. Nothing in this section shall be

26  construed to prevent or limit the agency from adjusting fees,

27  reimbursement rates, lengths of stay, number of visits, number

28  of services, or any other adjustments necessary to comply with

29  the availability of moneys and any limitations or directions

30  provided for in the General Appropriations Act or chapter 216.

31  


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CODING: Words stricken are deletions; words underlined are additions.




    ENROLLED

    2005 Legislature                 CS for SB 1208, 1st Engrossed



 1         (8)  NURSING FACILITY SERVICES.--The agency shall pay

 2  for 24-hour-a-day nursing and rehabilitative services for a

 3  recipient in a nursing facility licensed under part II of

 4  chapter 400 or in a rural hospital, as defined in s. 395.602,

 5  or in a Medicare certified skilled nursing facility operated

 6  by a hospital, as defined by s. 395.002(11), that is licensed

 7  under part I of chapter 395, and in accordance with provisions

 8  set forth in s. 409.908(2)(a), which services are ordered by

 9  and provided under the direction of a licensed physician.

10  However, if a nursing facility has been destroyed or otherwise

11  made uninhabitable by natural disaster or other emergency and

12  another nursing facility is not available, the agency must pay

13  for similar services temporarily in a hospital licensed under

14  part I of chapter 395 provided federal funding is approved and

15  available. The agency shall pay only for bed-hold days if the

16  facility has an occupancy rate of 95 percent or greater. When

17  determining eligibility for nursing and rehabilitative

18  services, if the individual is a beneficiary of an approved

19  long-term care partnership program policy and has exhausted

20  the benefits of the policy, the total countable assets of the

21  individual shall be reduced by $1 for each $1 of benefits paid

22  out under the individual's approved long-term care partnership

23  program policy. The agency is authorized to seek any federal

24  waivers to implement this policy.

25         Section 2.  Section 409.9102, Florida Statutes, is

26  created to read:

27         409.9102  Florida Long-term Care Partnership

28  Program.--The Agency for Health Care Administration is

29  directed to establish the Florida Long-term Care Partnership

30  Program, which shall:

31  


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CODING: Words stricken are deletions; words underlined are additions.




    ENROLLED

    2005 Legislature                 CS for SB 1208, 1st Engrossed



 1         (1)  Provide incentives for an individual to obtain

 2  insurance to cover the costs of long-term care.

 3         (2)  Establish standards for long-term care insurance

 4  policies for designation as approved long-term care

 5  partnership program policies in consultation with the Office

 6  of Insurance Regulation.

 7         (3)  Provide a mechanism to qualify for coverage of the

 8  costs of long-term care needs under Medicaid without first

 9  being required to substantially exhaust his or her resources,

10  including a reduction of the individual's asset valuation by

11  $1 for each $1 of benefits paid out under the individual's

12  approved long-term care partnership program policy as a

13  determination of Medicaid eligibility.

14         (4)  Provide and approve long-term care partnership

15  plan information distributed to individuals through insurance

16  companies offering approved partnership policies.

17         (5)  Alleviate the financial burden on the state's

18  medical assistance program by encouraging the pursuit of

19  private initiatives.

20         Section 3.  The Agency for Health Care Administration

21  shall develop a plan for implementation of the Florida

22  Long-term Care Partnership Program. The agency shall present

23  the plan in the form of recommended legislation to the

24  President of the Senate and the Speaker of House of

25  Representatives prior to the commencement of the next

26  legislative session.

27         Section 4.  This act shall take effect upon becoming a

28  law, except that the amendments to section 409.905, Florida

29  Statutes, and the newly created section 409.9102, Florida

30  Statutes, provided in this act shall take effect contingent

31  upon amendment to section 1917(b)(1)(c) of the Social Security


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CODING: Words stricken are deletions; words underlined are additions.




    ENROLLED

    2005 Legislature                 CS for SB 1208, 1st Engrossed



 1  Act by the United States Congress to delete the "May 14,

 2  1993," deadline for approval by states of long-term care

 3  partnership plans.

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CODING: Words stricken are deletions; words underlined are additions.

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