March 30, 2020
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HB 1073

1
A bill to be entitled
2An act relating to the Florida KidCare program; amending
3s. 409.811, F.S.; defining the term "Florida KidCare
4program"; deleting a definition to conform; amending s.
5409.8132, F.S.; limiting when an applicant may apply for
6Medikids program enrollment; deleting a special enrollment
7period provision; amending s. 409.8134, F.S.; eliminating
8the Agency for Health Care Administration's ability to
9request an increase in the Florida KidCare program
10enrollment ceiling; providing for open enrollment periods;
11providing a timeframe for statewide announcement of open
12enrollment periods; providing limitations; providing a
13disenrollment process under certain circumstances;
14providing additional data for certain agencies to collect
15and analyze; amending s. 409.814, F.S.; revising Florida
16KidCare program eligibility criteria; limiting coverage;
17providing an exception for certain children otherwise
18eligible or covered under a family member's employer
19health coverage; restricting enrollment of children whose
20coverage was voluntarily canceled; providing an age
21limitation for certain components; requiring certain
22transfers to be managed within authorized levels of
23funding; requiring certain reserves to be established and
24reviewed; requiring each applicant to provide certain
25documentation; requiring the program to withhold benefits
26from certain enrollees; providing additional fraudulent
27activities; amending s. 409.815, F.S.; making dental
28services contingent upon an annual appropriation; amending
29s. 624.91, F.S.; removing the requirement for the Florida
30Healthy Kids Corporation to work with the Florida
31Partnership for School Readiness; limiting eligibility for
32state-funded assistance in paying Florida Healthy Kids
33premiums; providing for future repeal of certain
34provisions; providing additional criteria for the
35corporation to determine eligibility; eliminating
36authority to establish an open enrollment period; revising
37the corporation's purchasing criteria; removing a
38restriction; eliminating authority to contract with
39certain entities; eliminating authority to establish a
40maximum number of participants; eliminating authority to
41establish eligibility criteria or premium and cost-sharing
42requirements; providing that contracted insurers are the
43payors of last resort; requiring contracted insurers to
44coordinate benefits with certain payors; requiring the
45Auditor General to perform an analysis on certain children
46enrolled in the Florida KidCare program and report such
47findings to the Governor and Legislature; requiring the
48Florida Healthy Kids Corporation to use certain funds to
49contract for an actuarial study; requiring the Auditor
50General to perform random audits to determine eligibility
51of children enrolled in the Florida Healthy Kids program;
52requiring the Office of Program Policy Analysis and
53Government Accountability to perform a study to determine
54the appropriate family premium for the Florida KidCare
55program and report its findings to the Legislature;
56amending s. 409.818, F.S.; deleting a cross reference;
57repealing s. 409.819, F.S., relating to a program
58identifying low-income, uninsured children for certain
59purposes; providing appropriations; providing effective
60dates.
61
62Be It Enacted by the Legislature of the State of Florida:
63
64     Section 1.  Subsections (14) through (22) of section
65409.811, Florida Statutes, are renumbered as subsections (15)
66through (23), respectively, present subsection (23) of said
67section is amended, and a new subsection (14) is added to said
68section, to read:
69     409.811  Definitions relating to Florida KidCare Kidcare
70Act.--As used in ss. 409.810-409.820, the term:
71     (14)  "Florida KidCare program," "KidCare program," or
72"program" means the health benefits program administered through
73ss. 409.810-409.820.
74     (23)  "Program" means the Florida Kidcare program, the
75medical assistance program authorized by Title XXI of the Social
76Security Act as part of the federal Balanced Budget Act of 1997.
77     Section 2.  Subsections (7), (8), and (9) of section
78409.8132, Florida Statutes, are amended to read:
79     409.8132  Medikids program component.--
80     (7)  ENROLLMENT.--Enrollment in the Medikids program
81component may only occur during periodic open enrollment periods
82as specified in s. 409.8134 by the agency. An applicant may
83apply for enrollment in the Medikids program component and
84proceed through the eligibility determination process at any
85time throughout the year. However, enrollment in Medikids shall
86not begin until the next open enrollment period; and A child may
87not receive services under the Medikids program until the child
88is enrolled in a managed care plan or MediPass. In addition,
89Once determined eligible, an applicant may receive choice
90counseling and select a managed care plan or MediPass. The
91agency may initiate mandatory assignment for a Medikids
92applicant who has not chosen a managed care plan or MediPass
93provider after the applicant's voluntary choice period ends. An
94applicant may select MediPass under the Medikids program
95component only in counties that have fewer than two managed care
96plans available to serve Medicaid recipients and only if the
97federal Health Care Financing Administration determines that
98MediPass constitutes "health insurance coverage" as defined in
99Title XXI of the Social Security Act.
100     (8)  SPECIAL ENROLLMENT PERIODS.--The agency shall
101establish a special enrollment period of 30 days' duration for
102any child who is enrolled in Medicaid if such child loses
103Medicaid eligibility and becomes eligible for Medikids, or for
104any child who is enrolled in Medikids if such child moves to
105another county that is not within the coverage area of the
106child's Medikids managed care plan or MediPass provider.
107     (8)(9)  PENALTIES FOR VOLUNTARY CANCELLATION.--The agency
108shall establish enrollment criteria that must include penalties
109or waiting periods of not fewer than 60 days for reinstatement
110of coverage upon voluntary cancellation for nonpayment of
111premiums.
112     Section 3.  Section 409.8134, Florida Statutes, is amended
113to read:
114     409.8134  Program enrollment and expenditure ceilings.--
115     (1)  Except for the Medicaid program, a ceiling shall be
116placed on annual federal and state expenditures and on
117enrollment in the Florida KidCare Kidcare program as provided
118each year in the General Appropriations Act. The agency, in
119consultation with the Department of Health, may propose to
120increase the enrollment ceiling in accordance with chapter 216.
121     (2)  Upon a unanimous recommendation by representatives
122from each of the four Florida KidCare administrators, the
123Florida KidCare program may conduct an open enrollment period
124for the purpose of enrolling children eligible for all program
125components listed in s. 409.813 except Medicaid. The four
126Florida KidCare administrators shall work together to ensure
127that the open enrollment period is announced statewide at least
1281 month before the open enrollment is to begin. Eligible
129children shall be enrolled on a first-come, first-served basis
130using the date the open enrollment application is received. Open
131enrollment shall immediately cease when the enrollment ceiling
132is reached. An open enrollment shall be held only if the Social
133Services Estimating Conference determines that sufficient funds
134have been appropriated to finance increased enrollment through
135federal fiscal year 2007. Individuals, including those on a
136waiting list after January 30, 2004, must reapply by submitting
137a new application during each new open enrollment period Except
138for the Medicaid program, whenever the Social Services
139Estimating Conference determines that there is presently, or
140will be by the end of the current fiscal year, insufficient
141funds to finance the current or projected enrollment in the
142Florida Kidcare program, all additional enrollment must cease
143and additional enrollment may not resume until sufficient funds
144are available to finance such enrollment.
145     (3)  Upon determination by the Social Services Estimating
146Conference that there are insufficient funds to finance the
147current enrollment in the Florida KidCare program within current
148appropriations, the program shall initiate disenrollment
149procedures to remove enrollees, except those children enrolled
150in the Children's Medical Services network, on a last-in, first-
151out basis until the expenditure and appropriation levels are
152balanced.
153     (4)(3)  The agencies that administer the Florida KidCare
154Kidcare program components shall collect and analyze the data
155needed to project Florida Kidcare program enrollment costs,
156including price level adjustments outreach impacts,
157participation and attrition rates, current and projected
158caseloads, utilization, and current and projected expenditures
159for the next 3 years. The agencies shall report the caseload and
160expenditure trends to the Social Services Estimating Conference
161in accordance with chapter 216.
162     Section 4.  Effective July 1, 2004, section 409.814,
163Florida Statutes, is amended to read:
164     409.814  Eligibility.--A child who has not reached 19 years
165of age whose family income is equal to or below 200 percent of
166the federal poverty level is eligible for the Florida KidCare
167Kidcare program as provided in this section. In determining the
168eligibility of such a child, an assets test is not required. An
169applicant under 19 years of age who, based on a complete
170application, appears to be eligible for the Medicaid component
171of the Florida Kidcare program is presumed eligible for coverage
172under Medicaid, subject to federal rules. A child who has been
173deemed presumptively eligible for Medicaid shall not be enrolled
174in a managed care plan until the child's full eligibility
175determination for Medicaid has been completed. The Florida
176Healthy Kids Corporation may, subject to compliance with
177applicable requirements of the Agency for Health Care
178Administration and the Department of Children and Family
179Services, be designated as an entity to conduct presumptive
180eligibility determinations. An applicant under 19 years of age
181who, based on a complete application, appears to be eligible for
182the Medikids, Florida Healthy Kids, or Children's Medical
183Services network program component, who is screened as
184ineligible for Medicaid and prior to the monthly verification of
185the applicant's enrollment in Medicaid or of eligibility for
186coverage under the state employee health benefit plan, may be
187enrolled in and begin receiving coverage from the appropriate
188program component on the first day of the month following the
189receipt of a completed application. For enrollment in the
190Children's Medical Services network, a complete application
191includes the medical or behavioral health screening. If,
192subsequently after verification, an individual is determined to
193be ineligible for coverage, he or she must immediately be
194disenrolled from the respective KidCare Title XXI-funded Kidcare
195program component.
196     (1)  A child who is eligible for Medicaid coverage under s.
197409.903 or s. 409.904 must be enrolled in Medicaid and is not
198eligible to receive health benefits under any other health
199benefits coverage authorized under the Florida KidCare program
200ss. 409.810-409.820.
201     (2)  A child who is not eligible for Medicaid, but who is
202eligible for the Florida KidCare Kidcare program, may obtain
203health benefits coverage under any of the other components
204listed in s. 409.813 types of health benefits coverage
205authorized in ss. 409.810-409.820 if such coverage is approved
206and available in the county in which the child resides. However,
207a child who is eligible for Medikids may participate in the
208Florida Healthy Kids program only if the child has a sibling
209participating in the Florida Healthy Kids program and the
210child's county of residence permits such enrollment.
211     (3)  A child who is eligible for the Florida KidCare
212Kidcare program who is a child with special health care needs,
213as determined through a medical or behavioral screening
214instrument, is eligible for health benefits coverage from and
215shall be referred to the Children's Medical Services network.
216     (4)  The following children are not eligible to receive
217premium assistance for health benefits coverage under the
218Florida KidCare program ss. 409.810-409.820, except under
219Medicaid if the child would have been eligible for Medicaid
220under s. 409.903 or s. 409.904 as of June 1, 1997:
221     (a)  A child who is eligible for coverage under a state
222health benefit plan on the basis of a family member's employment
223with a public agency in the state.
224     (b)  A child who is currently eligible for or covered under
225a family member's group health benefit plan or under other
226employer health insurance coverage, excluding coverage provided
227under the Florida Healthy Kids Corporation as established under
228s. 624.91, provided that the cost of the child's participation
229is not greater than 7.5 percent of the family's income. This
230provision shall be applied during redetermination for children
231who were enrolled prior to July 1, 2004. These enrollees shall
232have 6 months of eligibility following redetermination to allow
233for a transition to the other health benefit plan.
234     (c)  A child who is seeking premium assistance for the
235Florida KidCare program through employer-sponsored group
236coverage, if the child has been covered by the same employer's
237group coverage during the 6 months prior to the family's
238submitting an application for determination of eligibility under
239the Florida Kidcare program.
240     (d)  A child who is an alien, but who does not meet the
241definition of qualified alien, in the United States.
242     (e)  A child who is an inmate of a public institution or a
243patient in an institution for mental diseases.
244     (f)  A child who has had his or her coverage in an
245employer-sponsored health benefit plan voluntarily canceled in
246the last 6 months, except those children who were on the waiting
247list prior to January 31, 2004.
248     (5)  A child whose family income is above 200 percent of
249the federal poverty level or a child who is excluded under the
250provisions of subsection (4) may participate in the Florida
251KidCare Kidcare program, excluding the Medicaid program, but is
252subject to the following provisions:
253     (a)  The family is not eligible for premium assistance
254payments and must pay the full cost of the premium, including
255any administrative costs.
256     (b)  The agency is authorized to place limits on enrollment
257in Medikids by these children in order to avoid adverse
258selection. The number of children participating in Medikids
259whose family income exceeds 200 percent of the federal poverty
260level must not exceed 10 percent of total enrollees in the
261Medikids program.
262     (c)  The board of directors of the Florida Healthy Kids
263Corporation is authorized to place limits on enrollment of these
264children in order to avoid adverse selection. In addition, the
265board is authorized to offer a reduced benefit package to these
266children in order to limit program costs for such families. The
267number of children participating in the Florida Healthy Kids
268program whose family income exceeds 200 percent of the federal
269poverty level must not exceed 10 percent of total enrollees in
270the Florida Healthy Kids program.
271     (d)  Children described in this subsection are not counted
272in the annual enrollment ceiling for the Florida KidCare Kidcare
273program.
274     (6)  Once a child is enrolled in the Florida KidCare
275Kidcare program, the child is eligible for coverage under the
276program for 6 months without a redetermination or reverification
277of eligibility, if the family continues to pay the applicable
278premium. Eligibility for program components funded through Title
279XXI of the Social Security Act shall terminate when a child
280attains the age of 19. Effective January 1, 1999, a child who
281has not attained the age of 5 and who has been determined
282eligible for the Medicaid program is eligible for coverage for
28312 months without a redetermination or reverification of
284eligibility.
285     (7)  When determining or reviewing a child's eligibility
286under the Florida KidCare program, the applicant shall be
287provided with reasonable notice of changes in eligibility which
288may affect enrollment in one or more of the program components.
289When a transition from one program component to another is
290authorized appropriate, there shall be cooperation between the
291program components and the affected family which promotes
292continuity of health care coverage. Any authorized transfers
293must be managed within the program's overall appropriated or
294authorized levels of funding. Each component of the program
295shall establish a reserve to ensure that transfers between
296components will be accomplished within current year
297appropriations. These reserves shall be reviewed by each
298convening of the Social Services Estimating Conference to
299determine the adequacy of such reserves to meet actual
300experience.
301     (8)  In determining the eligibility of a child, an assets
302test is not required. Each applicant shall provide written
303documentation during the application process and the
304redetermination process, including, but not limited to, the
305following:
306     (a)  Proof of family income.
307     (b)  A statement from all employers of family members that:
308     1.  The employer does not sponsor a health benefit plan for
309employees; or
310     2.  The potential enrollee is not covered by the employer-
311sponsored health benefit plan because the potential enrollee is
312not eligible for coverage, or, if the potential enrollee is
313eligible but not covered, a statement of the cost to enroll the
314potential enrollee in the employer-sponsored health benefit
315plan.
316     (9)  Subject to paragraph (4)(b) and s. 624.91(3), the
317Florida KidCare program shall withhold benefits from an enrollee
318if the program obtains evidence that the enrollee is no longer
319eligible, submitted incorrect or fraudulent information in order
320to establish eligibility, or failed to provide verification of
321eligibility. The applicant or enrollee shall be notified that
322because of such evidence program benefits will be withheld
323unless the applicant or enrollee contacts a designated
324representative of the program by a specified date, which must be
325within 10 days after the date of notice, to discuss and resolve
326the matter. The program shall make every effort to resolve the
327matter within a timeframe that will not cause benefits to be
328withheld from an eligible enrollee.
329     (10)  The following individuals may be subject to
330prosecution in accordance with s. 414.39:
331(a)  An applicant obtaining or attempting to obtain
332benefits for a potential enrollee under the Florida KidCare
333program when the applicant knows or should have known the
334potential enrollee does not qualify for the Florida KidCare
335program.
336     (b)  An individual who assists an applicant in obtaining or
337attempting to obtain benefits for a potential enrollee under the
338Florida KidCare program when the individual knows or should have
339known the potential enrollee does not qualify for the Florida
340KidCare program.
341     Section 5.  Paragraph (q) of subsection (2) of section
342409.815, Florida Statutes, is amended to read:
343     409.815  Health benefits coverage; limitations.--
344     (2)  BENCHMARK BENEFITS.--In order for health benefits
345coverage to qualify for premium assistance payments for an
346eligible child under ss. 409.810-409.820, the health benefits
347coverage, except for coverage under Medicaid and Medikids, must
348include the following minimum benefits, as medically necessary.
349     (q)  Dental services.--Covered services may include those
350dental services provided to children by the Florida Medicaid
351program under s. 409.906(5), contingent upon an annual
352appropriation in the General Appropriations Act up to a maximum
353benefit of $750 per enrollee per year.
354     Section 6.  Subsections (3) through (7) of section 624.91,
355Florida Statutes, are renumbered as subsections (4) through (8),
356respectively, present subsections (2) and (4) of said section
357are amended, and a new subsection (3) is added to said section,
358to read:
359     624.91  The Florida Healthy Kids Corporation Act.--
360     (2)  LEGISLATIVE INTENT.--
361     (a)  The Legislature finds that increased access to health
362care services could improve children's health and reduce the
363incidence and costs of childhood illness and disabilities among
364children in this state. Many children do not have comprehensive,
365affordable health care services available. It is the intent of
366the Legislature that the Florida Healthy Kids Corporation
367provide comprehensive health insurance coverage to such
368children. The corporation is encouraged to cooperate with any
369existing health service programs funded by the public or the
370private sector and to work cooperatively with the Florida
371Partnership for School Readiness.
372     (b)  It is the intent of the Legislature that the Florida
373Healthy Kids Corporation serve as one of several providers of
374services to children eligible for medical assistance under Title
375XXI of the Social Security Act. Although the corporation may
376serve other children, the Legislature intends the primary
377recipients of services provided through the corporation be
378school-age children with a family income below 200 percent of
379the federal poverty level, who do not qualify for Medicaid. It
380is also the intent of the Legislature that state and local
381government Florida Healthy Kids funds be used to continue and
382expand coverage, subject to specific appropriations in the
383General Appropriations Act, to children not eligible for federal
384matching funds under Title XXI.
385     (3)  ELIGIBILITY FOR STATE-FUNDED ASSISTANCE.-?Only the
386following individuals are eligible for state-funded assistance
387in paying Florida Healthy Kids premiums:
388     (a)  Residents of this state who are eligible for the
389Florida KidCare program pursuant to s. 409.814.
390     (b)  Notwithstanding s. 409.814, legal aliens who are
391enrolled in the Florida Healthy Kids program as of January 31,
3922004, who do not qualify for Title XXI federal funds because
393they are not qualified aliens as defined in s. 409.811.
394     (c)  Notwithstanding s. 409.814, individuals who have
395attained the age of 19 as of March 31, 2004, who were receiving
396Florida Healthy Kids benefits prior to the enactment of the
397Florida KidCare program. This paragraph shall be repealed March
39831, 2005.
399     (d)  Notwithstanding s. 409.814, state employee dependents
400who were enrolled in the Florida Healthy Kids program as of
401January 31, 2004. Such individuals shall remain eligible until
402January 1, 2005.
403     (5)(4)  CORPORATION AUTHORIZATION, DUTIES, POWERS.--
404     (a)  There is created the Florida Healthy Kids Corporation,
405a not-for-profit corporation.
406     (b)  The Florida Healthy Kids Corporation shall:
407     1.  Arrange for the collection of any family, local
408contributions, or employer payment or premium, in an amount to
409be determined by the board of directors, to provide for payment
410of premiums for comprehensive insurance coverage and for the
411actual or estimated administrative expenses.;
412     2.  Arrange for the collection of any voluntary
413contributions to provide for payment of premiums for children
414who are not eligible for medical assistance under Title XXI of
415the Social Security Act. Each fiscal year, the corporation shall
416establish a local match policy for the enrollment of non-Title-
417XXI-eligible children in the Healthy Kids program. By May 1 of
418each year, the corporation shall provide written notification of
419the amount to be remitted to the corporation for the following
420fiscal year under that policy. Local match sources may include,
421but are not limited to, funds provided by municipalities,
422counties, school boards, hospitals, health care providers,
423charitable organizations, special taxing districts, and private
424organizations. The minimum local match cash contributions
425required each fiscal year and local match credits shall be
426determined by the General Appropriations Act. The corporation
427shall calculate a county's local match rate based upon that
428county's percentage of the state's total non-Title-XXI
429expenditures as reported in the corporation's most recently
430audited financial statement. In awarding the local match
431credits, the corporation may consider factors including, but not
432limited to, population density, per capita income, and existing
433child-health-related expenditures and services.;
434     3.  Subject to the provisions of s. 409.8134, accept
435voluntary supplemental local match contributions that comply
436with the requirements of Title XXI of the Social Security Act
437for the purpose of providing additional coverage in contributing
438counties under Title XXI.;
439     4.  Establish the administrative and accounting procedures
440for the operation of the corporation.;
441     5.  Establish, with consultation from appropriate
442professional organizations, standards for preventive health
443services and providers and comprehensive insurance benefits
444appropriate to children,; provided that such standards for rural
445areas shall not limit primary care providers to board-certified
446pediatricians.;
447     6.  Determine Establish eligibility for criteria which
448children seeking must meet in order to participate in the Title
449XXI-funded components of the Florida KidCare program consistent
450with the requirements specified in s. 409.814, as well as the
451non-Title-XXI-eligible children as provided in subsection (3).;
452     7.  Establish procedures under which providers of local
453match to, applicants to and participants in the program may have
454grievances reviewed by an impartial body and reported to the
455board of directors of the corporation.;
456     8.  Establish participation criteria and, if appropriate,
457contract with an authorized insurer, health maintenance
458organization, or third-party insurance administrator to provide
459administrative services to the corporation.;
460     9.  Establish enrollment criteria which shall include
461penalties or waiting periods of not fewer than 60 days for
462reinstatement of coverage upon voluntary cancellation for
463nonpayment of family premiums.;
464     10.  If a space is available, establish a special open
465enrollment period of 30 days' duration for any child who is
466enrolled in Medicaid or Medikids if such child loses Medicaid or
467Medikids eligibility and becomes eligible for the Florida
468Healthy Kids program;
469     10.11.  Contract with authorized insurers or any provider
470of health care services, meeting standards established by the
471corporation, for the provision of comprehensive insurance
472coverage to participants. Such standards shall include criteria
473under which the corporation may contract with more than one
474provider of health care services in program sites. Health plans
475shall be selected through a competitive bid process. The Florida
476Healthy Kids Corporation shall purchase goods and services in
477the most cost-effective manner consistent with the delivery of
478quality medical care. The maximum administrative cost for a
479Florida Healthy Kids Corporation contract shall be 15 percent.
480The minimum medical loss ratio for a Florida Healthy Kids
481Corporation contract shall be 85 percent. The selection of
482health plans shall be based primarily on quality criteria
483established by the board. The health plan selection criteria and
484scoring system, and the scoring results, shall be available upon
485request for inspection after the bids have been awarded.;
486     11.12.  Establish disenrollment criteria in the event local
487matching funds are insufficient to cover enrollments.;
488     12.13.  Develop and implement a plan to publicize the
489Florida Healthy Kids Corporation, the eligibility requirements
490of the program, and the procedures for enrollment in the program
491and to maintain public awareness of the corporation and the
492program.;
493     13.14.  Secure staff necessary to properly administer the
494corporation. Staff costs shall be funded from state and local
495matching funds and such other private or public funds as become
496available. The board of directors shall determine the number of
497staff members necessary to administer the corporation.;
498     15.  As appropriate, enter into contracts with local school
499boards or other agencies to provide onsite information,
500enrollment, and other services necessary to the operation of the
501corporation;
502     14.16.  Provide a report annually to the Governor, Chief
503Financial Officer, Commissioner of Education, Senate President,
504Speaker of the House of Representatives, and Minority Leaders of
505the Senate and the House of Representatives.;
506     17.  Each fiscal year, establish a maximum number of
507participants, on a statewide basis, who may enroll in the
508program; and
509     15.18.  Establish eligibility criteria, premium and cost-
510sharing requirements, and benefit packages which conform to the
511provisions of the Florida KidCare Kidcare program, as created in
512ss. 409.810-409.820.
513     (c)  Coverage under the corporation's program is secondary
514to any other available private coverage held by, or applicable
515to, the participant child or family member. Insurers under
516contract with the corporation are the payors of last resort and
517must coordinate benefits with any other third-party payor that
518may be liable for the participant's medical care The corporation
519may establish procedures for coordinating benefits under this
520program with benefits under other public and private coverage.
521     (d)  The Florida Healthy Kids Corporation shall be a
522private corporation not for profit, organized pursuant to
523chapter 617, and shall have all powers necessary to carry out
524the purposes of this act, including, but not limited to, the
525power to receive and accept grants, loans, or advances of funds
526from any public or private agency and to receive and accept from
527any source contributions of money, property, labor, or any other
528thing of value, to be held, used, and applied for the purposes
529of this act.
530     Section 7.  The Auditor General shall perform an analysis
531of children enrolled in the Florida KidCare program who are
532ineligible pursuant to the requirements of s. 409.814, Florida
533Statutes, to obtain recommendations to implement mechanisms to
534prevent such enrollment. The results of such analysis and the
535consequent recommendations shall be reported to the Governor,
536the President of the Senate, and the Speaker of the House of
537Representatives by December 31, 2004.
538     Section 8.  The Florida Healthy Kids Corporation shall use
539existing funds from their operating fund established by s.
540624.915, Florida Statutes, to contract for an actuarial study on
541the impact of full-pay enrollees on the cost of services for
542each KidCare program component.
543     Section 9.  The Auditor General shall perform random audits
544to ensure that all children enrolled in the Florida Healthy Kids
545program are eligible pursuant to ss. 409.814 and 624.91, Florida
546Statutes.
547     Section 10.  The Office of Program Policy Analysis and
548Government Accountability shall perform a study to determine the
549appropriate family premium for the Florida KidCare program and
550submit a report to the President of the Senate and the Speaker
551of the House of Representatives by January 1, 2005. The report
552shall set out no fewer than three options and shall make a
553recommendation as to the appropriate family premium for the
554Florida KidCare program. Each option shall include a detailed
555explanation of the analysis that led to the conclusion. A
556discussion of family premiums collected by Title XXI programs in
557other states shall be part of the report.
558     Section 11.  Subsection (2) of section 409.818, Florida
559Statutes, is amended to read:
560     409.818  Administration.--In order to implement ss.
561409.810-409.820, the following agencies shall have the following
562duties:
563     (2)  The Department of Health shall:
564     (a)  Design an eligibility intake process for the program,
565in coordination with the Department of Children and Family
566Services, the agency, and the Florida Healthy Kids Corporation.
567The eligibility intake process may include local intake points
568that are determined by the Department of Health in coordination
569with the Department of Children and Family Services.
570     (b)  Design and implement program outreach activities under
571s. 409.819.
572     (b)(c)  Chair a state-level coordinating council to review
573and make recommendations concerning the implementation and
574operation of the program. The coordinating council shall include
575representatives from the department, the Department of Children
576and Family Services, the agency, the Florida Healthy Kids
577Corporation, the Office of Insurance Regulation of the Financial
578Services Commission, local government, health insurers, health
579maintenance organizations, health care providers, families
580participating in the program, and organizations representing
581low-income families.
582     (c)(d)  In consultation with the Florida Healthy Kids
583Corporation and the Department of Children and Family Services,
584establish establishing a toll-free telephone line to assist
585families with questions about the program.
586     (d)(e)  Adopt rules necessary to implement outreach
587activities.
588     Section 12.  Section 409.819, Florida Statutes, is
589repealed.
590     Section 13.  The sums of $6,566,073 from the General
591Revenue Fund, $454,687 from the Grants and Donations Trust Fund,
592and $16,272,440 from the Medical Quality Assurance Trust Fund
593are appropriated to the Agency for Health Care Administration,
594and the sum of $1,984,113 is appropriated from the Grants and
595Donations Trust Fund to the Department of Health, for the 2003-
5962004 fiscal year for the purpose of serving children on whose
597behalf applications are submitted to the Florida KidCare program
598as of January 30, 2004, and who are determined to be eligible
599for program components funded under Title XXI of the Social
600Security Act.
601     Section 14.  Except as otherwise provided herein, this act
602shall take effect upon becoming a law.


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