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Florida Statutes, Title XXX

Florida/Statutes

← All Florida coverage

Title XXX, Social Welfare

16 chapters · 723 sections in this title.

All chapters in Title XXX723 Ch 409, Social and Economic Assistance211 Ch 420, Housing98 Ch 429, Assisted Care Communities77 Ch 413, Employment and Related Services for …66 Ch 414, Family Self-sufficiency48 Ch 421, Public Housing48 Ch 430, Elder Affairs39 Ch 425, Rural Electric Cooperatives31 Ch 427, Special Transportation and Communica…27 Ch 415, Adult Protective Services25 Ch 410, Aging and Adult Services15 Ch 411, Handicap or High-risk Condition Prev…12 Ch 418, Recreation Districts12 Ch 422, Housing Cooperation Law9

723 sections·Filtered byTitle XXX✕

Fla. Stat. § 409.8132 Medikids program component
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(1) PROGRAM COMPONENT CREATED; PURPOSE.—The Medikids program component is created in the Agency for Health Care Administration to provide health care services under the Florida Kidcare program to eligible children using the administrative structure and provider network of the Med…
Fla. Stat. § 409.8134 Program expenditure ceiling; enrollment
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(1) Except for the Medicaid program, a ceiling shall be placed on annual federal and state expenditures for the Florida Kidcare program as provided each year in the General Appropriations Act.(2) The Florida Kidcare program may conduct enrollment continuously throughout the year.…
Fla. Stat. § 409.8135 Behavioral health services
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In order to ensure a high level of integration of physical and behavioral health care and to meet the more intensive treatment needs of enrollees with the most serious emotional disturbances or substance abuse problems, the Department of Health shall contract with the Department …
Fla. Stat. § 409.814 Eligibility
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1A child who has not reached 19 years of age whose family income is equal to or below 300 percent of the federal poverty level is eligible for the Florida Kidcare program as provided in this section. If an enrolled individual is determined to be ineligible for coverage, he or she…

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Fla. Stat. § 409.815 Health benefits coverage; limitations

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(1) MEDICAID BENEFITS.—For purposes of the Florida Kidcare program, benefits available under Medicaid and Medikids include those goods and services provided under the medical assistance program authorized by Title XIX of the Social Security Act, and regulations thereunder, as adm…

Fla. Stat. § 409.816 Limitations on premiums and cost sharing

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The following limitations on premiums and cost sharing are established for the program.(1) Enrollees who receive coverage under the Medicaid program may not be required to pay:(a) Enrollment fees, premiums, or similar charges; or(b) Copayments, deductibles, coinsurance, or simila…

Fla. Stat. § 409.817 Approval of health benefits coverage; financial assistance

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In order for health insurance coverage to qualify for premium assistance payments for an eligible child under ss. 409.810-409.821, the health benefits coverage must:(1) Be certified by the Office of Insurance Regulation of the Financial Services Commission under s. 409.818 as mee…

Fla. Stat. § 409.8175 Delivery of services in rural counties

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A health maintenance organization or a health insurer may reimburse providers located in a rural county according to the Medicaid fee schedule for services provided to enrollees in rural counties if the provider agrees to accept such fee schedule.History.—ss. 43, 57, ch. 98-288; …

Fla. Stat. § 409.8177 Program evaluation

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(1) The agency, in consultation with the Department of Health, the Department of Children and Families, and the Florida Healthy Kids Corporation, shall contract for an evaluation of the Florida Kidcare program and shall by January 1 of each year submit to the Governor, the Presid…

Fla. Stat. § 409.818 Administration

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In order to implement ss. 409.810-409.821, the following agencies shall have the following duties:(1) The Department of Children and Families shall:(a) Develop a simplified eligibility application mail-in form to be used for determining the eligibility of children for coverage un…

Fla. Stat. § 409.820 Quality assurance and access standards

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Except for Medicaid, the Department of Health, in consultation with the agency and the Florida Healthy Kids Corporation, shall develop a minimum set of quality assurance and access standards for all program components. The standards must include a process for granting exceptions …

Fla. Stat. § 409.821 Florida Kidcare program public records exemption

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(1) Personal identifying information of a Florida Kidcare program applicant or enrollee, as defined in s. 409.811, held by the Agency for Health Care Administration, the Department of Children and Families, the Department of Health, or the Florida Healthy Kids Corporation is conf…

Fla. Stat. § 409.901 Definitions; ss. 409.901-409.920

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As used in ss. 409.901-409.920, except as otherwise specifically provided, the term:(1) “Affiliate” or “affiliated person” means any person who directly or indirectly manages, controls, or oversees the operation of a corporation or other business entity that is a Medicaid provide…

Fla. Stat. § 409.902 Designated single state agency; payment requirements; program title; release of medical records

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(1) The Agency for Health Care Administration is designated as the single state agency authorized to make payments for medical assistance and related services under Title XIX of the Social Security Act. These payments shall be made, subject to any limitations or directions provid…

Fla. Stat. § 409.90201 Recipient address update process

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The Agency for Health Care Administration and the Department of Children and Families, in consultation with hospitals and nursing homes that serve Medicaid recipients, shall develop a process to update a recipient’s address in the Medicaid eligibility system at the time a recipie…

Fla. Stat. § 409.9021 Forfeiture of eligibility agreement

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As a condition of Medicaid eligibility, subject to federal approval, a Medicaid applicant shall agree in writing to forfeit all entitlements to any goods or services provided through the Medicaid program for the next 10 years if he or she has been found to have committed Medicaid…

Fla. Stat. § 409.9025 Eligibility while an inmate

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(1) Notwithstanding any other provision of law other than s. 409.9021, in the event that a person who is an inmate in the state’s correctional system as defined in s. 944.02, in a county detention facility as defined in s. 951.23, or in a municipal detention facility as defined i…

Fla. Stat. § 409.903 Mandatory payments for eligible persons

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The agency shall make payments for medical assistance and related services on behalf of the following persons who the department, or the Social Security Administration by contract with the Department of Children and Families, determines to be eligible, subject to the income, asse…

Fla. Stat. § 409.904 Optional payments for eligible persons

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The agency may make payments for medical assistance and related services on behalf of the following persons who are determined to be eligible subject to the income, assets, and categorical eligibility tests set forth in federal and state law. Payment on behalf of these Medicaid e…

Fla. Stat. § 409.9041 Working People with Disabilities program

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(1) As used in this section, the term “department” means the Department of Children and Families.(2) The Working People with Disabilities program is established within the agency. The purpose of the program is to eliminate barriers to employment by allowing certain working indivi…

Fla. Stat. § 409.905 Mandatory Medicaid services

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The agency may make payments for the following services, which are required of the state by Title XIX of the Social Security Act, furnished by Medicaid providers to recipients who are determined to be eligible on the dates on which the services were provided. Any service under th…

Fla. Stat. § 409.906 Optional Medicaid services

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Subject to specific appropriations, the agency may make payments for services which are optional to the state under Title XIX of the Social Security Act and are furnished by Medicaid providers to recipients who are determined to be eligible on the dates on which the services were…

Fla. Stat. § 409.9062 Lung transplant services for Medicaid recipients

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Subject to the availability of funds and subject to any limitations or directions provided for in the General Appropriations Act or chapter 216, the Agency for Health Care Administration Medicaid program shall pay for medically necessary lung transplant services for Medicaid reci…

Fla. Stat. § 409.9063 Coverage of continuous glucose monitors for Medicaid recipients

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(1) As used in this section, the term “continuous glucose monitor” means an instrument or a device designed for the purpose of aiding in the treatment of diabetes by measuring glucose levels on demand or at set intervals through a small, electronic sensor that slightly penetrates…

Fla. Stat. § 409.90637 Agency to seek federal approval for coverage and reimbursement authority for mobile crisis response services

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Effective upon this act becoming a law, the Agency for Health Care Administration shall seek federal approval for coverage and reimbursement authority for mobile crisis response services pursuant to 42 U.S.C. s. 1396w-6. The Department of Children and Families must coordinate wit…

Fla. Stat. § 409.90638 Agency to seek federal approval to implement acute hospital care at home program in state Medicaid program

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The Agency for Health Care Administration shall seek federal approval necessary to implement an acute hospital care at home program in the state Medicaid program which is substantially consistent with the parameters specified in 42 U.S.C. s. 1395cc–7(a)(2) and (3).History.—s. 32,…

Fla. Stat. § 409.9066 Medicare prescription discount program

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(1) As a condition of participation in the Florida Medicaid program or the pharmaceutical expense assistance program, a pharmacy must agree to charge any individual who is a Medicare beneficiary and who is a Florida resident showing a Medicare card when he or she presents a presc…

Fla. Stat. § 409.907 Medicaid provider agreements

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The agency may make payments for medical assistance and related services rendered to Medicaid recipients only to an individual or entity who has a provider agreement in effect with the agency, who is performing services or supplying goods in accordance with federal, state, and lo…

Fla. Stat. § 409.9071 Medicaid provider agreements for school districts certifying state match

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(1) The agency shall reimburse school-based services as provided in ss. 409.908(21) and 1011.70 pursuant to the rehabilitative services option provided under 42 U.S.C. s. 1396d(a)(13). For purposes of this section, billing agent consulting services are considered billing agent se…

Fla. Stat. § 409.9072 Medicaid provider agreements for charter schools and private schools

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(1) Subject to a specific appropriation by the Legislature, the agency shall reimburse private schools as defined in s. 1002.01 and schools designated as charter schools under s. 1002.33 which are Medicaid providers for school-based services pursuant to the rehabilitative service…

Fla. Stat. § 409.908 Reimbursement of Medicaid providers

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Subject to specific appropriations, the agency shall reimburse Medicaid providers, in accordance with state and federal law, according to methodologies set forth in the rules of the agency and in policy manuals and handbooks incorporated by reference therein. These methodologies …

Fla. Stat. § 409.9081 Copayments

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(1) The agency shall require, subject to federal regulations and limitations, each Medicaid recipient to pay at the time of service a nominal copayment for the following Medicaid services:(a) Hospital outpatient services: up to $3 for each hospital outpatient visit.(b) Physician …

Fla. Stat. § 409.9082 Quality assessment on nursing home facility providers; exemptions; purpose; federal approval required; remedies

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(1) As used in this section, the term:(a) “Net patient service revenue” means gross revenues from services provided to nursing home facility patients, less reductions from gross revenue resulting from an inability to collect payment of charges. Such reductions include bad debts; …

Fla. Stat. § 409.9083 Quality assessment on privately operated intermediate care facilities for the developmentally disabled; exemptions; purpose; federal approval required; remedies

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(1) As used in this section, the term:(a) “Intermediate care facility for the developmentally disabled” or “ICF/DD” means a privately operated intermediate care facility for the developmentally disabled licensed under part VIII of chapter 400.(b) “Net patient service revenue” mea…

Fla. Stat. § 409.909 Statewide Medicaid Residency Program

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(1) The Statewide Medicaid Residency Program is established to improve the quality of care and access to care for Medicaid recipients, expand graduate medical education on an equitable basis, and increase the supply of highly trained physicians statewide. The agency shall make pa…

Fla. Stat. § 409.910 Responsibility for payments on behalf of Medicaid-eligible persons when other parties are liable

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(1) It is the intent of the Legislature that Medicaid be the payor of last resort for medically necessary goods and services furnished to Medicaid recipients. All other sources of payment for medical care are primary to medical assistance provided by Medicaid. If benefits of a li…

Fla. Stat. § 409.9101 Recovery for payments made on behalf of Medicaid-eligible persons

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(1) This section may be cited as the “Medicaid Estate Recovery Act.”(2) It is the intent of the Legislature by this section to supplement Medicaid funds that are used to provide medical services to eligible persons. Medicaid estate recovery shall be accomplished by the agency fil…

Fla. Stat. § 409.9102 A qualified state Long-Term Care Insurance Partnership Program in Florida

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The Agency for Health Care Administration, in consultation with the Office of Insurance Regulation and the Department of Children and Families, is directed to establish a qualified state Long-Term Care Insurance Partnership Program in Florida, in compliance with the requirements …

Fla. Stat. § 409.911 Disproportionate share program

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Subject to specific allocations established within the General Appropriations Act and any limitations established pursuant to chapter 216, the agency shall distribute, pursuant to this section, moneys to hospitals providing a disproportionate share of Medicaid or charity care ser…

Fla. Stat. § 409.9113 Disproportionate share program for teaching hospitals

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In addition to the payments made under s. 409.911, the agency shall make disproportionate share payments to teaching hospitals, as defined in s. 408.07, for their increased costs associated with medical education programs and for tertiary health care services provided to the indi…

Fla. Stat. § 409.9115 Disproportionate share program for mental health hospitals

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The Agency for Health Care Administration shall design and implement a system of making mental health disproportionate share payments to hospitals that qualify for disproportionate share payments under s. 409.911. This system of payments shall conform with federal requirements an…

Fla. Stat. § 409.91151 Expenditure of funds generated through mental health disproportionate share program

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Funding generated through the mental health disproportionate share program shall be expended in accordance with legislatively authorized appropriations. If such funding is not addressed in legislatively authorized appropriations, the Agency for Health Care Administration shall pr…

Fla. Stat. § 409.9116 Disproportionate share/financial assistance program for rural hospitals

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In addition to the payments made under s. 409.911, the Agency for Health Care Administration shall administer a federally matched disproportionate share program and a state-funded financial assistance program for statutory rural hospitals. The agency shall make disproportionate s…

Fla. Stat. § 409.9118 Disproportionate share program for specialty hospitals

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The Agency for Health Care Administration shall design and implement a system of making disproportionate share payments to those hospitals licensed in accordance with part I of chapter 395 as a specialty hospital which meet all requirements listed in subsection (2). Notwithstandi…

Fla. Stat. § 409.91188 Specialty prepaid health plans for Medicaid recipients with HIV or AIDS

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The Agency for Health Care Administration is authorized to contract with specialty prepaid health plans and pay them on a prepaid capitated basis to provide Medicaid benefits to Medicaid-eligible recipients who have human immunodeficiency syndrome (HIV) or acquired immunodeficien…

Fla. Stat. § 409.9119 Disproportionate share program for specialty hospitals for children

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In addition to the payments made under s. 409.911, the Agency for Health Care Administration shall develop and implement a system under which disproportionate share payments are made to those hospitals that are separately licensed by the state as specialty hospitals for children,…

Fla. Stat. § 409.91195 Medicaid Pharmaceutical and Therapeutics Committee

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There is created a Medicaid Pharmaceutical and Therapeutics Committee within the agency for the purpose of developing a Medicaid preferred drug list and a preferred product list.(1) The committee shall be composed of 11 members appointed by the Governor. Four members shall be phy…

Fla. Stat. § 409.91196 Supplemental rebate agreements; public records and public meetings exemption

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1(1) The rebate amount, percent of rebate, manufacturer’s pricing, and supplemental rebate information held by the Agency for Health Care Administration under s. 409.912(5)(a)8. are confidential and exempt from s. 119.07(1) and s. 24(a), Art. I of the State Constitution.(2) That …

Fla. Stat. § 409.912 Cost-effective purchasing of health care

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The agency shall purchase goods and services for Medicaid recipients in the most cost-effective manner consistent with the delivery of quality medical care. To ensure that medical services are effectively utilized, the agency may, in any case, require a confirmation or second phy…

Fla. Stat. § 409.91206 Alternatives for health and long-term care reforms

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The Governor, the President of the Senate, and the Speaker of the House of Representatives may convene workgroups to propose alternatives for cost-effective health and long-term care reforms, including, but not limited to, reforms for Medicaid.History.—s. 11, ch. 2008-143.