To revise and update Safety Net Program information.

 

DEPARTMENT OF HEALTH

Division of Children's Medical Services

RULE NO.:RULE TITLE:

64C-2.004Sliding Fee Scale

PURPOSE AND EFFECT: To revise and update Safety Net Program information.

SUMMARY: The rule title will be changed and the Safety Net Program information will be updated and revised.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:

The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: Based on the SERC checklist, this rulemaking will not have an adverse impact or regulatory costs in excess of $1 million within five years as established in s.120.541(2)(a), F. S.

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY: 391.026(18) FS.

LAW IMPLEMENTED: 391.029(3)(a) FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAR.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Kelli Stannard, Director of Operations, CMS Managed Care Plan and Specialty Programs; [e-mail].

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

64C-2.004 Safety Net Program Sliding Fee Scale.

(1) The Safety Net Program is a program through Subject to funding, Children’s Medical Services (CMS) that, subject to funding, may pay for certain medical services to children with chronic and serious health care needs who do not qualify for Medicaid or Title XXI of the Social Security Act.

(a) Children eligible for assistance using these funds must be uninsured, or insured but not covered for medically necessary services, or unable to access services due to lack of providers or lack of financial resources regardless of insurance status.

(b) The department may serve children on a first-come, first-serve basis until the appropriated funds are fully obligated.

(c) Receiving services through the Safety Net Program does not constitute an entitlement for coverage or services when funds appropriated for this purpose are exhausted.

(2) No change.

(3) CMS will calculate the family’s percentage for subsection (2) based on the annual taxable family income and family size. For purposes of this calculation, CMS will utilize the 2017 2013 Federal Poverty Guidelines for the 48 Contiguous States and the District of Columbia, (effective January 31, 2017) 24, 2013, which is hereby incorporated by reference, and may be obtained at: https://aspe.hhs.gov/poverty-guidelines http://aspe.hhs.gov/poverty/13poverty.shtlm or can be found at http://www.flrules.org/Gateway/reference.asp?No=Ref-       02623.

(4) No change.

Rulemaking Authority 391.026(18) FS. Law Implemented 391.029(3)(a), 391.0315 FS. History‒New 5-15-13,            .

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Kelli Stannard, Director, CMS Managed Care Plan Operations

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Celeste Philip, MD, MPH, Surgeon General and Secretary

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: February 6, 2017

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: November 4, 2016