(1) The following Medicaid-eligible persons are exempt from mandatory managed care enrollment required by s. 409.965, and may voluntarily choose to participate in the managed medical assistance program:
(a) Medicaid recipients who have other creditable health care coverage, excluding Medicare.
(b) Medicaid recipients residing in residential commitment facilities operated through the Department of Juvenile Justice or a treatment facility as defined in s. 394.455(49).
(c) Persons eligible for refugee assistance.
(d) Medicaid recipients who are residents of a developmental disability center, including Sunland Center in Marianna and Tacachale in Gainesville.
(e) Medicaid recipients enrolled in the home and community based services waiver pursuant to chapter 393, and Medicaid recipients waiting for waiver services.
(f) Medicaid recipients residing in a group home facility licensed under chapter 393.
(g) Children receiving services in a prescribed pediatric extended care center.
(2) Persons eligible for Medicaid but exempt from mandatory participation who do not choose to enroll in managed care shall be served in the Medicaid fee-for-service program as provided under part III of this chapter.
(3) The agency shall seek federal approval to require Medicaid recipients enrolled in managed care plans, as a condition of Medicaid eligibility, to pay the Medicaid program a share of the premium of $10 per month.
History.—s. 13, ch. 2011-134; s. 51, ch. 2012-5; s. 6, ch. 2014-57; s. 29, ch. 2014-224; s. 76, ch. 2016-241; s. 21, ch. 2020-39; s. 11, ch. 2022-36.
Structure Florida Statutes
Chapter 409 - Social and Economic Assistance
Part IV - Medicaid Managed Care (Ss. 409.961-409.985)
409.961 - Statutory construction; applicability; rules.
409.963 - Single state agency.
409.964 - Managed care program; state plan; waivers.
409.965 - Mandatory enrollment.
409.966 - Eligible plans; selection.
409.967 - Managed care plan accountability.
409.968 - Managed care plan payments.
409.969 - Enrollment; disenrollment.
409.971 - Managed medical assistance program.
409.972 - Mandatory and voluntary enrollment.
409.975 - Managed care plan accountability.
409.976 - Managed care plan payment.
409.978 - Long-term care managed care program.
409.98 - Long-term care plan benefits.
409.981 - Eligible long-term care plans.
409.982 - Long-term care managed care plan accountability.
409.983 - Long-term care managed care plan payment.
409.984 - Enrollment in a long-term care managed care plan.
409.985 - Comprehensive Assessment and Review for Long-Term Care Services (CARES) Program.