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State Children’s Health Insurance Program

Phase 1 Effective Date: April 1, 1998

Revised: 1/26/98, 2/19/98, 3/3/98, 3/6/98 Phase 2 Effective Date: July 1, 1998

Revised: 8/20/98, 8/24/98, 10/1/99, 7/28/00, 1/31/01, 7/02/02, 7/22/02, 1/3/03, 2/13/04, 9/27/04, 11/15/04, 8/11/05, 10/1/06, 7/1/09, 7/1/10, 7/1/11, 7/1/12 26 • conducting Title XIX screening of Florida KidCare applications; • electronically transmitting application data for children who appear to be eligible for Medicaid to the Department of Children and Families eligibility determination workers for a full Medicaid eligibility determination; • collecting monthly premiums from Title XXI families in accordance with the fee schedule, distributing coupon books to families, sending follow-up letters to families who have not made their monthly premium payments, and disenrolling children whose families do not make their monthly premium payment; • making referrals to the Children’s Medical Services Network (CMSN) of applicants or current enrollees who indicate their child has a special health care need; • transferring a data file of MediKids eligibles to the Agency for Health Care Administration for choice counseling once an application is received from a potential MediKids enrollee; and • notifying MediKids enrollees who attain the age of 5 that they will be enrolled in Healthy Kids at the first of the month following the month in which the child reached his fifth birthday, if space is available for such a transition. Enrollment in a Florida KidCare program component will not occur until the following conditions are met after ineligibility for and non-enrollment in Medicaid is determined and financial eligibility has been established: MediKids: (1) the FHKC receives the premium payment, and (2) the family has made a choice of a managed care plan or MediPass provider. Healthy Kids: FHKC receives the premium payment. CMSN: (1) the FHKC receives the premium payment, and (2) the Children’s Medical Services Network confirms that the child meets the clinical eligibility criteria for participation in the Children’s Medical Services Network.

PIC Services: Title XXI PIC services is an extension of the Medicaid 1115 waiver which established PIC services as a coordinated effort between the Department of Health, chiefly CMSN,