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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 2 Non-Payment Waiting Period………………………………………………………………..61 Florida Healthy Kids Co-payments .................................................................................. .…101 Title XXI Billing Methodology ....................................................................................... ….118 SCHIP Budget Plan Template .......................................................................................... ….120 Review Processes for Florida KidCare ................................................................................ .126 Appendix A…KidCare Medicaid Screening Criteria ………………………….…………...131

Appendix B …Dispute Review Process…………………………………………………….134

Appendix C …Florida KidCare Grievance Procedure.……………………………………..141

Appendix D…Healthy Kids Dental Prior Authorization Process…………………………...146

Appendix E…Dependents of State Employee Coverage……………………………………152