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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 53 f. The child’s health benefits coverage ended because the child reached the maximum lifetime coverage amount; g. The child has exhausted coverage under a COBRA continuation provision; h. The health benefits coverage does not cover the child’s health care needs; or i. Domestic violence led to loss of coverage. 7. Children who do not have an SSN - the family’s statement is accepted that they applied and provide the date of application for a SSN. The family’s statement is accepted for the child’s social security number. 8. Child care expenses – the family’s statement is accepted if they incur child care expenses and the amount of this expense. 9. Child Support payments – The family’s statement is accepted if the family pays child support and the amount of the payments. 10. Loss of income – the family’s statement is accepted for the loss of income and termination of employment. 11. Pregnancy and due date – The family’s statement regarding pregnancy and the due date is accepted for any female member of the household.

System Improvements Florida KidCare partners initiated several improvements to the processing system to streamline the program and to improve overall program efficiency. • The Medicaid screening process was revised to count Social Security Income. Previously, Social Security benefits were not counted in the initial screen process, and as many as one-third of all KidCare referrals to DCF were denied and sent back to DHACS in the disposition file. Many of these “false positive” referrals eventually resulted in enrollment in CMSN, MediKids, or Healthy Kids. Children who were unnecessarily referred to DCF took longer to complete the process and also represented additional work and cost at DCF. Revising the Medicaid screen within the KidCare processing system to count Social Security benefits eliminates more than half of the false positive DCF referrals without negatively affecting the screen’s basic integrity or accuracy. Reducing the number of false positives referrals lessens the time it takes to process applications and provides a more reliable basis for referring children to