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The 2025 Florida Statutes
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F.S. 409.902409.902 Designated single state agency; payment requirements; program title; release of medical records.—(1) The Agency for Health Care Administration is designated as the single state agency authorized to make payments for medical assistance and related services under Title XIX of the Social Security Act. These payments shall be made, subject to any limitations or directions provided for in the General Appropriations Act, only for services included in the program, shall be made only on behalf of eligible individuals, and shall be made only to qualified providers in accordance with federal requirements for Title XIX of the Social Security Act and the provisions of state law. This program of medical assistance is designated the “Medicaid program.” The Department of Children and Families is responsible for Medicaid eligibility determinations, including, but not limited to, policy, rules, and the agreement with the Social Security Administration for Medicaid eligibility determinations for Supplemental Security Income recipients, as well as the actual determination of eligibility. As a condition of Medicaid eligibility, subject to federal approval, the Agency for Health Care Administration and the Department of Children and Families shall ensure that each recipient of Medicaid consents to the release of her or his medical records to the Agency for Health Care Administration and the Medicaid Fraud Control Unit of the Department of Legal Affairs. (2) Eligibility is restricted to United States citizens and to lawfully admitted noncitizens who meet the criteria provided in s. 414.095(3).(a) Citizenship or immigration status must be verified. For noncitizens, this includes verification of the validity of documents with the United States Citizenship and Immigration Services using the federal SAVE verification process. (b) State funds may not be used to provide medical services to individuals who do not meet the requirements of this subsection unless the services are necessary to treat an emergency medical condition or are for pregnant women. Such services are authorized only to the extent provided under federal law and in accordance with federal regulations as provided in 42 C.F.R. s. 440.255. (3) To the extent that funds are appropriated, the department shall collaborate with the Agency for Health Care Administration to develop an Internet-based system that is modular, interoperable, and scalable for eligibility determination for Medicaid and the Children’s Health Insurance Program (CHIP) that complies with all applicable federal and state laws and requirements. (4) The system shall accomplish the following primary business objectives:(a) Provide individuals and families with a single point of access to information that explains benefits, premiums, and cost sharing available through Medicaid, the Children’s Health Insurance Program, or any other state or federal health insurance exchange. (b) Enable timely, accurate, and efficient enrollment of eligible persons into available assistance programs. (c) Prevent eligibility fraud. (d) Allow for detailed financial analysis of eligibility-based cost drivers. (5) The system shall include, but is not limited to, the following business and functional requirements:(a) Allow for the completion and submission of an online application for eligibility determination that accepts the use of electronic signatures. (b) Include a process that enables automatic enrollment of qualified individuals in Medicaid, the Children’s Health Insurance Program, or any other state or federal exchange that offers cost-sharing benefits for the purchase of health insurance. (c) Allow for the determination of Medicaid eligibility based on modified adjusted gross income by using information submitted in the application and information accessed and verified through automated and secure interfaces with authorized databases. (d) Include the ability to determine specific categories of Medicaid eligibility and interfaces with the Florida Medicaid Management Information System to support a determination, using federally approved assessment methodologies, of state and federal financial participation rates for persons in each eligibility category. (e) Allow for the accurate and timely processing of eligibility claims and adjudications. (f) Align with and incorporate all applicable state and federal laws, requirements, and standards to include the information technology security requirements established pursuant to s. 282.318 and the accessibility standards established under part II of chapter 282. (g) Produce transaction data, reports, and performance information that contribute to an evaluation of the program, continuous improvement in business operations, and increased transparency and accountability. (6) The department shall develop the system, subject to the approval by the Legislative Budget Commission and as required by the General Appropriations Act for the 2012-2013 fiscal year. (7) The system must be completed by October 1, 2013, and ready for implementation by January 1, 2014. (8) The department shall implement the following project governance structure until the system is implemented:(a) The Secretary of Children and Families shall have overall responsibility for the project. (b) The project shall be governed by an executive steering committee composed of three department staff members appointed by the Secretary of Children and Families; three agency staff members, including at least two state Medicaid program staff members, appointed by the Secretary of the Agency for Health Care Administration; one staff member from Children’s Medical Services within the Department of Health appointed by the Surgeon General; and a representative from the Florida Healthy Kids Corporation. (c) The executive steering committee shall have the overall responsibility for ensuring that the project meets its primary business objectives and shall:1. Provide management direction and support to the project management team. 2. Review and approve any changes to the project’s scope, schedule, and budget. 3. Review, approve, and determine whether to proceed with any major deliverable project. 4. Recommend suspension or termination of the project to the Governor, the President of the Senate, and the Speaker of the House of Representatives if the committee determines that the primary business objectives cannot be achieved. (d) A project management team shall be appointed by and work under the direction of the executive steering committee. The project management team shall:1. Provide planning, management, and oversight of the project. 2. Submit an operational work plan and provide quarterly updates to the plan to the executive steering committee. The plan must specify project milestones, deliverables, and expenditures. 3. Submit written monthly project status reports to the executive steering committee. History.—s. 31, ch. 91-282; s. 2, ch. 95-393; s. 12, ch. 2000-163; s. 49, ch. 2000-256; s. 15, ch. 2002-400; s. 32, ch. 2011-135; s. 4, ch. 2012-33; s. 202, ch. 2014-19.
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Annotations, Discussions, Cases:
Cases Citing Statute 409.902
Total Results: 24
790 So. 2d 1036, 2001 WL 776533
Supreme Court of Florida | Filed: Jul 12, 2001 | Docket: 1734415
Cited 8 times | Published
is administered by AHCA. See § 409.902, Fla. Stat. (2000). Section 409.902 provides that state Medicaid
782 So. 2d 977, 2001 WL 360245
District Court of Appeal of Florida | Filed: Apr 12, 2001 | Docket: 456493
Cited 5 times | Published
payments under the Florida Medicaid program. See § 409.902, Fla. Stat. (1999). The Florida Medicaid program
756 So. 2d 218, 2000 WL 423471
District Court of Appeal of Florida | Filed: Apr 20, 2000 | Docket: 471169
Cited 4 times | Published
footnote 16. It appears that our State, via section 409.902, Florida Statutes, has elected to fund only
845 So. 2d 223, 2003 Fla. App. LEXIS 4733, 2003 WL 1798101
District Court of Appeal of Florida | Filed: Apr 8, 2003 | Docket: 1728765
Cited 3 times | Published
for the administration of Medicaid in Florida. § 409.902, Fla. Stat. (2001). Medicaid is a prospective
965 So. 2d 154, 2007 WL 2174850
District Court of Appeal of Florida | Filed: Jul 31, 2007 | Docket: 446804
Cited 1 times | Published
services on behalf of eligible individuals. See § 409.902, Fla. Stat. (2005); see generally, Russell, 929
929 So. 2d 601, 2006 Fla. App. LEXIS 6903, 2006 WL 1210200
District Court of Appeal of Florida | Filed: May 8, 2006 | Docket: 1726966
Cited 1 times | Published
services on behalf of eligible individuals. See § 409.902, Fla. Stat. (2005). Foster children, like Amber
916 So. 2d 994, 2005 WL 3533677
District Court of Appeal of Florida | Filed: Dec 28, 2005 | Docket: 1659603
Cited 1 times | Published
authorized under Title XIX of the Social Security Act. § 409.902, Fla. Stat. (1999); see 42 U.S.C. § 1396 (2000)
915 So. 2d 643, 2005 WL 2467615
District Court of Appeal of Florida | Filed: Oct 7, 2005 | Docket: 1690647
Cited 1 times | Published
expenses through Florida's Medicaid program. § 409.902.
The Co-Personal Representatives the Decedent's
636 So. 2d 117, 1994 Fla. App. LEXIS 3543, 1994 WL 133528
District Court of Appeal of Florida | Filed: Apr 19, 1994 | Docket: 64748138
Cited 1 times | Published
administer payments under the Medicaid program. § 409.902, Fla.Stat. (1991). In its complaint, the Department
District Court of Appeal of Florida | Filed: Sep 12, 2019 | Docket: 16189565
Published
for administering Florida’s Medicaid program. §
409.902, Fla. Stat. Florida grants AHCA the right to be
270 So. 3d 488
District Court of Appeal of Florida | Filed: Apr 26, 2019 | Docket: 64713205
Published
Medicaid payments for services rendered. See § 409.902(1), Fla. Stat.
Historically, the Agency reimbursed
270 So. 3d 488
District Court of Appeal of Florida | Filed: Apr 26, 2019 | Docket: 64713206
Published
Medicaid payments for services rendered. See § 409.902(1), Fla. Stat.
Historically, the Agency reimbursed
District Court of Appeal of Florida | Filed: Apr 26, 2019 | Docket: 15004989
Published
Medicaid payments for services rendered. See § 409.902(1), Fla.
Stat.
Historically, the Agency
272 So. 3d 431
District Court of Appeal of Florida | Filed: Feb 27, 2019 | Docket: 14572789
Published
responsible for determining
eligibility for Medicaid. § 409.902(1), Fla. Stat. The Agency “is
designated as the
263 So. 3d 817
District Court of Appeal of Florida | Filed: Jan 14, 2019 | Docket: 8494334
Published
Agency for Health Care Administration
(AHCA). See § 409.902(1), Fla. Stat. (2016). When a person
receives
212 So. 3d 516, 2017 WL 945532, 2017 Fla. App. LEXIS 3214
District Court of Appeal of Florida | Filed: Mar 10, 2017 | Docket: 4616395
Published
administers the Florida Medicaid program. See § 409.902, Fla. Stat. (2015).
2
. "Florida
194 So. 3d 1042, 2016 WL 1295045, 2016 Fla. App. LEXIS 5171
District Court of Appeal of Florida | Filed: Apr 4, 2016 | Docket: 3050457
Published
participants’ co-payment amounts.
See
§ 409.902, Fla. Stat. (2011); Fla. Admin. Code R. 65A-1
185 So. 3d 1298, 2016 WL 764718
District Court of Appeal of Florida | Filed: Feb 28, 2016 | Docket: 3039864
Published
responsible for making eligibility determinations. § 409.902, Fla. Stat. (2014). The State Medicaid program
199 So. 3d 286, 2015 Fla. App. LEXIS 17914, 2015 WL 7566262
District Court of Appeal of Florida | Filed: Nov 25, 2015 | Docket: 60256572
Published
state entity that determines ICP eligibility. § 409.902, Fla. Stat. (2013). The Department conducts periodic
898 So. 2d 1040, 2005 Fla. App. LEXIS 3456, 2005 WL 598365
District Court of Appeal of Florida | Filed: Mar 16, 2005 | Docket: 64837437
Published
services on behalf of eligible individuals. See § 409.902-905, Fla. Stat. (2003). In the case before us
872 So. 2d 970, 2004 WL 840149
District Court of Appeal of Florida | Filed: Apr 21, 2004 | Docket: 2552134
Published
invalid. The rules were implemented pursuant to section 409.902, Florida Statutes (2000) which authorizes the
869 So. 2d 653, 2004 Fla. App. LEXIS 4091, 2004 WL 625773
District Court of Appeal of Florida | Filed: Mar 31, 2004 | Docket: 64829184
Published
making Medicaid eligibility determinations. See § 409.902, Fla. Stat. (2002). In this case, the hearing
852 So. 2d 322, 2003 Fla. App. LEXIS 11714, 2003 WL 21750273
District Court of Appeal of Florida | Filed: Jul 30, 2003 | Docket: 64824364
Published
SHAHOOD, JJ., concur.
. The State has cited section 409.902, Florida Statutes, which provides:
*325As a
837 So. 2d 537, 2003 Fla. App. LEXIS 1395, 2003 WL 289462
District Court of Appeal of Florida | Filed: Feb 12, 2003 | Docket: 64820729
Published
in a manner inconsistent with agency rules.
Section 409.902, Florida Statutes (2001), assigns the responsibility
