No. CS/CS/SB 1668
Filed under Healthcare.
Florida Birth-Related Neurological Injury Compensation Association; Requiring the Agency for Health Care Administration to recover from the Florida Birth-Related Neurological Injury Compensation Association specified costs incurred by Medicaid; revising the exclusiveness of rights and remedies of the Florida Birth-Related Neurological Injury Compensation Plan; revising services eligible for compensation under certain annual benefits under the plan; requiring family members of plan participants to continuously maintain certain health insurance coverage for the participant; revising requirements for the administration of assessments and appropriations dedicated to the Florida Birth-Related Neurological Injury Compensation Plan, etc.
Plain English Summary
AI-GENERATEDFamily members of children and adults compensated for birth-related neurological injuries must now continuously maintain comprehensive health insurance for that person, applying for Medicaid within 30 days if they lack coverage when an award is approved.
The compensation plan must now pay the participant's health insurance premiums and out-of-pocket costs, and must reimburse Medicaid for claims paid on a participant's behalf, crediting those funds to the state's Medical Care Trust Fund.
New compensable expenses include dental services, legal costs of establishing guardianship, and psychotherapy for family members, which now continues up to $20,000 total after the participant dies.
The plan must now test its own solvency every quarter and alert state regulators if underfunded, while a new $20 million state-backed fund covers short-term cash shortfalls.
AIEvery family member of a plan participant must keep continuous, comprehensive major-medical health insurance on that person. A new participant's family gets 60 days after the compensation order (or 30 days to apply for Medicaid); families already in the program must comply by January 1, 2027.
AIWhen a compensated participant is also enrolled in Medicaid, the plan must pay Medicaid's fee-for-service and capitation costs for that person's care, crediting the money to the state's Medical Care Trust Fund. A companion change lets the state recover those costs directly from the association.
AIBy December 31, 2026, the plan must pay back any participant whose medically necessary care was reduced or denied on or before June 30, 2026 because the family lacked qualifying health insurance -- a one-time catch-up tied to the new insurance mandate.
AILegal fees to set up or maintain a guardianship for a participant become a compensable expense under the plan, with no dollar cap stated for this category, unlike the plan's other benefits.
AIPsychotherapy coverage now reaches any relative who has lived with the participant, not just immediate family, and adds psychiatrists to the eligible providers. Coverage continues after the participant dies, up to $20,000 total, versus $10,000 annually during their lifetime.
AIA family member cannot be paid for custodial care during hours when another caregiver is simultaneously providing care, or when that family member is separately compensated by someone else for work performed during those same hours.
AIThe plan's board cannot create or expand benefits that add cost while the plan is running an annual cash-flow deficit shown in its audited financials, though it must still pay the benefits the law already requires.
AIEvery quarter the association must calculate its own actuarial soundness and immediately notify the state's insurance office if the plan comes up short, triggering defined regulator review and valuation deadlines instead of waiting for the next biennial check.