Florida Governor Extends 30-Day Retroactive Medicaid Eligibility

July 2019 ~

The Governor of Florida has extended legislation reducing retroactive Medicaid eligibility from 90 to 30 days for at least one more year.

Standard Medicaid regulations allow beneficiaries to receive coverage for a 90-day period before they apply for Medicaid. The legislation, SB 2502, is part of the state’s recently approved state budget and will allow the program to stay in place until June 2020.

Under SB 2502, coverage becomes effective as of the first day of the month in which an application is filed. Retroactive coverage becomes effective based on the filing date.

The legislation also mandates the state Agency for Health Care Administration to submit a report to the legislature about the impact of the change on patients and health care providers by January 2020.

The state Agency for Health Care Administration requested the policy change, in early 2019, after lawmakers voted to support shortening the retroactive eligibility period. Florida Medicaid officials had previously estimated the eligibility would affect about 39,000 people annually (not including pregnant women and children) and totaling to approximately $98 million in costs. At that time, the agency stated that the change would not harm applicants so long as they submitted their paperwork on time.

The state legislature is hopeful that the program will encourage Medicaid beneficiaries to maintain continuous coverage by applying for the Medicaid managed-care program proactively, rather than after treatment has been received.


Source(s): New4Jax; Gibbs Law Office; Miami Herald;