(1) The department shall establish the medical criteria to determine if an applicant for the Children’s Medical Services program is an eligible individual.

Ask a legal question, get an answer ASAP!
Click here to chat with a lawyer about your rights.

   (2) The following individuals are financially eligible to receive services through the program:

   (a) A high-risk pregnant female who is eligible for Medicaid.

   (b) Children with special health care needs from birth to 21 years of age who are eligible for Medicaid.

   (c) Children with special health care needs from birth to 19 years of age who are eligible for a program under Title XXI of the Social Security Act.

   (3) Subject to the availability of funds, the following individuals may receive services through the program:

   (a) Children with special health care needs from birth to 21 years of age whose family income is above the requirements for financial eligibility under Title XXI of the Social Security Act and whose projected annual cost of care adjusts the family income to Medicaid financial criteria. In cases where the family income is adjusted based on a projected annual cost of care, the family shall participate financially in the cost of care based on criteria established by the department.

   (b) Children with special health care needs from birth to 21 years of age, as provided in Title V of the Social Security Act.

   (c) An infant who receives an award of compensation under s. 766.31(1). The Florida Birth-Related Neurological Injury Compensation Association shall reimburse the Children’s Medical Services Network the state’s share of funding, which must thereafter be used to obtain matching federal funds under Title XXI of the Social Security Act.

   (4) The department shall determine the financial and medical eligibility of children for the program. The department shall also determine the financial ability of the parents, or persons or other agencies having legal custody over such individuals, to pay the costs of health services under the program. The department may pay reasonable travel expenses related to the determination of eligibility for or the provision of health services.

   (5) Any child who has been provided with surgical or medical care or treatment under this act prior to being adopted shall continue to be eligible to be provided with such care or treatment after his or her adoption, regardless of the financial ability of the persons adopting the child.

s. 6, ch. 13620, 1929; CGL 1936 Supp. 3640(6); s. 1, ch.