Florida Senate - 2009                          SENATOR AMENDMENT
       Bill No. CS for SB 1880
       
       
       
       
       
       
                                Barcode 741036                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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                Floor: 1/AD/2R         .                                
             04/27/2009 06:36 PM       .                                
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       Senator Joyner moved the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete line 71
    4  and insert:
    5         Section 2. Effective January 1, 2010, subsections (1) and
    6  (2) and paragraph (a) of subsection (4) of section 627.64171,
    7  Florida Statutes, are amended to read:
    8         627.64171 Coverage for length of stay and outpatient
    9  postsurgical care.—
   10         (1) Any health insurance policy that is issued, amended,
   11  delivered, or renewed in this state which provides coverage for
   12  breast cancer treatment may not limit inpatient hospital
   13  coverage for lymph node dissections or mastectomies to any
   14  period that is less than that determined by the treating
   15  physician to be medically necessary in accordance with
   16  prevailing medical standards and after consultation with the
   17  insured patient.
   18         (2) Any health insurance policy that provides coverage for
   19  lymph node dissections or mastectomies under subsection (1) must
   20  also provide coverage for outpatient postsurgical followup care
   21  in keeping with prevailing medical standards by a licensed
   22  health care professional qualified to provide postsurgical lymph
   23  node dissection or mastectomy care. The treating physician,
   24  after consultation with the insured patient, may choose that the
   25  outpatient care be provided at the most medically appropriate
   26  setting, which may include the hospital, treating physician’s
   27  office, outpatient center, or home of the insured patient.
   28         (4)(a) This section does not require an insured patient to
   29  have a lymph node dissection or the mastectomy in the hospital
   30  or stay in the hospital for a fixed period of time following the
   31  lymph node dissection or mastectomy.
   32         Section 3. Effective January 1, 2010, subsections (1) and
   33  (2) and paragraph (a) of subsection (4) of section 627.66121,
   34  Florida Statutes, are amended to read:
   35         627.66121 Coverage for length of stay and outpatient
   36  postsurgical care.—
   37         (1) Any group, blanket, or franchise accident or health
   38  insurance policy that is issued, amended, delivered, or renewed
   39  in this state which provides coverage for breast cancer
   40  treatment may not limit inpatient hospital coverage for lymph
   41  node dissections or mastectomies to any period that is less than
   42  that determined by the treating physician to be medically
   43  necessary in accordance with prevailing medical standards and
   44  after consultation with the insured patient.
   45         (2) Any group, blanket, or franchise accident or health
   46  insurance policy that provides coverage for lymph node
   47  dissections or mastectomies under subsection (1) must also
   48  provide coverage for outpatient postsurgical followup care in
   49  keeping with prevailing medical standards by a licensed health
   50  care professional qualified to provide postsurgical lymph node
   51  dissection or mastectomy care. The treating physician, after
   52  consultation with the insured patient, may choose that the
   53  outpatient care be provided at the most medically appropriate
   54  setting, which may include the hospital, treating physician’s
   55  office, outpatient center, or home of the insured patient.
   56         (4)(a) This section does not require an insured patient to
   57  have a lymph node dissection or the mastectomy in the hospital
   58  or stay in the hospital for a fixed period of time following the
   59  lymph node dissection or mastectomy.
   60         Section 4. Effective January 1, 2010, paragraphs (a) and
   61  (c) of subsection (31) of section 641.31, Florida Statutes, are
   62  amended to read:
   63         641.31 Health maintenance contracts.—
   64         (31)(a) Health maintenance contracts that provide coverage,
   65  benefits, or services for breast cancer treatment may not limit
   66  inpatient hospital coverage for lymph node dissections or
   67  mastectomies to any period that is less than that determined by
   68  the treating physician under contract with the health
   69  maintenance organization to be medically necessary in accordance
   70  with prevailing medical standards and after consultation with
   71  the covered patient. Such contract must also provide coverage
   72  for outpatient postsurgical followup care in keeping with
   73  prevailing medical standards by a licensed health care
   74  professional under contract with the health maintenance
   75  organization qualified to provide postsurgical lymph node
   76  dissection or mastectomy care. The treating physician under
   77  contract with the health maintenance organization, after
   78  consultation with the covered patient, may choose that the
   79  outpatient care be provided at the most medically appropriate
   80  setting, which may include the hospital, treating physician’s
   81  office, outpatient center, or home of the covered patient.
   82         (c)1. This subsection does not require a covered patient to
   83  have a lymph node dissection or the mastectomy in the hospital
   84  or stay in the hospital for a fixed period of time following the
   85  lymph node dissection or mastectomy.
   86         2. This subsection does not prevent a contract from
   87  imposing deductibles, coinsurance, or other cost sharing in
   88  relation to benefits pursuant to this subsection, except that
   89  such cost sharing shall not exceed cost sharing with other
   90  benefits.
   91         Section 5. Except as otherwise expressly provided in this
   92  act, this act shall take effect July 1,2009.
   93  
   94  ================= T I T L E  A M E N D M E N T ================
   95         And the title is amended as follows:
   96         Delete lines 2 - 11
   97  and insert:
   98         An act relating to breast cancer treatment; creating
   99         s. 381.932, F.S.; providing definitions; establishing
  100         a breast cancer early detection and treatment referral
  101         program within the Department of Health; providing
  102         purposes of the program; requiring the department to
  103         provide information regarding breast cancer and
  104         referrals for screening and treatment; requiring the
  105         State Surgeon General to submit a report to the
  106         Legislature; amending ss. 627.64171, 627.66121, and
  107         641.31, F.S.; including lymph node dissections under
  108         provisions prescribing the length of hospital stay
  109         relating to a mastectomy and the outpatient
  110         postsurgical followup care that specified health
  111         insurers and health maintenance organizations must
  112         cover; limiting application; providing effective
  113         dates.