Florida Senate - 2020                        COMMITTEE AMENDMENT
       Bill No. SB 1556
       
       
       
       
       
       
                                Ì844372,Î844372                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  02/11/2020           .                                
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       The Committee on Banking and Insurance (Bean) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Section 765.523, Florida Statutes, is created to
    6  read:
    7         765.523Discrimination in access to anatomical gifts and
    8  organ transplants prohibited.—
    9         (1)As used in this section, the term:
   10         (a)“Auxiliary aids and services” means:
   11         1.Qualified interpreters or other effective methods of
   12  making aurally delivered materials available to individuals with
   13  hearing impairments.
   14         2.Qualified readers, recorded texts, texts in an
   15  accessible electronic format, or other effective methods of
   16  making visually delivered materials available to individuals
   17  with visual impairments.
   18         3.Supported decisionmaking services, including any of the
   19  following:
   20         a.The use of a support person to assist an individual in
   21  making medical decisions, communicating information to the
   22  individual, or ascertaining his or her wishes.
   23         b.The provision of information to a person designated by
   24  the individual, consistent with federal and state laws governing
   25  the disclosure of health information.
   26         c.Measures used to ensure that the individual’s guardian
   27  or legal representative, if any, is included in decisions
   28  involving the individual’s health care and that medical
   29  decisions are in accordance with the individual’s own expressed
   30  interests.
   31         d.Any other aid or service that is used to provide
   32  information in a format that is readily understandable and
   33  accessible to individuals with cognitive, neurological,
   34  developmental, or intellectual disabilities.
   35         (b)“Covered entity” means any of the following:
   36         1.A licensed health care practitioner as defined in s.
   37  456.001.
   38         2.A health care facility as defined in s. 408.07.
   39         3.Any other entity responsible for potential recipients of
   40  an anatomical gift or organ transplant.
   41         (c)“Disability” has the same meaning as “developmental
   42  disability” and “intellectual disability” as those terms are
   43  defined in s. 393.063.
   44         (d)“Organ transplant” means the transplantation or
   45  transfusion of a part of a human body into the body of another
   46  individual for the purpose of treating or curing a medical
   47  condition.
   48         (e)“Qualified individual” means an individual who has a
   49  disability and meets the clinical eligibility requirements for
   50  the receipt of an anatomical gift or an organ transplant,
   51  regardless of:
   52         1.The support networks available to the individual;
   53         2.The provision of auxiliary aids and services; or
   54         3.Reasonable modifications to the policies, practices, or
   55  procedures of a covered entity pursuant to subsection (4).
   56         (2)A covered entity may not do any of the following solely
   57  on the basis of an individual’s disability:
   58         (a)Consider a qualified individual ineligible to receive
   59  an anatomical gift or organ transplant.
   60         (b)Deny medical or other services related to an organ
   61  transplant, including evaluation, surgery, counseling, and
   62  posttransplant treatment and services.
   63         (c)Refuse to refer the individual to an organ procurement
   64  organization or a related specialist for the purpose of
   65  evaluation or receipt of an organ transplant.
   66         (d)Refuse to place a qualified individual on an organ
   67  transplant waiting list.
   68         (e)Place a qualified individual at a lower priority
   69  position on an organ transplant waiting list than the position
   70  at which the qualified individual would have been placed if not
   71  for the disability.
   72         (3)(a)A covered entity may take an individual’s disability
   73  into account if, following an individualized evaluation of him
   74  or her, a physician finds the individual’s disability to be
   75  medically significant to the provision of the anatomical gift or
   76  organ transplant, but only to the extent that the covered entity
   77  is making treatment or coverage recommendations or decisions for
   78  the individual.
   79         (b)If an individual has the necessary support system to
   80  assist him or her in complying with posttransplant medical
   81  requirements, a covered entity may not consider the individual’s
   82  inability to independently comply with the posttransplant
   83  medical requirements to be medically significant for the
   84  purposes of paragraph (a).
   85         (4)A covered entity shall make reasonable modifications to
   86  policies, practices, or procedures when the modifications are
   87  necessary to allow an individual with a disability access to
   88  services, including transplant-related counseling, information,
   89  coverage, or treatment, unless the covered entity can
   90  demonstrate that making the modifications would fundamentally
   91  alter the nature of the services. Such modifications shall
   92  include, but not be limited to, communication with the persons
   93  responsible for supporting the individual with his or her
   94  postsurgical and posttransplant care, including medication. Such
   95  modifications shall also consider the support networks available
   96  to the individual, including, but not limited to, family,
   97  friends, and home and community-based services coverage when
   98  determining whether the individual is able to comply with
   99  posttransplant medical requirements.
  100         (5)A covered entity shall take such steps as may be
  101  necessary to ensure that an individual with a disability is not
  102  denied services, including transplant-related counseling,
  103  information, coverage, or treatment, due to the absence of
  104  auxiliary aids and services, unless the covered entity can
  105  demonstrate that taking the steps would fundamentally alter the
  106  nature of the services being offered or would result in an undue
  107  burden on the covered entity.
  108         (6)If a covered entity violates this section, the
  109  qualified individual who is affected by the violation may bring
  110  an action in the appropriate circuit court for injunctive or
  111  other equitable relief.
  112         (7)This section may not be construed to require a covered
  113  entity to make a referral or recommendation for or perform a
  114  medically inappropriate organ transplant.
  115         Section 2. Section 627.64197, Florida Statutes, is created
  116  to read:
  117         627.64197Coverage for organ transplants.—A health
  118  insurance policy issued, delivered, or renewed on or after July
  119  1, 2020, in this state by an insurer which provides coverage for
  120  organ transplants on an expense-incurred basis may not deny
  121  coverage for an organ transplant solely on the basis of an
  122  insured’s disability. This section may not be construed to
  123  require such insurer to provide coverage for an organ transplant
  124  that is not medically necessary. For purposes of this section,
  125  the term “organ transplant” has the same meaning as in s.
  126  765.523.
  127         Section 3. Section 627.65736, Florida Statutes, is created
  128  to read:
  129         627.65736Coverage for organ transplants.—A group health
  130  insurance policy delivered, issued, or renewed on or after July
  131  1, 2020, in this state by an insurer or nonprofit health care
  132  services plan which provides coverage for organ transplants on
  133  an expense-incurred basis may not deny coverage for an organ
  134  transplant solely on the basis of an insured’s disability. This
  135  section may not be construed to require such insurer or
  136  nonprofit health care service plan to provide coverage for an
  137  organ transplant that is not medically necessary. For purposes
  138  of this section, the term “organ transplant” has the same
  139  meaning as in s. 765.523.
  140         Section 4. Section 641.31075, Florida Statutes, is created
  141  to read:
  142         641.31075Coverage for organ transplants.—A health
  143  maintenance contract issued or renewed on or after July 1, 2020,
  144  in this state by a health maintenance organization which
  145  provides coverage for organ transplants may not deny coverage
  146  for an organ transplant solely on the basis of a subscriber’s
  147  disability. This section may not be construed to require such
  148  health maintenance organization to provide coverage for an organ
  149  transplant that is not medically necessary. For purposes of this
  150  section, the term “organ transplant” has the same meaning as in
  151  s. 765.523.
  152         Section 5. This act shall take effect July 1, 2020.
  153  
  154  ================= T I T L E  A M E N D M E N T ================
  155  And the title is amended as follows:
  156         Delete everything before the enacting clause
  157  and insert:
  158                        A bill to be entitled                      
  159         An act relating to nondiscrimination in organ
  160         transplants; creating s. 765.523, F.S.; defining
  161         terms; prohibiting certain entities from making
  162         certain determinations or engaging in certain actions
  163         related to organ transplants solely on the basis of an
  164         individual’s disability; specifying an instance where
  165         certain entities may consider an individual’s
  166         disability, with an exception; requiring certain
  167         entities to make reasonable modifications in their
  168         policies, practices, and procedures under certain
  169         circumstances, with an exception; providing criteria
  170         for such modifications; requiring certain entities to
  171         take certain necessary steps to ensure an individual
  172         with a disability is not denied services, with
  173         exceptions; providing a cause of action for injunctive
  174         and other relief; providing construction; creating ss.
  175         627.64197, 627.65736, and 641.31075, F.S.; prohibiting
  176         insurers, nonprofit health care service plans, and
  177         health maintenance organizations that provide coverage
  178         for organ transplants from denying coverage solely on
  179         the basis of an individual’s disability under certain
  180         circumstances; providing construction; defining the
  181         term “organ transplant”; providing an effective date.