Senate Bill 0228c1

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    Florida Senate - 1998                            CS for SB 228

    By the Committee on Health Care and Senators Gutman,
    Holzendorf, Kurth, Myers, Forman, Cowin, Grant, Bronson,
    Latvala, Kirkpatrick, Sullivan, Horne, Casas, Brown-Waite,
    Lee, Dudley, Klein, Harris, Jones, Geller, Laurent, Turner,
    Campbell, Crist, Dyer and Meadows

    317-1667A-98

  1                      A bill to be entitled

  2         An act relating to cleft-lip and cleft-palate

  3         treatment; creating s. 627.64193, F.S.;

  4         requiring certain health insurance policies to

  5         provide coverage for cleft-lip and cleft-palate

  6         treatment for children; amending s. 627.6515,

  7         F.S.; applying certain requirements for group

  8         coverage to out-of-state groups; creating s.

  9         627.66911, F.S.; requiring certain health

10         insurance policies to provide coverage for

11         cleft-lip and cleft-palate treatment for

12         children; amending s. 627.6699, F.S.; applying

13         certain requirements for group coverage to

14         coverage for small employers; amending s.

15         641.31, F.S.; providing for cleft-lip and

16         cleft-palate treatment for children by health

17         maintenance organizations; providing a

18         legislative determination of an important state

19         interest; providing applicability; providing an

20         effective date.

21

22  Be It Enacted by the Legislature of the State of Florida:

23

24         Section 1.  Section 627.64193, Florida Statutes, is

25  created to read:

26         627.64193  Required coverage for cleft lip and cleft

27  palate.--A health insurance policy that covers a child under

28  the age of 18 must provide coverage for treatment of cleft lip

29  and cleft palate for the child. The coverage must include

30  medical, dental, speech therapy, audiology, and nutrition

31  services only if such services are prescribed by the treating

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    Florida Senate - 1998                            CS for SB 228
    317-1667A-98




  1  physician or surgeon and such physician or surgeon certifies

  2  that such services are medically necessary and consequent to

  3  treatment of the cleft lip or cleft palate. The coverage

  4  required by this section is subject to terms and conditions

  5  applicable to other benefits. This section does not apply to

  6  specified-accident, specified-disease, hospital indemnity,

  7  limited benefit disability income, or long-term-care insurance

  8  policies.

  9         Section 2.  Paragraph (c) of subsection (2) of section

10  627.6515, Florida Statutes, is amended to read:

11         627.6515  Out-of-state groups.--

12         (2)  This part does not apply to a group health

13  insurance policy issued or delivered outside this state under

14  which a resident of this state is provided coverage if:

15         (c)  The policy provides the benefits specified in ss.

16  627.419, 627.6574, 627.6575, 627.6579, 627.6612, 627.66121,

17  627.66122, 627.6613, 627.667, 627.6675, and 627.6691, and

18  627.66911.

19         Section 3.  Section 627.66911, Florida Statutes, is

20  created to read:

21         627.66911  Required coverage for cleft lip and cleft

22  palate.--A health insurance policy that covers a child under

23  the age of 18 must provide coverage for treatment of cleft lip

24  and cleft palate for the child. The coverage must include

25  medical, dental, speech therapy, audiology, and nutrition

26  services only if such services are prescribed by the treating

27  physician or surgeon and such physician or surgeon certifies

28  that such services are medically necessary and consequent to

29  treatment of the cleft lip or cleft palate. The coverage

30  required by this section is subject to terms and conditions

31  applicable to other benefits. This section does not apply to

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    Florida Senate - 1998                            CS for SB 228
    317-1667A-98




  1  specified-accident, specified-disease, hospital indemnity,

  2  limited benefit disability income, or long-term-care insurance

  3  policies.

  4         Section 4.  Paragraph (b) of subsection (12) of section

  5  627.6699, Florida Statutes, is amended to read:

  6         627.6699  Employee Health Care Access Act.--

  7         (12)  STANDARD, BASIC, AND LIMITED HEALTH BENEFIT

  8  PLANS.--

  9         (b)1.  Each small employer carrier issuing new health

10  benefit plans shall offer to any small employer, upon request,

11  a standard health benefit plan and a basic health benefit plan

12  that meets the criteria set forth in this section.

13         2.  For purposes of this subsection, the terms

14  "standard health benefit plan" and "basic health benefit plan"

15  mean policies or contracts that a small employer carrier

16  offers to eligible small employers that contain:

17         a.  An exclusion for services that are not medically

18  necessary or that are not covered preventive health services;

19  and

20         b.  A procedure for preauthorization by the small

21  employer carrier, or its designees.

22         3.  A small employer carrier may include the following

23  managed care provisions in the policy or contract to control

24  costs:

25         a.  A preferred provider arrangement or exclusive

26  provider organization or any combination thereof, in which a

27  small employer carrier enters into a written agreement with

28  the provider to provide services at specified levels of

29  reimbursement or to provide reimbursement to specified

30  providers. Any such written agreement between a provider and a

31  small employer carrier must contain a provision under which

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    Florida Senate - 1998                            CS for SB 228
    317-1667A-98




  1  the parties agree that the insured individual or covered

  2  member has no obligation to make payment for any medical

  3  service rendered by the provider which is determined not to be

  4  medically necessary.  A carrier may use preferred provider

  5  arrangements or exclusive provider arrangements to the same

  6  extent as allowed in group products that are not issued to

  7  small employers.

  8         b.  A procedure for utilization review by the small

  9  employer carrier or its designees.

10

11  This subparagraph does not prohibit a small employer carrier

12  from including in its policy or contract additional managed

13  care and cost containment provisions, subject to the approval

14  of the department, which have potential for controlling costs

15  in a manner that does not result in inequitable treatment of

16  insureds or subscribers.  The carrier may use such provisions

17  to the same extent as authorized for group products that are

18  not issued to small employers.

19         4.  The standard health benefit plan shall include:

20         a.  Coverage for inpatient hospitalization;

21         b.  Coverage for outpatient services;

22         c.  Coverage for newborn children pursuant to s.

23  627.6575;

24         d.  Coverage for child care supervision services

25  pursuant to s. 627.6579;

26         e.  Coverage for adopted children upon placement in the

27  residence pursuant to s. 627.6578;

28         f.  Coverage for mammograms pursuant to s. 627.6613;

29         g.  Coverage for handicapped children pursuant to s.

30  627.6615;

31

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    Florida Senate - 1998                            CS for SB 228
    317-1667A-98




  1         h.  Emergency or urgent care out of the geographic

  2  service area; and

  3         i.  Coverage for services provided by a hospice

  4  licensed under s. 400.602 in cases where such coverage would

  5  be the most appropriate and the most cost-effective method for

  6  treating a covered illness.

  7         5.  The standard health benefit plan and the basic

  8  health benefit plan may include a schedule of benefit

  9  limitations for specified services and procedures.  If the

10  committee develops such a schedule of benefits limitation for

11  the standard health benefit plan or the basic health benefit

12  plan, a small employer carrier offering the plan must offer

13  the employer an option for increasing the benefit schedule

14  amounts by 4 percent annually.

15         6.  The basic health benefit plan shall include all of

16  the benefits specified in subparagraph 4.; however, the basic

17  health benefit plan shall place additional restrictions on the

18  benefits and utilization and may also impose additional cost

19  containment measures.

20         7.  Sections 627.419(2), (3), and (4), 627.6574,

21  627.6612, 627.66121, 627.66122, 627.6616, 627.6618, and

22  627.668, and 627.66911 apply to the standard health benefit

23  plan and to the basic health benefit plan. However,

24  notwithstanding said provisions, the plans may specify limits

25  on the number of authorized treatments, if such limits are

26  reasonable and do not discriminate against any type of

27  provider.

28         8.  Each small employer carrier that provides for

29  inpatient and outpatient services by allopathic hospitals may

30  provide as an option of the insured similar inpatient and

31  outpatient services by hospitals accredited by the American

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    Florida Senate - 1998                            CS for SB 228
    317-1667A-98




  1  Osteopathic Association when such services are available and

  2  the osteopathic hospital agrees to provide the service.

  3         Section 5.  Subsection (34) is added to section 641.31,

  4  Florida Statutes, to read:

  5         641.31  Health maintenance contracts.--

  6         (34)  A health maintenance contract that covers a child

  7  under the age of 18 must provide coverage for treatment of

  8  cleft lip and cleft palate for the child. The coverage must

  9  include medical, dental, speech therapy, audiology, and

10  nutrition services only if such services are prescribed by the

11  primary care physician or physician to whom the child is

12  referred and such physician certifies that such services are

13  medically necessary and consequent to treatment of the cleft

14  lip or cleft palate. The coverage required by this section is

15  subject to terms and conditions applicable to other benefits.

16         Section 6.  Pursuant to Section 18, Article VII of the

17  State Constitution, the Legislature determines that this act

18  fulfills an important state interest.

19         Section 7.  This act shall take effect October 1, 1998,

20  and shall apply to policies and contracts issued or renewed on

21  or after that date.

22

23          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
24                         Senate Bill 228

25

26  Deletes guarantee issue requirement for insurer and HMO
    coverage of cranio-facial anomalies and mandates insurer and
27  HMO coverage of medical, dental, speech therapy, audiology,
    and nutrition services for treatment of children under age 18
28  with cleft lip and cleft palate, if certain conditions are
    met.
29
    Amends ss. 627.6515, 627.6699, 641.31, F.S., and creates ss.
30  627.64193 and 627.66911, F.S., to clearly state applicability
    of coverage requirements.
31

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