| 1 | A bill to be entitled |
| 2 | An act relating to congenital craniofacial anomalies; |
| 3 | requiring that the Agency for Health Care Administration, |
| 4 | in consultation with the Office of Insurance Regulation, |
| 5 | conduct a study concerning the medical necessity, costs, |
| 6 | and efficacy of mandating coverage for certain treatments |
| 7 | and therapies; requiring that the agency report its |
| 8 | findings and recommendations to the Legislature; providing |
| 9 | an appropriation; providing an effective date. |
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| 11 | Be It Enacted by the Legislature of the State of Florida: |
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| 13 | Section 1. (1) The Agency for Health Care Administration, |
| 14 | in consultation with the Office of Insurance Regulation, shall |
| 15 | conduct a study evaluating the medical necessity, efficacy, and |
| 16 | costs of requiring health insurers and health maintenance |
| 17 | organizations to provide coverage for cranial-skull-molding |
| 18 | orthotics and other therapies used in the treatment of |
| 19 | deformational or positional plagiocephaly. The agency and office |
| 20 | shall evaluate whether gaps in coverage currently exist in the |
| 21 | small and large group insurance markets for medically necessary |
| 22 | care and treatment of plagiocephaly. The agency shall provide |
| 23 | information concerning the types of benefits, including the cost |
| 24 | of such benefits, provided to Medicaid recipients for the |
| 25 | treatment of plagiocephaly, and the demographic characteristics |
| 26 | of such Medicaid recipients. The Department of Health shall |
| 27 | coordinate with the agency to provide such information |
| 28 | concerning coverage and the costs of providing such coverage to |
| 29 | children having plagiocephaly who are enrolled in the Children's |
| 30 | Medical Services Program. |
| 31 | (2) The agency, in consultation with the office, may |
| 32 | contract with an actuary who is a member of the American Academy |
| 33 | of Actuaries and other persons who have an extensive background |
| 34 | in health insurance for the purpose of assisting the agency in |
| 35 | evaluating the medical necessity, efficacy, and costs of such |
| 36 | coverage. The agency shall report its findings and |
| 37 | recommendations related to mandating insurance coverage for the |
| 38 | treatment of plagiocephaly to the President of the Senate and |
| 39 | the Speaker of the House of Representatives no later than |
| 40 | January 1, 2009. |
| 41 | Section 2. For the 2008-2009 fiscal year, the sum of |
| 42 | $25,000 is appropriated in nonrecurring funds from the Insurance |
| 43 | Regulatory Trust Fund to the Office of Insurance Regulation for |
| 44 | the purpose of funding the study conducted by the Agency for |
| 45 | Health Care Administration as provided in this act. |
| 46 | Section 3. This act shall take effect July 1, 2008. |