| 1 | A bill to be entitled |
| 2 | An act relating to health insurance; amending s. 627.4236, |
| 3 | F.S.; revising the definition of the term "bone marrow |
| 4 | transplant"; amending ss. 627.642, 627.657, and 641.31, |
| 5 | F.S.; requiring an identification card containing |
| 6 | specified information to be given to insureds under health |
| 7 | benefit plans and group health insurance policies and |
| 8 | persons having health care services through health |
| 9 | maintenance contracts; providing applicability; providing |
| 10 | for an exception to certain identification card |
| 11 | requirements for cards issued before a certain date; |
| 12 | providing an effective date. |
| 13 |
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| 14 | Be It Enacted by the Legislature of the State of Florida: |
| 15 |
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| 16 | Section 1. Subsection (1) of section 627.4236, Florida |
| 17 | Statutes, is amended to read: |
| 18 | 627.4236 Coverage for bone marrow transplant procedures.-- |
| 19 | (1) As used in this section, the term "bone marrow |
| 20 | transplant" means human blood precursor cells administered to a |
| 21 | patient to restore normal hematological and immunological |
| 22 | functions following ablative or nonablative therapy with |
| 23 | curative or life-prolonging intent. Human blood precursor cells |
| 24 | may be obtained from the patient in an autologous transplant or |
| 25 | from a medically acceptable related or unrelated donor, and may |
| 26 | be derived from bone marrow, circulating blood, or a combination |
| 27 | of bone marrow and circulating blood. If chemotherapy is an |
| 28 | integral part of the treatment involving bone marrow |
| 29 | transplantation, the term "bone marrow transplant" includes both |
| 30 | the transplantation and the chemotherapy. |
| 31 | Section 2. Subsection (3) is added to section 627.642, |
| 32 | Florida Statutes, to read: |
| 33 | 627.642 Outline of coverage.-- |
| 34 | (3) In addition to the outline of coverage, a policy as |
| 35 | specified in s. 627.6699(3)(k) must be accompanied by an |
| 36 | identification card that contains, at a minimum: |
| 37 | (a) The name of the organization issuing the policy or the |
| 38 | name of the organization administering the policy, whichever |
| 39 | applies. |
| 40 | (b) The name of the contract holder. |
| 41 | (c) The type of plan only if the plan is filed in the |
| 42 | state, an indication that the plan is self-funded, or the name |
| 43 | of the network. |
| 44 | (d) The member identification number, contract number, and |
| 45 | policy or group number, if applicable. |
| 46 | (e) A contact phone number or electronic address for |
| 47 | authorizations and admission certifications. |
| 48 | (f) A phone number or electronic address whereby the |
| 49 | covered person or hospital, physician, or other person rendering |
| 50 | services covered by the policy may obtain benefits verification |
| 51 | and information in order to estimate patient financial |
| 52 | responsibility, in compliance with privacy rules under the |
| 53 | Health Insurance Portability and Accountability Act. |
| 54 | (g) The national plan identifier, in accordance with the |
| 55 | compliance date set forth by the federal Department of Health |
| 56 | and Human Services. |
| 57 |
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| 58 | The identification card must present the information in a |
| 59 | readily identifiable manner or, alternatively, the information |
| 60 | may be embedded on the card and available through magnetic |
| 61 | stripe or smart card. The information may also be provided |
| 62 | through other electronic technology. |
| 63 | Section 3. Present subsection (2) of section 627.657, |
| 64 | Florida Statutes, is renumbered as subsection (3), and a new |
| 65 | subsection (2) is added to that section to read: |
| 66 | 627.657 Provisions of group health insurance policies.-- |
| 67 | (2) The medical policy as specified in s. 627.6699(3)(k) |
| 68 | must be accompanied by an identification card that contains, at |
| 69 | a minimum: |
| 70 | (a) The name of the organization issuing the policy or |
| 71 | name of the organization administering the policy, whichever |
| 72 | applies. |
| 73 | (b) The name of the certificateholder. |
| 74 | (c) The type of plan only if the plan is filed in the |
| 75 | state, an indication that the plan is self-funded, or the name |
| 76 | of the network. |
| 77 | (d) The member identification number, contract number, and |
| 78 | policy or group number, if applicable. |
| 79 | (e) A contact phone number or electronic address for |
| 80 | authorizations and admission certifications. |
| 81 | (f) A phone number or electronic address whereby the |
| 82 | covered person or hospital, physician, or other person rendering |
| 83 | services covered by the policy may obtain benefits verification |
| 84 | and information in order to estimate patient financial |
| 85 | responsibility, in compliance with privacy rules under the |
| 86 | Health Insurance Portability and Accountability Act. |
| 87 | (g) The national plan identifier, in accordance with the |
| 88 | compliance date set forth by the federal Department of Health |
| 89 | and Human Services. |
| 90 |
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| 91 | The identification card must present the information in a |
| 92 | readily identifiable manner or, alternatively, the information |
| 93 | may be embedded on the card and available through magnetic |
| 94 | stripe or smart card. The information may also be provided |
| 95 | through other electronic technology. |
| 96 | Section 4. Subsection (41) is added to section 641.31, |
| 97 | Florida Statutes, to read: |
| 98 | 641.31 Health maintenance contracts.-- |
| 99 | (41) The contract, certificate, or member handbook must be |
| 100 | accompanied by an identification card that contains, at a |
| 101 | minimum: |
| 102 | (a) The name of the organization offering the contract or |
| 103 | name of the organization administering the contract, whichever |
| 104 | applies. |
| 105 | (b) The name of the subscriber. |
| 106 | (c) A statement that the health plan is a health |
| 107 | maintenance organization. Only a health plan with a certificate |
| 108 | of authority issued under this chapter may be identified as a |
| 109 | health maintenance organization. |
| 110 | (d) The member identification number, contract number, and |
| 111 | group number, if applicable. |
| 112 | (e) A contact phone number or electronic address for |
| 113 | authorizations and admission certifications. |
| 114 | (f) A phone number or electronic address whereby the |
| 115 | covered person or hospital, physician, or other person rendering |
| 116 | services covered by the contract may obtain benefits |
| 117 | verification and information in order to estimate patient |
| 118 | financial responsibility, in compliance with privacy rules under |
| 119 | the Health Insurance Portability and Accountability Act. |
| 120 | (g) The national plan identifier, in accordance with the |
| 121 | compliance date set forth by the federal Department of Health |
| 122 | and Human Services. |
| 123 |
|
| 124 | The identification card must present the information in a |
| 125 | readily identifiable manner or, alternatively, the information |
| 126 | may be embedded on the card and available through magnetic |
| 127 | stripe or smart card. The information may also be provided |
| 128 | through other electronic technology. |
| 129 | Section 5. Notwithstanding the provisions of this act, |
| 130 | companies that contract with this state, pursuant to s. 110.123, |
| 131 | Florida Statutes, to provide medical services to enrollees in |
| 132 | the state group insurance program are not required to update any |
| 133 | identification card issued to such enrollee prior to January 1, |
| 134 | 2009, in order to conform with this act. Identification cards |
| 135 | for enrollees in the state group insurance program issued on or |
| 136 | after January 1, 2009, must contain all information required by |
| 137 | this act. |
| 138 | Section 6. This act shall take effect January 1, 2009, and |
| 139 | shall apply to identification cards issued for policies or |
| 140 | certificates issued or renewed on or after that date. |