| 1 | A bill to be entitled |
| 2 | An act relating to autism; creating s. 381.986, F.S.; |
| 3 | requiring that a physician refer a minor to an appropriate |
| 4 | specialist for screening for autism spectrum disorder |
| 5 | under certain circumstances; defining the term |
| 6 | "appropriate specialist"; amending ss. 627.6686 and |
| 7 | 641.31098, F.S.; defining the term "direct patient |
| 8 | access"; requiring certain insurers and health maintenance |
| 9 | organizations to provide direct patient access to an |
| 10 | appropriate specialist for a minimum number of visits per |
| 11 | year for the screening, evaluation, or diagnosis of autism |
| 12 | spectrum disorder; 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. Section 381.986, Florida Statutes, is created |
| 17 | to read: |
| 18 | 381.986 Screening for autism spectrum disorder.-- |
| 19 | (1) If the parent or legal guardian of a minor who is an |
| 20 | eligible individual, as defined in s. 627.6686 or s. 641.31098, |
| 21 | believes that the minor exhibits symptoms of autism spectrum |
| 22 | disorder, the parent or legal guardian may report his or her |
| 23 | observation to a physician licensed in this state. The physician |
| 24 | shall immediately refer the minor to an appropriate specialist |
| 25 | for the screening for, evaluation of, or diagnosis of autism |
| 26 | spectrum disorder. This section does not apply to a physician |
| 27 | providing care under s. 395.1041. |
| 28 | (2) As used in this section, the term "appropriate |
| 29 | specialist" means a qualified professional who is experienced in |
| 30 | the evaluation of autism spectrum disorder, who has training in |
| 31 | validated diagnostic tools, and includes, but is not limited to, |
| 32 | a person who is licensed in this state as: |
| 33 | (a) A psychologist; |
| 34 | (b) A psychiatrist; |
| 35 | (c) A neurologist; |
| 36 | (d) A developmental or behavioral pediatrician who |
| 37 | specializes in child neurology; or |
| 38 | (e) A professional whose licensure is deemed appropriate |
| 39 | by the Children's Medical Services Early Steps Program within |
| 40 | the Department of Health. |
| 41 | Section 2. Present paragraphs (c), (d), and (e) of |
| 42 | subsection (2) of section 627.6686, Florida Statutes, are |
| 43 | redesignated as paragraphs (d), (e), and (f), respectively, a |
| 44 | new paragraph (c) is added to that subsection, and paragraph (a) |
| 45 | of subsection (3) of that section is amended, to read: |
| 46 | 627.6686 Coverage for individuals with autism spectrum |
| 47 | disorder required; exception.-- |
| 48 | (2) As used in this section, the term: |
| 49 | (c) "Direct patient access" means the ability of an |
| 50 | insured to obtain services from an in-network provider without a |
| 51 | referral or other authorization before receiving services. |
| 52 | (3) A health insurance plan issued or renewed on or after |
| 53 | April 1, 2009, shall provide coverage to an eligible individual |
| 54 | for: |
| 55 | (a) Direct patient access to an appropriate specialist, as |
| 56 | defined in s. 381.986, for a minimum of three visits per policy |
| 57 | year for the screening for, evaluation of, or diagnosis Well- |
| 58 | baby and well-child screening for diagnosing the presence of |
| 59 | autism spectrum disorder. |
| 60 | Section 3. Present paragraphs (c) and (d) of subsection |
| 61 | (2) of section 641.31098, Florida Statutes, are redesignated as |
| 62 | paragraphs (d) and (e), respectively, a new paragraph (c) is |
| 63 | added to that subsection, and paragraph (a) of subsection (3) of |
| 64 | that section is amended, to read: |
| 65 | 641.31098 Coverage for individuals with developmental |
| 66 | disabilities.-- |
| 67 | (2) As used in this section, the term: |
| 68 | (c) "Direct patient access" means the ability of a |
| 69 | subscriber to obtain services from an in-network provider |
| 70 | without a referral or other authorization before receiving |
| 71 | services. |
| 72 | (3) A health maintenance contract issued or renewed on or |
| 73 | after April 1, 2009, shall provide coverage to an eligible |
| 74 | individual for: |
| 75 | (a) Direct patient access to an appropriate specialist, as |
| 76 | defined in s. 381.986, for a minimum of three visits per policy |
| 77 | year for the screening for, evaluation of, or diagnosis Well- |
| 78 | baby and well-child screening for diagnosing the presence of |
| 79 | autism spectrum disorder. |
| 80 | Section 4. This act shall take effect July 1, 2010. |