Florida Senate - 2012                                    SB 1066
       
       
       
       By Senator Garcia
       
       
       
       
       40-00719A-12                                          20121066__
    1                        A bill to be entitled                      
    2         An act relating to cancer chemotherapy treatment;
    3         creating ss. 627.42391 and 641.3115, F.S.; requiring
    4         that a group insurance policy or group health
    5         maintenance contract that provides coverage for cancer
    6         chemotherapy treatment provide coverage for orally
    7         administered anticancer medication on a basis no less
    8         favorable than that required by the policy or contact
    9         for intravenously administered or injected anticancer
   10         medications; prohibiting an insurer from increasing a
   11         copayment, deductible, or coinsurance amount for
   12         intravenously administered or injected anticancer
   13         medications covered under a policy or contract;
   14         providing that an insurer is not prohibited from
   15         requiring prior authorization or imposing other
   16         appropriate utilization controls in approving coverage
   17         for any cancer chemotherapy treatment; providing that
   18         coverage for cancer chemotherapy treatment is not
   19         required; exempting the state group insurance program
   20         and Medicaid managed care plans from application of
   21         the act; providing an effective date.
   22  
   23  Be It Enacted by the Legislature of the State of Florida:
   24  
   25         Section 1. Section 627.42391, Florida Statutes, is created
   26  to read:
   27         627.42391 Cancer chemotherapy treatment parity.—
   28         (1) A group insurance policy that provides coverage for
   29  cancer chemotherapy treatment must provide coverage for a
   30  prescribed, orally administered anticancer medication on a basis
   31  no less favorable than that required by the policy for
   32  intravenously administered or injected anticancer medications.
   33         (2) An insurer may not increase a copayment, deductible, or
   34  coinsurance amount for intravenously administered or injected
   35  anticancer medications that are covered under its policies on
   36  July 1, 2012.
   37         (3) This section does not prohibit an insurer from
   38  requiring prior authorization or imposing other appropriate
   39  utilization controls in approving coverage for any cancer
   40  chemotherapy treatment.
   41         (4) This section does not require coverage for cancer
   42  chemotherapy treatment.
   43         (5) This section does not apply to:
   44         (a) The state group insurance program; or
   45         (b) A managed care plan under the Medicaid program.
   46         Section 2. Section 641.3115, Florida Statutes, is created
   47  to read:
   48         641.3115 Cancer chemotherapy treatment parity.—
   49         (1) A group health maintenance contract that provides
   50  coverage for cancer chemotherapy treatment must provide coverage
   51  for a prescribed, orally administered anticancer medication on a
   52  basis no less favorable than that required under the health
   53  maintenance contract for intravenously administered or injected
   54  anticancer medications.
   55         (2) A group health maintenance organization may not
   56  increase a copayment, deductible, or coinsurance amount for
   57  intravenously administered or injected anticancer medications
   58  covered under its health maintenance contracts on July 1, 2012.
   59         (3) This section does not prohibit a health maintenance
   60  organization from requiring prior authorization or imposing
   61  other appropriate utilization controls in approving coverage for
   62  any cancer chemotherapy treatment.
   63         (4) This section does not require coverage for cancer
   64  chemotherapy treatment.
   65         (5) This section does not apply to:
   66         (a) The state group insurance program; or
   67         (b) A managed care plan under the Medicaid program.
   68         Section 3. This act shall take effect July 1, 2012.