Florida Senate - 2012                                     SB 324
       
       
       
       By Senator Bullard
       
       
       
       
       39-00273-12                                            2012324__
    1                        A bill to be entitled                      
    2         An act relating to congenital craniofacial anomalies;
    3         requiring the Agency for Health Care Administration,
    4         in consultation with the Office of Insurance
    5         Regulation, to conduct a study concerning the medical
    6         necessity, costs, and efficacy of mandating coverage
    7         for certain treatments and therapies; requiring that
    8         the agency report its findings and recommendations to
    9         the Legislature; providing an appropriation; providing
   10         an effective date.
   11  
   12  Be It Enacted by the Legislature of the State of Florida:
   13  
   14         Section 1. (1) The Agency for Health Care Administration,
   15  in consultation with the Office of Insurance Regulation, shall
   16  conduct a study evaluating the medical necessity, efficacy, and
   17  costs of requiring health insurers and health maintenance
   18  organizations to provide coverage for cranial-skull-molding
   19  orthotics and other therapies used in the treatment of
   20  deformational or positional plagiocephaly. The agency and office
   21  shall evaluate whether gaps in coverage currently exist in the
   22  small and large group insurance markets for medically necessary
   23  care and treatment of plagiocephaly. The agency shall provide
   24  information concerning the types of benefits, including the cost
   25  of such benefits, provided to Medicaid recipients for the
   26  treatment of plagiocephaly and the demographic characteristics
   27  of such Medicaid recipients. The Department of Health shall
   28  coordinate with the agency to provide such information
   29  concerning coverage and the costs of providing such coverage to
   30  children who have plagiocephaly and who are enrolled in the
   31  Children’s Medical Services Program.
   32         (2) The agency, in consultation with the office, may
   33  contract with an actuary who is a member of the American Academy
   34  of Actuaries and other persons who have an extensive background
   35  in health insurance for the purpose of assisting the agency in
   36  evaluating the medical necessity, efficacy, and costs of such
   37  coverage. The agency shall report its findings and
   38  recommendations related to mandating insurance coverage for the
   39  treatment of plagiocephaly to the President of the Senate and
   40  the Speaker of the House of Representatives by January 1, 2013.
   41         Section 2. For the 2012-2013 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, 2012.