HB 829

1	A bill to be entitled
2	An act relating to newborn screening for congenital
3	heart disease; creating s. 383.146, F.S.; providing
4	definitions; providing requirements for screening
5	newborns for congenital heart disease; providing for
6	certain insurance and managed care coverage; providing
7	for referral for ongoing services; authorizing the
8	Department of Health to adopt rules to implement the
9	screening; providing powers and duties of the
10	department; providing an effective date.
11
12	WHEREAS, congenital heart disease is the most common birth
13	defect in infants, affecting 8 out of every 1,000 newborn
14	babies, and
15	WHEREAS, early detection of congenital heart disease is
16	crucial to the health of a newborn baby because, if the
17	condition goes undiagnosed, it can cause major problems later in
18	the child's life, and
19	WHEREAS, pulse oximetry is a noninvasive method of
20	monitoring the oxygen level in the blood and is recommended as a
21	method of screening a patient for congenital heart disease, and
22	WHEREAS, physical exertion and participation in sports can
23	cause excess stress on the heart and, if the disease is not
24	detected and is severe enough, participation in strenuous
25	activity can result in death, NOW, THEREFORE,
26
27	Be It Enacted by the Legislature of the State of Florida:
28
29	Section 1.  Section 383.146, Florida Statutes, is created
30	to read:
31	383.146  Newborn screening for congenital heart disease.-
32	(1)  DEFINITIONS.-As used in this section, the term:
33	(a)  "Department" means the Department of Health.
34	(b)  "Newborn" means an age range from birth through 29
35	days.
36	(c)  "Screening" means a test or battery of tests
37	administered to determine whether a newborn has congenital heart
38	disease.
39	(2)  REQUIREMENTS FOR SCREENING OF NEWBORNS; INSURANCE
40	COVERAGE; REFERRAL FOR ONGOING SERVICES.-
41	(a)  Each licensed hospital or other state-licensed
42	birthing facility that provides maternity and newborn care
43	services shall provide that all newborns are, prior to
44	discharge, screened for congenital heart disease.
45	(b)  Each licensed birth center that provides maternity and
46	newborn care services shall provide that all newborns are, prior
47	to discharge, referred to a physician licensed under chapter 458
48	or chapter 459 or a hospital for screening for the detection of
49	congenital heart disease. The referral for appointment shall be
50	made within 10 days after discharge. Written documentation of
51	the referral must be placed in the newborn's medical chart.
52	(c)  If the parent or legal guardian of the newborn objects
53	to the screening, the screening must not be completed
54	notwithstanding any other provision of this section. In such
55	case, the physician, midwife, or other person who is attending
56	the newborn shall maintain a record that the screening has not
57	been performed and attach a written objection that must be
58	signed by the parent or guardian.
59	(d)  For home births, the health care provider in
60	attendance is responsible for the coordination and referral to a
61	physician licensed under chapter 458 or chapter 459 or a
62	hospital. The referral for appointment shall be made within 10
63	days after the birth. In cases in which the home birth is not
64	attended by a primary health care provider, a referral to a
65	physician licensed pursuant to chapter 458 or chapter 459 or a
66	hospital must be made by the health care provider within 10 days
67	after the child's birth.
68	(e)  All newborn and infant screenings shall be conducted
69	by a physician licensed under chapter 458 or chapter 459.
70	Appropriate documentation of the screening completion, results,
71	interpretation, and recommendations must be placed in the
72	medical record within 24 hours after completion of the screening
73	procedure.
74	(f)  The screening of a newborn for congenital heart
75	disease must be completed before the newborn is discharged from
76	the hospital.
77	(g)  Each hospital shall formally designate a lead
78	physician responsible for programmatic oversight for newborn
79	congenital heart disease screening. Each licensed birth center
80	shall designate a licensed health care provider to provide such
81	programmatic oversight and to ensure that the appropriate
82	referrals are being completed.
83	(h)  By October 1, 2012, congenital heart disease screening
84	must be conducted on all newborns in hospitals in this state on
85	birth admission. When a newborn is delivered in a facility other
86	than a hospital, the parents must be instructed on the
87	importance of having the screening performed and must be given
88	information to assist them in having the screening performed
89	within 10 days after the child's birth.
90	(i)  The initial procedure for screening of the newborn for
91	congenital heart disease and any medically necessary followup
92	reevaluations leading to diagnosis shall be a covered benefit,
93	reimbursable under Medicaid as an expense compensated
94	supplemental to the per diem rate for Medicaid patients enrolled
95	in MediPass or Medicaid patients covered by a fee for service
96	program. For Medicaid patients enrolled in health maintenance
97	organizations, providers shall be reimbursed directly by the
98	Medicaid Program Office at the Medicaid rate. This service may
99	not be considered a covered service for the purposes of
100	establishing the payment rate for Medicaid health maintenance
101	organizations. All health insurance policies and health
102	maintenance organizations as provided under ss. 627.6416,
103	627.6579, and 641.31(30), except for supplemental policies that
104	only provide coverage for specific diseases, hospital indemnity,
105	or Medicare supplement, or to the supplemental polices, shall
106	compensate providers for the covered benefit at the contracted
107	rate. Nonhospital-based providers shall be eligible to bill
108	Medicaid for the professional and technical component of each
109	procedure code.
110	(3)  RULES.-After consultation with the Genetics and
111	Newborn Screening Advisory Council, the department shall adopt
112	and enforce rules requiring that every newborn in this state be
113	subjected to a test for congenital heart disease. The department
114	shall adopt such additional rules as are necessary for the
115	administration of this section, including rules providing
116	definitions of terms, rules relating to the methods used and
117	time or times for testing as accepted medical practice
118	indicates, rules relating to charging and collecting fees for
119	the administration of the newborn screening program authorized
120	by this section, rules for processing requests and releasing
121	test and screening results, and rules requiring mandatory
122	reporting of the results of tests and screenings for this
123	condition to the department.
124	(4)  POWERS AND DUTIES OF THE DEPARTMENT.-The department
125	shall administer and provide services authorized pursuant to
126	this section and shall:
127	(a)  Ensure the availability and quality of the necessary
128	laboratory tests and materials.
129	(b)  Furnish all physicians, county health departments,
130	perinatal centers, birthing centers, and hospitals forms on
131	which the results of tests for congenital heart disease shall be
132	reported to the department.
133	(c)  Have the authority to charge and collect fees
134	sufficient to administer the newborn screening program
135	authorized under this section.
136	Section 2.  This act shall take effect July 1, 2012.

CODING: Words stricken are deletions; words underlined are additions.