Florida Senate - 2013                                    SB 1242
       
       
       
       By Senator Ring
       
       
       
       
       29-01077-13                                           20131242__
    1                        A bill to be entitled                      
    2         An act relating to coverage for mental and nervous
    3         disorders; amending s. 627.668, F.S.; revising
    4         requirements and limitations for optional coverage for
    5         mental and nervous disorders; authorizing an insurer
    6         or health maintenance organization to take certain
    7         steps to reduce service costs; specifying
    8         nonapplication under certain circumstances; amending
    9         s. 627.6675, F.S.; conforming a cross-reference;
   10         repealing s. 627.669, F.S., relating to optional
   11         coverage required for substance abuse impaired
   12         persons; requiring the Office of Insurance Regulation
   13         to submit a report to the Legislature containing
   14         specified information; providing for application;
   15         providing an effective date.
   16  
   17  Be It Enacted by the Legislature of the State of Florida:
   18  
   19         Section 1. Section 627.668, Florida Statutes, is amended to
   20  read:
   21         627.668 Optional coverage for mental and nervous disorders
   22  required; exception.—
   23         (1) Every insurer, health maintenance organization, and
   24  nonprofit hospital and medical service plan corporation
   25  transacting group health insurance or providing prepaid health
   26  care in this state under a group hospital and medical expense
   27  incurred insurance policy, a group prepaid health care contract,
   28  or a group hospital and medical service plan contract shall make
   29  available to the policyholder as part of the application, for an
   30  appropriate additional premium under a group hospital and
   31  medical expense-incurred insurance policy, under a group prepaid
   32  health care contract, and under a group hospital and medical
   33  service plan contract, the benefits or level of benefits
   34  specified in subsections subsection (2) and (3) for the
   35  necessary care and treatment of mental and nervous disorders, as
   36  defined in the most recent edition of the Diagnostic and
   37  Statistical Manual of Mental Disorders published by standard
   38  nomenclature of the American Psychiatric Association. This
   39  requirement is, subject to the right of the applicant for a
   40  group policy or contract to select any alternative benefits or
   41  level of benefits as may be offered by the insurer, health
   42  maintenance organization, or service plan corporation. provided
   43  that, If alternate inpatient, outpatient, or partial
   44  hospitalization benefits are selected, such benefits may shall
   45  not be less than the level of benefits required under
   46  subsections (2) and (3) paragraph (2)(a), paragraph (2)(b), or
   47  paragraph (2)(c), respectively. With respect to the state group
   48  insurance program, the term “policyholder” means the State of
   49  Florida.
   50         (2)Under group policies or contracts, inpatient hospital
   51  benefits, partial hospitalization benefits, and outpatient
   52  benefits consisting of durational limits, dollar amounts,
   53  deductibles, and coinsurance factors may not be less favorable
   54  for the necessary care and treatment of schizophrenia and
   55  psychotic disorders, mood disorders, anxiety disorders,
   56  substance abuse disorders, eating disorders, and childhood
   57  attention deficit disorder or attention deficit hyperactivity
   58  disorder than for physical illness generally.
   59         (3)(2)Under group policies or contracts, Inpatient
   60  hospital benefits, partial hospitalization benefits, and
   61  outpatient benefits for mental health disorders not listed in
   62  subsection (2) may consisting of durational limits, dollar
   63  amounts, deductibles, and coinsurance factors shall not be less
   64  favorable than for physical illness generally, except that:
   65         (a) Inpatient benefits must be provided at least 45 may be
   66  limited to not less than 30 days per benefit year as defined in
   67  the policy or contract. If inpatient hospital benefits are
   68  provided beyond 45 30 days per benefit year, the durational
   69  limits, dollar amounts, and coinsurance factors thereto need not
   70  be the same as applicable to physical illness generally.
   71         (b) Outpatient benefits must provide 60 visits per benefit
   72  year may be limited to $1,000 for consultations with a licensed
   73  physician, a psychologist licensed pursuant to chapter 490, a
   74  mental health counselor licensed pursuant to chapter 491, a
   75  marriage and family therapist licensed pursuant to chapter 491,
   76  and a clinical social worker licensed pursuant to chapter 491.
   77  If benefits are provided beyond the 60 visits $1,000 per benefit
   78  year, the durational limits, dollar amounts, and coinsurance
   79  factors thereof need not be the same as applicable to physical
   80  illness generally.
   81         (c) Partial hospitalization benefits shall be provided
   82  under the direction of a licensed physician. For purposes of
   83  this part, the term “partial hospitalization services” is
   84  defined as those services offered by a program accredited by the
   85  Joint Commission (TJC) on Accreditation of Hospitals (JCAH) or
   86  in compliance with equivalent standards. Alcohol rehabilitation
   87  programs accredited by the Joint Commission on Accreditation of
   88  Hospitals or approved by the state and licensed drug abuse
   89  rehabilitation programs are shall also be qualified providers
   90  under this section. In any benefit year, if partial
   91  hospitalization services or a combination of inpatient and
   92  partial hospitalization are used utilized, the total benefits
   93  paid for all such services may shall not exceed the cost of 45
   94  30 days of inpatient hospitalization for psychiatric services,
   95  including physician fees, which prevail in the community in
   96  which the partial hospitalization services are rendered. If
   97  partial hospitalization services benefits are provided beyond
   98  the limits set forth in this paragraph, the durational limits,
   99  dollar amounts, and coinsurance factors thereof need not be the
  100  same as those applicable to physical illness generally.
  101         (4)In order to reduce service costs and utilization
  102  without compromising quality of care, the insurer or health
  103  maintenance organization that provides benefits under this
  104  section may impose appropriate financial incentives, peer
  105  review, utilization requirements, and other methods used for the
  106  management of benefits provided for other medical conditions.
  107         (5)(3) Insurers must maintain strict confidentiality
  108  regarding psychiatric and psychotherapeutic records submitted to
  109  an insurer for the purpose of reviewing a claim for benefits
  110  payable under this section. These records submitted to an
  111  insurer are subject to the limitations of s. 456.057, relating
  112  to the furnishing of patient records.
  113         (6)This section does not apply with respect to a group
  114  health plan, or health insurance coverage offered in connection
  115  with a group health plan, if the application of this section to
  116  such plan or coverage results in an increase of more than 2
  117  percent in the cost of such coverage, as determined and
  118  certified by an independent actuary to the Office of Insurance
  119  Regulation.
  120         Section 2. Paragraph (b) of subsection (8) of section
  121  627.6675, Florida Statutes, is amended to read:
  122         627.6675 Conversion on termination of eligibility.—Subject
  123  to all of the provisions of this section, a group policy
  124  delivered or issued for delivery in this state by an insurer or
  125  nonprofit health care services plan that provides, on an
  126  expense-incurred basis, hospital, surgical, or major medical
  127  expense insurance, or any combination of these coverages, shall
  128  provide that an employee or member whose insurance under the
  129  group policy has been terminated for any reason, including
  130  discontinuance of the group policy in its entirety or with
  131  respect to an insured class, and who has been continuously
  132  insured under the group policy, and under any group policy
  133  providing similar benefits that the terminated group policy
  134  replaced, for at least 3 months immediately prior to
  135  termination, shall be entitled to have issued to him or her by
  136  the insurer a policy or certificate of health insurance,
  137  referred to in this section as a “converted policy.” A group
  138  insurer may meet the requirements of this section by contracting
  139  with another insurer, authorized in this state, to issue an
  140  individual converted policy, which policy has been approved by
  141  the office under s. 627.410. An employee or member shall not be
  142  entitled to a converted policy if termination of his or her
  143  insurance under the group policy occurred because he or she
  144  failed to pay any required contribution, or because any
  145  discontinued group coverage was replaced by similar group
  146  coverage within 31 days after discontinuance.
  147         (8) BENEFITS OFFERED.—
  148         (b) An insurer shall offer the benefits specified in s.
  149  627.668 and the benefits specified in s. 627.669 if those
  150  benefits were provided in the group plan.
  151         Section 3. Section 627.669, Florida Statutes, is repealed.
  152         Section 4. Report.—By January 1, 2016, the Office of
  153  Insurance Regulation shall prepare and submit a report to the
  154  Governor, the President of the Senate, and the Speaker of the
  155  House of Representatives on the following:
  156         (1) An estimate of the impact of this act on health
  157  insurance costs.
  158         (2) Actions taken by the office to ensure that health
  159  insurance plans are in compliance with this act and that quality
  160  and access to treatment for mental health conditions provided by
  161  the plans are not compromised by providing financial parity for
  162  such coverage.
  163         Section 5. Applicability.—The provisions of this act do
  164  not:
  165         (1) Limit the provision of specialized Medicaid-covered
  166  services for individuals with mental health or substance
  167  disorders.
  168         (2) Supersede the provisions of federal law, federal or
  169  state Medicaid policy, or the terms and conditions imposed on
  170  any Medicaid waiver granted to the state with respect to the
  171  provision of services to individuals with mental health or
  172  substance abuse disorders.
  173         (3) Affect any annual health insurance plan until its date
  174  of renewal or any health insurance plan governed by a collective
  175  bargaining agreement or employment contract until the expiration
  176  of that contract.
  177         Section 6. This act shall take effect January 1, 2014, and
  178  applies to policies and contracts issued or renewed on or after
  179  that date.